ER/Observation Services Coding
Perform a prospective or retrospective review of a sample of ER and/or observation services claims to evaluate complete and accurate charge capture, documentary support for claimed services and appropriate diagnosis coding.
This review includes a focus on revenue optimization and prevention of overpayment via compliance with regulations governing the definition, medical necessity and reimbursement of these strictly regulated services; particularly time in observation care, time documentation, and calendar dates of observation care admission & discharge. It also includes the issues of primary care within the ER setting, critical care within the ER setting, consults within the ER setting, fracture care issues, procedures within the ER setting and modifier utilization.
In academic medical center ER's, compliance with PATH regulations is available as an add-on service. This includes "moonlighting" issues.
Seminars in coding, documentation, billing and PATH for clinical and non-clinical staff are available
Billing seminars in this area are available.
Additional services are available.