PPS has reviewed coding assignments for the professional component for 25 years.
A core service for Prospective Payment Specialists is to validate the clinical documentation by a physician providing inpatient, outpatient, rehabilitation services or clinical care including intensive physical therapy and occupational therapy services.
These reviews include determining if a separately identifiable Evaluation and Management Service is documented and determining the extent of the history obtained, the examination performed and the complexity of the medical decision-making.
CONDUCTING REVIEWS OFF-SITE OR ON-SITE.
On-site or off-site, PPS’ staff of credentialed coders, including CPCs, will review documentation and related coding for a sample of patient encounters on a pre-bill basis. The sample size can be mutually determined by Prospective Payment Specialists and the facility. PPS will ensure that the documentation is appropriate for time-based services and that the correct CPT code is selected. CPT codes for therapy modalities will be reviewed to ensure that the codes match the documentation present in the medical record.
Following the initial on-site review, education will be provided to both the physicians and the coding staff. PPS routinely enlists our staff of physicians to provide education for our clients’ doctors. We have been validating physician coding and documentation for 25 years, and you will find that our education provides excellent results while often establishing better physician relations at your facility.
PPS offers Continuing Education Units (CEUs) through AHIMA as a part of the Education Portion of our Coding Validation Service.
OUR CONSULTANTS MAKE THE DIFFERENCE.
PPS’ specialists include physicians as well as credentialed coders, with a minimum of 10 years of experience. We are proud to have a domestic, dedicated staff of employees who possess RHIA, RHIT, CCS, CPC, CCDS and other credentials.