Coding And Compliance Audit

Coding And Compliance Audit

What can you expect from your coding and compliance audit?

Our team conducts a review of your coding, billing and documentation procedures in a manner that closely simulates an actual carrier audit. Our team will compare your coding and documentation to CMS and National Guidelines and perform a full assessment of the medical necessity of the encounters. We help you every step of the way, from determining the sample size selection, providing a concise report of findings and providing customized education for providers and staff.

Your detailed coding and documentation report covers:

  • an analysis of your Evaluation and Management (E/M) coding accuracy, documentation, accuracy of procedural coding, accuracy of modifier assignment, bundling as well as potential issues with your Electronic Medical Records (EHR) such as faulty templates.
  • ICD-10 reporting from a Risk Adjustment Coding (Hierarchical Category Coding – HCC) perspective for those who participate in Risk Adjustment Cost Sharing to ensure all risk adjusted coding opportunities are being captured as well as educate on documentation which falls short of fully supporting diagnosis codes as reported,
  • recommendations to correct the issues as well as training suggestions and programs (optional) to help mitigate future risk.

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