Coding Accuracy and MS-DRG Focused Audit

  • Quality Review of inpatient medical records following government and coding guidelines.
  • OIG focused MS-DRGs reviewed.
  • Evaluation in coding accuracy in conjunction with medical record documentation.
  • Review for physician documentation deficiencies, correct code and MS-DRG assignment.
  • Identify cases where increase or decrease adjustments are necessary.   

    Educate Coders & Physicians on Audit Findings.

Ambulatory Surgery Audits
Review and analyze:

  • Coding accuracy and proper assignment of ICD-9-CM diagnosis codes.
  • Proper application of CPT coding guidelines and principles.
  • Proper assignment of CPT and HCPCS Level II modifiers.
  • UB-04 billing forms for accuracy in representing the services provided in conjunction with the medical record documentation.

Ensure Coders Understanding of Correct Coding Iniative Edits.

Physician Outpatient Billing Review
Review for appropriate:

  • Assignment of diagnosis codes.
  • Assignment of E/M codes.
  • Documentation in the medical record to support code assignment.

Quality Monitoring & Auditing Service
Our consultants can audit and monitor your coding and documentation quality on a monthly or weekly continuous basis

  • We will provide continuous education and training for all coders.
  • Assist in the implementation or revision of a documentation enhancement program.
  • Continuously monitor documentation and coding quality.
  • Monitors are customized per facility's needs and desired outcomes.
  • Enforce coding guidelines.
  • Improve documentation quality.
  • Submit statistics to administration.
  • Implement and monitor coding, discharge summary reconciliation, and prospective
    review process.
  • MS-DRG versus paid MS-DRG report monitoring.
  • Educate and train coders on how to educate physicians.
  • Assist in physician education.
  • Educate and train new coders.
    .
 
Documentation Solutions, LLC ::: PO Box 634, Dearborn Heights, MI  48127-0634 ::: 800-419-6847