Physician Coding Services

AdvantEdge Coding Solutions 

  • Augmenting coding staff
  • Comprehensive coding workflow analysis and implementation
  • Coding audits
  • Compliance training
  • Coding Education

Coding is one of the most important functions of the billing process. Coding professionals have to understand, in great detail, complex regulatory requirements and the clinical work being performed. AdvantEdge has experienced and certified coders with the skills to perform this work at a high level of proficiency every day. Our “standards of ethical coding” highlight the “decision-making” dimensions of coding and outline the company’s expectations for making ethical decisions. All coding work is audited by quality assurance experts to ensure the highest accuracy.

 

AdvantEdge Coders

  • Use skills and knowledge of coding and classification systems and official resources to select the appropriate diagnostic, procedural, and supply codes, including applicable modifiers, and other codes (including substances, equipment, supplies, or other items used).
  • Apply accurate, complete and consistent coding logic and workflow to produce highly accurate coding outputs.
  •  Assign and report only the codes that are clearly and consistently supported by the provider’s documentation. This documentation is usually the chart or report but also includes all forms, records and other electronic and printed records and/or scanned images of clinical procedures.
  • Adhere to ICD coding conventions and official coding guidelines approved by the Cooperating Parties (the American Health Information Management Association, American Hospital Association, Centers for Medicare and Medicaid Services, and National Center for Health Statistics).
  • Follow CPT rules established by the American Medical Association, and any other coding rules and guidelines established for use with mandated standard code sets. AdvantEdge coders are all currently preparing for ICD-10 implementation in October of 2014.
  • Seek clarification and proper documentation from the provider prior to assigning codes when documentation is conflicting, incomplete or ambiguous.
  • Work with AdvantEdge Client Managers to assist and educate physicians and other clinicians in proper documentation practices when needed to more accurately reflect the acuity, severity, and the occurrence of events.
  • Protect the confidentiality of health information at all times and refuse to access it if not required for coding related activities.
  • Are credentialed through AHIMA or AAPC and follow all procedures to maintain these credentials.
  • Maintain and continually enhance their coding competency through participation in educational programs, reading official coding publications, and attending other continuing educational programs to stay abreast of changes in codes, coding guidelines and regulatory and other requirements.

 

Medical Coding (a definition)

Medical coding is the transformation of narrative descriptions of diseases, injuries, and healthcare procedures into numeric or alphanumeric designations (that is, codes). Codes are highly detailed in order to accurately describe the diagnoses (what is wrong with the patient) and the procedures performed to test or treat these diagnoses. The former are referred to as diagnosis codes (ICD-9 which will be replaced by ICD-10 in 2014) and the latter as CPT® codes.

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