Inpatient/Outpatient Coding and Documentation Reviews

The primary objective for coding and documentation reviews is to assess Client's inpatient coding and/or outpatient coding for strict compliance with criteria set forth by CMS rules and regulations for all codes and American Hospital Association's Coding Clinic for ICD-9-CM, and CPT Assistant. 

The scope of the engagement includes on-site review and technical expertise. Our consultant specialists will validate records and corresponding billing claims for:

• Coding assignments (ICD-9-CM, CPT, and HCPCS) 
• Diagnosis supports services performed 
• Validation of procedure charging 
• Review documentation for quality 
• Medical necessity 
• Physician orders and certifications/re-certifications 
• Physician signatures 
• Nurse's notes

Value Added Benefits for this Service: 

• Ensure coding and billing compliance 
• Enhanced coding techniques 
• More knowledgeable staff 
• Quantifiable results