Coding Accuracy & Audit
NCCI/LCD checks, modifier validation, and charge audits to boost Clean Claim Rate and cut preventable denials—backed by sampling plans, coaching, and clear dashboards.
Why Coding Accuracy
- Reduce avoidable denials tied to coding, modifiers, and documentation gaps
- Apply payer- and specialty-specific rules (NCCI, LCD/NCD) consistently
- Close feedback loops between coding, providers, and billing teams
- Lift Clean Claim Rate and First Pass Yield while staying audit-ready
Who’s on the Team
- Professional & Facility Coders (multi-specialty)
- Coding Auditors & Educators
- Charge Integrity / CDM Review
- HIM & Documentation Improvement
- RCM Analysts (denial trends ↔ coding feedback)
How We Work
- Intake & Baseline: denial mix, top edits, documentation patterns
- Standards: payer rules (NCCI/LCD/NCD), specialty guidelines, modifiers
- Workflows: pre-bill checks, edit queues, charge audits, escalation paths
- QA & Education: sampling/AQL, coaching notes, provider feedback sessions
- Reporting: Clean Claim Rate, FPY, edit recurrence, appeal lift
Engagement & Controls
- Engagement options: pre-bill coding, retrospective audits, or both
- Sampling plans by specialty, volume, and risk class
- Evidence-linked findings with remediation tracking
- BAA + HIPAA-aligned controls and secure workspaces
See our Trust Center and Incident Response for HIPAA-aligned practices.
Provider Education Tips
- Share top 20 denial reasons and payer edits to focus early wins
- Publish a single source of truth for modifiers and documentation minima
- Schedule brief provider huddles to review recurring issues
- Track recurrence by code/modifier to prove drift reduction
Pathways
Many clinics begin with targeted audits, then extend to pre-bill coding and continuous education. Others combine coding accuracy with Denial Management and AR Follow-Up for end-to-end lift.
Fewer denials. Cleaner claims.
Share your top denial reasons and payer edits—we’ll design a coding audit plan with measurable targets.
