Validate the Accuracy of the ICD-10-CM/PCS Diagnosis & Procedural Coding
Verify the Principle Diagnosis Selection and Sequencing of all ICD-10-CM codes
Complications and Comorbidities (CCs & MCCs) Verification
Validate the Accuracy of the DRG & MS-DRG Assignments
Provide DRG and Coding Accuracy Rates
Validate the Accuracy of Billing (i.e., UB-04s)
Validate Overall Compliance
Case Mix Analysis and/or Review
POA (Present On Admission) Validation
Discharge Disposition Validation
Admission Criteria Review
Analyze the Physician Query process
Evaluate the Clinical Documentation
Review Retrospective and/or Concurrent Cases
Remittance Advice Review
Re-abstract cases to indicate recommended coding changes
Provide Accuracy Rates and Statistics as a Group and/or at the Coder Specific Level
Provide Financial Impacts
Education (AHIMA and AAPC recognized CEU's for Coders)
Our Inpatient Medical Records Reviews include an evaluation of your ICD‑10‑CM/PCS Diagnosis and Procedural code assignments, Complications and Comorbidities (CCs & MCCs), the Level of Clinical Documentation, Physician Querying, and the Sequencing of Codes in order to assign the appropriate DRG and/or MS-DRG. PRC’s consulting staff has extensive experience in auditing Inpatient admissions for compliance as well as identifying opportunities to enhance DRG assignments through improving Clinical Documentation. Therefore, PRC will not only validate the coding scheme assigned, but we will review admissions, in detail, to uncover opportunities to enhance Clinical Documentation along with DRG assignments and the Hospital’s Case Mix Index. During these projects, PRC will also review UB‑04s in order to validate the accuracy of billing claims. A comprehensive, written report will be submitted and PRC will conduct Educational sessions to present findings, and discuss recommendations.
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Please contact us for an initial consultation. Whether you know exactly what your facility needs, or whether you want PRC to assist in developing a roadmap to success based on your specific objectives, we are looking forward to working with you.
Call today at (800) 848-8772 or Email us at email@example.com