MEDICAL CODING

MEDICAL CODING

Certified coder for coding
The challenge is that there are thousands of conditions, diseases, injuries, and causes of death, and there are also thousands of services performed by providers and an equal number of injectable drugs and supplies to be tracked. These are categorized using medical coding to make reporting and monitoring simpler. In the field of healthcare, every disease, process, and tool has its own set of names, acronyms, descriptors, and eponyms. All of these components are presented in an alpha-numeric style through medical coding, which standardizes their language and makes it easier to manage, understand, and alter.
The main task of a Medical Coder is to review the patient’s medical record (i.e., the transcription of the doctor’s notes, ordered laboratory tests, requested imaging studies, and other sources) to verify the work that was done by applying standard coding guidelines and assign codes using CPT, ICD-10-CM, HCPCS Level II classification systems and modifiers. It’s very important to assign the correct set of codes and modifier combinations to patient’s medical records before a claim is sent over to the insurance for processing since these records are used not just to establish medical necessity to the insurance for services but also to ensure correct reimbursement for a medical practitioner’s time and efforts involved in delivering a level of care and services to the patient on the day of the visit. Complying with the best standard practices would mean improved regulatory compliance with fewer or no denial for the practice, resulting in faster payments with reduced costs and increased revenue.

ICD-10-CM (International Classification of Diseases, 10th Edition, Clinically Modified)

The more than 69,000-code set is made up of codes for conditions and disease, poisons, neoplasm, injuries, causes of injuries, and activities being performed when the injuries were incurred. Codes are "smart codes" that contain up to seven alphanumeric characters and are used to expressly state the complaint of the patient.

CPT (Current Procedure Terminology)

The American Medical Association owns and maintains this code collection, which consists of over 8,000 five-character alphanumeric codes that describe the services that doctors, paraprofessionals, therapists, and other professionals deliver to patients. The CPT method is used to report the majority of outpatient services. It is also used by doctors to report services rendered in inpatient hospitals.
Health Care Procedural Coding System, Level II, or HCPCS Level II
The 7,000+ alphanumeric codes that make up HCPCS Level II were initially created for use by Medicare, Medicaid, Blue Cross/Blue Shield, and other providers to report procedures and bill for supplies. However, they are now used for many other purposes, including quality measure tracking, outpatient surgery billing, and academic studies.

Modifiers

Hundreds of alphanumeric two-character modifier codes are used in CPT and HCPCS Level II codes to provide clarification. They could include information on the patient's condition, the area of the body being treated, a payment request, an event that altered the service the code refers to, or a component of quality

RCM Billing Services Coding Team

We have a dedicated specialist coder available to take care of all your coding needs as they have years of experience to their credit and working exposure on multispecialty projects means they are the best in the industry when it comes to tackling any situation that may arise during reading a chart or reviewing other medical tests or records to ensure correct codes are selected. Our robust internal coding training system ensures that our coders are well trained and tested on their knowledge of anatomy, physiology, medical procedures, and payer rules and policies before they go live on any project and once they are into an active role they are further made are aware of the quarterly and yearly updates that we get from the responsible authorities/associations related to CPT, HCPCS and ICD-10 CM codes so that they stay updated to the most recent and relevant changes that have taken place in the coding world.

All our coders and auditors are certified from AAPC (American Academy of Professional Coders) or AHIMA (American Health Information Management Association) and have access to not only the latest ICD-10-CM, CPT, and HCPCS Level II coding books, but also to the updated version of Optum360 encoder pro software, that has the details of all the codes and coding guidelines along with the access to the latest version of the NCCI edits.

Reasons to trust RCM Billing Services for your coding needs:

  • All our coders and auditors are certified from AAPC (American Academy of Professional Coders) or AHIMA (American Health Information Management Association)
  • They have access to the latest ICD-10-CM, CPT, and HCPCS Level II coding books, updated version of Optum360 encoder pro software and the latest version of the NCCI edits.
  • We have a coder available for your speciality needs.
  • More than 70% of the coders have multispecialty experience.
  • A strong internal coding training mechanism to educate and increase awareness about regular quarterly and annual updates in the coding guidelines.
  • Regular internal training programs run to educate and test on knowledge and to share quarterly and yearly updates related to coding changes and payer rules and policies.
  • 98% quality SLA with 24 hours TAT.
  • Quality work with reduced costs