Medical Coding Services
Inpatient Coding Reviews – Our coding specialists will validate the ICD-9-CM/ICD-10-CM code sequencing of the principal diagnosis and the secondary diagnoses and procedures for the assignment of the MS-DRG. A thorough review of the medical record documentation against the hospital final billed claim will confirm reporting accuracy. This review also addresses validating the coder assigned present on admission (POA) indicators and discharge status (disposition).
Outpatient Coding Reviews – Our coding specialists will validate the CPT©/HCPCS and ICD-9-CM/ICD-10-CM diagnosis coding assignment for outpatient services. The medical record documentation is reviewed against the hospital final billed claim to confirm reporting accuracy. The review will include an assessment of documentation quality for supporting medical necessity. Supporting medical record documentation including the physician order, physician progress notes, results for diagnostic tests/studies, and/or procedural documentation is reviewed for completeness.
Contract Coding Services – Our coding specialists are qualified to assist our clients in quickly and efficiently reducing coding backlogs, providing back-up support during staffing shortages, and performing on-going coding support services. Our specialists are experienced in the use of TruCode, Meditech, VISTA, 3M, McKesson, Cerner, and CHCS/CHCSII. All coding services will be performed by AHIMA and/or AAPC credentialed coding professionals. Our coding expertise includes the following: Inpatient/MS-DRG, Outpatient Surgery, Physician E/M, Emergency Department E/M, Interventional Radiology, Ambulatory Surgery, GI/Endoscopy.
Objective: To provide a helpline resource for the provider community to address coding and billing questions that may arise during day-to-day operations. HMI will answer questions using the most current coding guidelines and published CMS billing guidance.
Resource: our consultant specialists will be available to answer questions via an e-mail service related, but not limited to the following:
● CPT©/HCPCS/UB revenue codes
● Modifier application
● OPPS billing
● CCI /MUE / Device and Procedure Edits
● Medical necessity
● Physician E/M billing
The current guidance utilized by HMI to respond to questions will be communicated via e-mail. This allows the individual to have access to these resources for future reference on related issues. Additionally, HMI will address within our e-newsletter, Coding and Billing for Prospective Payment Systems, common coding and billing questions that are submitted through the helpline.
Warranty: Every effort will be made to respond to questions within a to 72 hour period and ensure the accuracy of the helpline responses. HMI’s helpline responses will be supported by the most current CMS guidelines available. HMI’s interpretation of the CMS guidelines may not always agree with the Client’s local MAC/FI. When HMI has direct access to the MAC/FI Part A or Part B guidelines, we will provide the most straightforward response available.
It is the client’s sole discretion to apply current guidelines to its coding and billing practices based on the information provided.