Outpatient Medical Coding
Codebusters Coding Teams are an on-demand, always on, coding solution for large hospital-based and freestanding outpatient surgery centers.
Accurate APC submittals are fundamental to meeting compliance requirements and achieving financial goals.
- Immediate access to hundreds of fully vetted outpatient surgery coders
- Maintain consistently low DNFB
- 100% accuracy guaranteed
- Continuous auditing and transparent reporting
- Proprietary workforce management platform
- Full department or specialty outsourcing
- Interim staffing and MSP Program support
- Reduce claim denials, increase CMI, improve AR
- Eliminate retention/recruiting struggles
Codebusters provides medical coding and auditing services for a wide variety of outpatient settings. Our professionals are experienced in facility-based outpatient, observation, and surgery coding, and clinic-based outpatient coding. Each coder or auditor with whom we work must show extensive experience coding in the client’s setting type and pass an exam specific to the client’s facility. Our in-house exams test candidates on real–case scenarios that ensure complete command of accurate ICD-10-CM and CPT coding.
Codebusters can assist providers in ensuring complete documentation, capturing correct information in the chargemaster, reviewing code assignment, and examining medical necessity compliance. Our coders provide documentation feedback, where appropriate, in order to assist the client with full revenue reimbursement.
Coding and billing for observation services are a common source of compliance concern, especially with the new CMS changes, the Medicare outpatient observation notification requirement, and the new changes in coding that occurred in 2016. Codebusters’ coders and auditors are fully trained in the ever-changing Observation Service requirements. Many facilities have lost millions of dollars in revenue due to out-dated coding of Observation status claims.
The professional and facility components of observation coding, each with their own set of guidelines, are paid based on a specific set of rules which changed dramatically in 2016.
Outpatient Surgery Coding
Codebusters’ coding experts ensure all CPT procedures are coded accurately and have a corresponding diagnosis that adheres to medically-necessary payer and provider guidelines. Our consultants accurately assign the appropriate modifiers that are essential to APC assignment and maximum reimbursement. The global surgical package rules, also called global surgery, includes all necessary services normally furnished by a surgeon before, during, and after a procedure so providers can be compliant within the complex compliance guidelines.