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Coding and Compliance Audit Review

Accurate Coding is Essential

Coding inaccuracy results in the loss of legitimate revenue due to coding errors and omissions. It can also create serious compliance exposure for the hospital. With the proliferation of RAC audits and the increased oversight from CMS, it is more important than ever for hospitals to maintain coding accuracy.

Hospital coders typically work within tight production deadlines often preventing them from thoroughly reviewing the supporting documentation. Even highly trained coding professionals can make errors when working in this environment.

M. Leco & Associates provides a quality control audit that validates the accuracy of your coding and assesses your compliance exposure.

Our credentialed RN coders will carefully review a statistically significant coding sample for accuracy. Their clinical expertise allows them to delve into the medical documentation to fully verify the legitimacy of each code and assess your compliance exposure. They will evaluate each account for correct coding based on the third party (governmental and commercial) payor guidelines and rules.
 
 


Outpatient accounts will be evaluated for correct ICD-9 diagnosis codes, CPT and HCPCS codes. Inpatient claims will be reviewed for correct ICD-9 diagnosis and procedure codes and DRG grouping. All accounts can also be reviewed to identify any revenue enhancement opportunities for the hospital.

Target Departments With High Error Rates

Our 25 years of experience has shown that certain departments, e.g., Interventional Radiology and the Cardiac Cath Lab, exhibit higher than average incidences of error due to the complexity of the procedures. Whether you are looking for a comprehensive review or want to target specific departments, we have the solution to meet your needs.

Comprehensive Reporting

After we complete the audit, you will receive a written report fully describing all coding discrepancies along with recommendations to improve the accuracy of your coding.

Going Beyond The Audit

M. Leco & Associates offers revenue recovery and charge process improvement services. All of our services address compliance, improve charge capture and improve billing accuracy. Most of our services are performance based, eliminating out of pocket cost and risk to the hospital.

  
 
 


Leco’s Compliance
Audit Team
Makes the Difference

Clinically-Experienced
Registered Nurse Coders

Average 15 years
auditing experience

Extensive experience with
commercial and governmental
regulations and
payer guidelines