Emergency Department Coding Review

Healthcare Coding and Consulting Services (HCCS) provides Emergency Department coding services to client hospitals designed to produce an accurately coded chart, from any payer, free of any potential violations, coded in a timely manner. Our coding is also designed to ensure that all legitimate revenue is being received from all payers for each chart. Prior to entering into an agreement for coding services HCCS offers client facilities an ED coding review service which is designed to provide valuable information on the quality of the documentation in your ED charts, the coding of the charts and the resultant billing. This study will provide the basis for a strategy that can put lost and unrealized revenues back into the hands of your institution. The cost of this coding review is nominal, designed to cover expenses, and will normally pay for itself within a matter of days based on the information you will receive.

The scope of the audit includes:

• Verification of ED Level of Service assigned for facility services
• Verification of ED Level of Service assigned for physician services, if applicable
• Verification and identification of all procedures performed and reportable by ED facility and/or physician staff
• Verification of diagnosis coding to the highest level of specificity
• Verification of assignment of principal diagnosis
• Verification of coding for medical necessity

Based on the audit results, information is presented to provide:

• Average level of service as coded by your facility, both facility and professional
• Average level of service as coded by HCCS, both facility and professional
• Average charge per patient as billed by your facility
• Average charge per patient if HCCS had coded the ED charts
• Analysis of documentation practices
• Analysis of coding, both ICD-9 and CPT-4
• Comprehensive comparative analysis of facility and professional charges
• Financial analysis of facility coding compared to HCCS Coding
• Analysis of facility billing practices, including price structure