Review, analyze and code diagnostic and procedural information that determines Medicare, Medicaid and private insurance payments. To accurately apply the International Classification of Diseases Manual - Clinical Modification (ICD-9-CM & ICD-10-CM), and the American Medical Association’s Current Procedural Terminology manual (CPT) coding methodology for reimbursement. The coding function is a primary source for data and information used in health care today, and promotes provider/patient continuity, accurate database information, and the ability to optimize reimbursement. It also ensures compliance with established coding guidelines, third party reimbursement policies, regulations and accreditations guidelines.
1. Abstracts all necessary information from EMR and assigns codes (ICD-9, CPT & HCPCS), which most accurately describe each documented diagnosis, surgical procedure and special therapy or procedure according to established guidelines
2. Assures the final diagnoses and operative procedures as stated by the physician or other health care providers are valid and complete.
3. Abstracts all necessary information from health records to identify secondary complications and co-morbid conditions.
4. Queries the provider for additional information or clarification of documentation when necessary.