Validation and the coding for DRG and Outpatient cases have been primary services for PPS for over 25 years.
OUR AUDITORS MAKE THE DIFFERENCE.
We are proud to have a domestic, dedicated staff of employees who possess RHIA, RHIT, CCS, CPC, CCDS and other credentials. Our Validation staff and Clinical Documentation Specialist staff have at least 10 years of hospital experience before joining PPS and are focused exclusively on coding validation and education. All of our PPS auditors and coders have official ICD-10 CM and PCS training and/or are AHIMA ICD-10 Certified Trainers.
FEEL CONFIDENT ABOUT OUR ACCURACY.
Our staff maintains a 98% accuracy level in the coding performed while adhering to high productivity levels. Please contact us to inquire about our productivity standards. All PPS staff members are peer reviewed regularly.
A PPS Pre-Billing Coding Validation Service can ensure billing compliance for your facility’s billing. When providing coding validation we will review all codes that are assigned, not just those that would change the DRG.
Coding validation can be done post billing and pre-billing, on-site or off-site. All pre-billing reviews are done within an 8 hour turn-around time. Plus, PPS has the flexibility to modify these services based upon your direction and needs.
- Examination of DRG, APC, Outpatient Surgery, Wound Care and other cases and corresponding bills for compliant and accurate coding, documentation and billing, after coding, but prior to billing
- Personnel are all domestic HIM professionals: RHIAs, RHITs and CCS with a minimum of ten years coding experience prior to joining the PPS team
- Pre-billing Reviews are submitted back to the client usually within 8 hours; 24 hours by contract
- Accurate billing and documentation for APC assignment
- Correct modifier usage and education
- Correct E/D billing
- Specialized expertise in wound care coding
- Correct Observation billing
- Years of E&M coding experience
- Full range of education with experience teaching Doctors, Coders and Billing Staff
- Validation of Medical Necessity coding and documentation
Education can be provided one-on-one and/or seminar style to your coding or physician staff.
- Physician education, as requested, by our staff of physicians to improve compliant documentation
- Service can be on-site or off-site
- Education can be webinar, one-on-one or on-site
- We have extensive experience with most EMR systems
- Our validation approach reviews all codes assigned, not just those that would change the DRG
- Reporting by case and providing statistical analysis
- CEUs are provided with education
- Inpatient- Including APR-DRG’s
- Emergency Department
- Physician Practice
- Ancillary Departments
- Same Day Surgery APR-DRG’s
Other medical records for appropriate assignment of the diagnoses and procedure codes. Plus, PPS reviews all codes assigned, not just those that would change a DRG.
- ICD-10 Validation
- OIG Work Plan
- ICD-9 coding for heart murmurs
- APR-DRGs: SOI and ROM
- Interventional radiology coding
- PCS Coding
- Coding guidelines for pathology reports
- Coding for observation services
- Information on medical coding auditing tools
- Medical coding audit worksheets
- Anesthesia coding and billing audit
- Residents and observation coding
- Coding for teaching physicians
- Cardiac catheterization coding or auditing for compliance
- Diabetes mellitus and inpatient coding with MS-DRGs