In order to get your claims paid on time, our team of proficient licensed medical coders from AAPC and AHIMA works quickly on your medical data and precisely codes to the utmost specificity.
Medical coding is the process of transforming healthcare diagnoses, practices, services, and equipment into internationally recognized medical alphanumeric codes.
Medical records are created each time a patient sees a doctor, physician, or other healthcare professional.
The documentation for these medical records could be anything from a transcription of a doctor's notes to lab and radiological reports.
Professionals with training in medical coding and billing subsequently convert the medical records into global alphanumeric codes. The insurance payers who will make the payment receive the converted codes next. then, with the
Our team of medical coding experts ensures that our clients are properly maximizing their revenue in a compliant and accurate manner by staying up to date on the latest industry changes, including ICD10- CM, ICD-10-PCS, CPT, and HCPCS. Our AAPC and AHIMA certified coders are also up to date on all other relevant industry changes.
You may anticipate complete, effective, and end-to-end risk adjustment coding services that will have a favorable influence on your healthcare organization by utilizing our meticulous processes that are based on the highest standards.
A. E&M codes, a coding scheme that involves the use of CPT codes ranging from 99202 to 99499 to reflect services rendered by a physician or other certified healthcare practitioner.
B. These CPT codes for evaluation and management are used when the practitioner is involved in either evaluating or managing the patient's health.
C. Specialty care consultants, emergency room physicians, and general care physicians frequently use these E&M CPT codes.
D. E&M codes include, for example, office visits, hospital visits, home services, and preventive medicine services.
E. Evaluation and management services should not include codes for operations such as surgeries, radiography and diagnostic tests, and certain treatment regimens.
— Anesthesia is a state of temporary induced (Drug/Gas) loss of sensation or awareness. The CPT code range from 00100 – 01999 plus “Anesthesia modifier”.
— An Anesthesiologist, Anesthesia assistant or qualified non-physician anesthetist can provide Anesthesia service.
Types of Anesthesia:
— General
— Regional and
— Local
(General anesthesia suppresses the CNS, Regional and local anesthesia block transmission of nerve impulses).
A surgical coder assigns medical codes for general surgery procedures for medical records and billing purposes. Usually, employers refer to a professional in this coding specialty as a Certified General Surgery Coder.
Radiology is a medical specialty that uses medical imaging to diagnose & treat diseases.
A radiologist uses techniques such as X-ray, Computed Tomography (CT), CT Angiography (CTA),
Magnetic Resonance Imaging (MRI), MR Angiography (MRA), Ultrasound, Nuclear Medicine, and Positron Emission Tomography (PET).
Components of Radiology Coding
1. Plain Radiography (X-Ray)
2. Fluoroscopy
3. Computed Tomography (CT)
4. Ultrasound
5. Magnetic Resonance Imaging (MRI)
6. Nuclear Medicine (NM)
coding is a risk-adjustment model originally designed to estimate future health care costs for patients. The Centers for Medicare & Medicaid Services (CMS) HCC model was initiated in 2004 and is becoming increasingly prevalent as the environment shifts to value-based payment models. HCC coding relies on ICD-10-CM coding to assign risk scores to patients. Each HCC is mapped to an ICD-10-CM code. Along with demographic factors such as age and gender, insurance companies use HCC coding to assign patients a risk adjustment factor (RAF) score. Using algorithms, insurance companies can use a patient’s RAF score to predict costs. For example, a patient with few serious health conditions could be expected to have average medical costs for a given time. However, a patient with multiple chronic conditions would be expected to have higher health care utilization and costs
A. Claim denials are amongst the topmost sources of revenue loss that have a direct impact on the cash flow of healthcare organizations.
B. Denied claims alone have costed Hospitals across the U.S, a staggering $262 billion a year—leading to major financial losses and increased recovery costs.
C. Consider that an average claim denial rate is at 9%—leaving about $5 million of money on the table.
D. Though there are multiple factors causing claim denials, coding errors are amongst the primary reasons for denials. However, the good news is that 90% of denials are preventable.
E. With a strategic approach and a streamlined denial management process, Hospitals and medical practices can manage as well as prevent future denials.
