Medical Coding Audits

The Office of the Inspector General is increasing its audit surveillance. With this in mind, every facility should be auditing its coding at least once per year. In the event of employee turnover, rapid facility growth, or in the event a problem has been previously uncovered, a more frequent auditing program is recommended. mdStrategies can develop a statistically valid audit program that will allow you to assess the accuracy of your current coding solution and allow you to target any areas in need of improvement.

mdStrategies has can develop a customized coding audit packages to assist your facility in identifying any areas needing improvement. You will receive a coding audit report with an explanation of findings and recommendations. Each report can include an analysis detailing the appropriate use of:

• ICD-9-CM diagnosis and procedural codes
• CPT-4 and Category III codes
• HCPCS Level II codes
• Revenue codes
• Modifiers
• Pathology note findings
• Implant codes
• National Correct Coding Initiative (NCCI Edits)
• Local Medical Review Policies

A comparison of codes selected versus correct coding assignment is completed. Detailed information and supporting documentation is provided to assist in understanding the correct coding guidelines.

Reimbursement Audits

mdStrategies is also available to perform reimbursements audits to determine if the amount of reimbursement received is in accordance with the procedures billed. Frequently, incorrect billing is a major source increased days an account spends in accounts receivable. Let one of our reimbursement specialists review your reimbursement system to ensure proper and efficient techniques are being followed.