Certified Coding and Audits...


Coding for Accuracy

We have established ourselves as one of the leading educators of current and upcoming coding requirements in our arena. We continue to push the boundaries developing exciting and innovative ways to educate medical staff on proper coding techniques. 

Coding and reimbursement can be a puzzle.  Not having up-to-date information can make the reimbursement puzzle break to pieces.  A properly educated staff will decrease incorrect coding and help protect you in audit situations.  It will also help you get paid the first time a claim is submitted.

Get up to date information on ICD-9 and CPT-4 codes and what impact proper coding can make on your reimbursement.  Emphasis will be placed on usage and proper documentation of E/M codes, modifiers, medical necessity, incident to billing and the use of ABN and NEMB.  Proper coding of diagnoses and symptoms and the importance of coding to the highest specificity will also be discussed as well as the consequences of improper coding.

Are You Missing Pieces of Your Reimbursement Puzzle?  Code 99211 does not require the presence of a physician.  This can be used to bill for services provided by your nursing staff.  Know the requirements to utilize this code.  We will also discuss other services that will or will not be reimbursed as well as services that can and cannot be billed at the same visit.  Review of denials from third party payers is a necessity.  Know the six steps for an effective appeals process.

Documentation is the key to proper reimbursement.  If the information was not documented, it never happened.  Know what your documentation needs to support the level of care provided.

Develop a billing and coding compliance plan that will effectively monitor the coding and reimbursement of your office.  Auditing is an important element of any compliance plan.  Know the different types of audits and the elements of an effective audit.