Legacy coding - a quality coding service

Coding Audits

Concurrent and retrospective coding audits have provided our clients the ability to pinpoint deficiencies affecting the revenue cycle, as well as minimize compliance risks. Our coding audits equip hospitals with an evaluation tool to use in concert with their compliance plans.

When reviewing for compliant coding, the objective is to ensure all coding was accurate and according to the documentation within the medical record at the time of coding, and that treatment was medically necessary according to Medicare’s policies and rules.  The coding review is designed to evaluate the documentation in the medical record and analyze coding completeness and accuracy to determine if the data quality and coding efforts are resulting in accurate clinical reporting and appropriate reimbursement.  It is also imperative that Present on Admission assignment is reviewed for appropriate documentation and accuracy.

External periodic review, either annually, semi-annually, quarterly, or as requested, of a random sample of cases should be undertaken to verify that correct codes have been assigned to all diagnoses and procedures and the correct DRG assignment was reached. The potential financial impact to the hospital is vital and is also demonstrated during the audit process.

What if your hospital would like a DRG-specific audit performed?  Many hospitals are sensitive to OIG and RAC targets. Legacy Coding can verify the proper DRG assignment and educate the coding staff in a concurrent and/or retrospective mode.

With all coding audits, educational conferences are conducted for CE credit hours.