AAPC-Certified Coders Ensure Payer Compliance.
We have AAPC-Certified Coders to review and audit medical records, to ensure payer compliance and that your providers are making the most of patient office visits. This in turn helps you gain the correct revenue per patient while also learning how to improve records management and coding initiatives for the future. ICD-10 codes are a departure from older diagnostic coding systems. One billing practice that raises red flags for insurers is using the same code repeatedly for multiple patients. The truth is, limiting yourself to a single code presents problems for both insurer and patient.

Reasons why use ICD-10 codes

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Physicians aren’t Islands

Keep in mind that individual physicians aren’t islands unto themselves. You are one link in a chain of providers who serve any given patient. The codes you choose will help other healthcare professionals glean insights and draw conclusions about the next steps they should take. There are even “cause codes” that explain how and where an injury occurred. An inaccurate or non-specific code can cause misdiagnosis and implementation of inaccurate therapies. Using the correct codes open dialogue between the initial physician and specialists.

Upcoding

Whether done intentionally or by mistake, upcoding happens when codes are switched out for more expensive medical procedures. This is a very common coding error. It is also illegal. Make sure your practice isn’t adding in or exchanging codes to boost revenues falsely.

Undercoding

Unlike upcoding, undercoding happens when a medical practice leaves out or switches codes for less expensive procedures. To keep this from happening, make sure your communication lines are clear and your billing staff is on the right page.
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Portraits

New ICD-10 codes are so specific that they need to be used together to paint clear “portraits” of your individual patients. The use of a single code can appear inaccurate simply because it’s monochromatic. If it were a painting, a single code would show Snow White in a snowstorm. When that’s all you submit, insurers worry that you’re not investigating deeply enough when you diagnose a patient or that you’re not understanding the importance of clearly communicating with insurers. Use multiple codes to provide a detailed rendition of your patient’s needs.