We have experience with coding for virtually all specialties. We have focused recently on the following because of demand but have the capacity and experience to help most specialties.
- Emergency Physician Coding – Hospital or Freestanding
- Urgent Care Coding
- Free Standing Facility Coding
- Hospitalist Coding
- Primary Care Offices
We offer auditing of all specialties’ coding to see if in compliance and getting maximum reimbursement. We also perform internal audits for our existing clients to ensure that we are providing our service with maximum effectiveness.
Why use AccuCode?
Medical practices that do their own coding and billing are losing about $10,000 a year on average from downcoding, incorrect codes, denials and other issues according to available data.
AccuCode will ensure that these coding errors do not occur with quarterly audits. We will share audit results with our clients and enact education and policies to correct any errors going forward.
AccuCode is dedicated to reporting and documenting diagnoses, services, and procedures to the optimal level demonstrated by provider documentation and medical necessity.
AccuCode will recover the money missed by downcoding and avoid the risk associated with upcoding so our clients can rest assured that they are optimizing their reimbursement. Declining reimbursement is one of the largest challenges medical providers face today.
Why is accurate coding so important?
Upcoding or downcoding can subject you to administrative, civil, or criminal liability.
Upcoding involves reporting a higher-level service or procedure or a more complex diagnosis, than is supported by medical necessity, medical facts, or the provider’s documentation.
Downcoding occurs because the provider fails to provide relevant documentation details to assign a service, procedure, or diagnosis to the optimal level of specificity.
Some providers downcode as a defensive strategy to avoid denial of claims or audits even though higher codes are justified based on the documentation that is provided. Downcoding can lead to charges of Medicare noncompliance. Downcoding will leave a significant amount of money on the table. For example, data shows that in 2008 medical practices lost up to $236 million because of downcoding.
Studies have found that approximately one third of medical visits were downcoded according to written documentation and approximately half downcoded based on documentation of medical decision making.
How do you avoid upcoding or downcoding?
Periodic audits of your coding, billing, and documentation practices are one of the best ways to detect and eliminate upcoding and downcoding. These audits can ensure that documentation guidelines are met and that services, procedures, and diagnoses are supported at the level they are billed. Medical documentation should be unambiguous to the auditor.