Medical Coding Services

Coding Disciplines We Cover

Coders are assigned by specialty rather than rotated through a generic queue, which preserves contextual judgement on documentation patterns, common modifiers and payer policy edge cases for each practice we support.

• Professional fee (Pro-Fee) coding for office, inpatient and outpatient encounters
• Facility coding including outpatient surgical and emergency department
• Evaluation and Management (E/M) leveling under 2021 and 2023 AMA guidelines
• Surgical coding with NCCI edit and modifier 25, 59, 24, 78 and 79 application
• HCC and risk adjustment coding for Medicare Advantage and ACO arrangements
• Specialty coding for cardiology, orthopedics, OB/GYN, behavioral health, radiology, pain management and more

Quality Assurance and Audit Defensibility

Every coder works under a documented QA structure. New accounts and new coders are placed at 100% pre-bill audit until target accuracy is reached, then transitioned to sampled audit with monthly accuracy reporting back to the practice. Documentation queries are routed to providers through agreed channels rather than guessed in chart.

• Dual-level pre-bill QA on a defined sample rate
• Provider documentation feedback with measurable query response tracking
• Quarterly coder education on CMS updates, AMA changes and payer policy bulletins
• Audit-ready coding rationale captured against each encounter

Compliance Posture

Coding decisions are aligned to CMS guidance, Official Coding Guidelines, NCCI edits and payer-specific medical necessity policy. Our compliance program treats coding as a documented, defensible activity — not an interpretive one — to protect providers from takebacks and external audit exposure.