Coding

Studies show that internal coding audit/reviews do not ensure that all legitimate patient revenue is realized in an OIG compliant manner. To remain compliant and optimize patient revenue, third-party coding audits must be an integral part of your practice’s coding and reimbursement process.

PCS works with physicians and healthcare staff to develop and implement improved mechanism for collecting information critical to patient care, coding, reimbursement and compliance. We can provide and assist to implement ICD-9-CM and CPT/HCPCS specific documentation tools.

This analysis is designed to identify specific areas of compliance related issues. It examines the coding patterns of your practice, which enables you to bill for and collect all legitimate patient revenue while maintaining OIG compliance. This service notes codes that are not being utilized, as well as, the method of how codes are documented via an office superbill/encounter form, hospital/nursing home charge ticket or procedure charge ticket. The process not only looks to enhance coding opportunities, but trains physicians and health care staff on appropriate coding methodology.

Features include:

ØUpdating of procedures, ICD-9-CM and CPT/HCPCS
            coding

ØEvaluating areas in need of improvements and educational
            training

ØEvaluating the medical record documentation

ØIdentifying lost revenue and risk revenue resulting from
           discrepancies

Benefits include:

ØAbility to monitor compliance with applicable regulations
            and coding guidelines

ØReduce risk concerning OIG priority issues

ØAbility to identify concerns by your practice

ØImproved accuracy and productivity

ØImproved revenue and reduced debt

ØExperts in the health care and coding industry perform all
            services

Return on Investment:

ØImproved reimbursement through appropriate coding

ØIncreased revenue by reducing rejected claims and ensuring
           Medicare and OIG compliance.

ØReceive data for analysis of coding and billing efforts and
            customized training programs.