Is your agency accurately billing for all of the services your clinicians are providing your patients? Many agencies are not aware of the cumulative monetary losses due to inadequate documentation and inaccurate coding practices. Failure to comply with proper sequencing can make your agency susceptible to audits. Compliance inaccuracies can leave your agency exposed to potentially threatening coding audits.
We perform a comprehensive review of your current coding quality that will bring to light any inconsistencies in your coding practices. Through our review of your documentation and coding practices, we help agencies identify how coding errors are impacting their bottom line.
- Missing Documentation
- PDGM and RCD Risk
- Inaccurate Coding
- Non-Compliant Billing
- Unrealized Reimbursement
- Audit Risk
How it Works
Contact us to receive your Getting Started with Your Coding Review packet and we’ll provide you with everything you need to begin the process of seeing how accurate coding can improve your bottom line and reduce your audit risk.
Provide us with a sample of your most complex records including the completed coding recommendations made by your coders through our secure HIPAA compliant web portal.
Each record will be reviewed referencing all available documentation provided to your coders at the time of its original coding. The requested documentation provided includes:
- The referral/intake form
- Initial physician orders
- Medication profile
- Supplemental therapy evaluations
- The OASIS integrated assessment tool
- The HIPPS/HHRG scores
The records submitted will be reviewed in keeping with ICD-10-CM Coding Conventions and CMS Coding Guidelines with the ultimate resource being The Coding Clinic, the Official Reference Source per CMS for ICD-10-CM Coding. Select Data will review the following for accuracy:
- Selection of the Primary Diagnosis in M1020
- Utilization of Secondary Diagnoses, including all Pertinent Co-Morbidities
- Identification Case Mix Diagnosis in M1024
- Specificity in Code Selection
- Incorrect Codes Assigned
- Conditions Resolved or Not Relevant to Home Care
- Supportive Documentation
- Identified risk for Potential Upcoding or Downcoding
Our Review Report will include the Coding Analysis and Overview, detailing Error Types, Total Errors, Percentage of Coding Errors, Results by Error Type and Results by Record. The comments and trends noted will be discussed with Risk Assessments, including our finding of your agency’s Coding Accuracy Rates. Our findings will be presented to you in writing, supported by a conference call moderated by Select Data and attended by your agency team members. A detailed overview of our findings will be presented with our recommendations for addressing areas of concern.
Select Data compliance procedures limit who may conduct a coding review. Your review will be conducted by a credentialed Coding Quality Analyst. Clinical QA will review the process, collate, and quantify the data and prepare the final presentation.