Coding and Documentation Audits

To minimize lost revenues and maintain compliance, accurate healthcare coding and documentation is critical for providers. A frequent audit of records can prevent continuous incorrect coding patterns and provide crucial analysis on potential sources of unbilled charges. Kraft Healthcare Consulting can provide a comprehensive review of the accuracy of coding, billing, and reimbursement practices. We identify areas of risk in coding and documentation processes and assist organizations in taking appropriate corrective action.

Our team of certified coders and health care consultants provides a myriad of services to bring solutions to your coding issues. The coding and documentation audit covers the following areas:

Sufficiency of documentation Accuracy in ICD-10 coding
Accuracy in CPT coding Accuracy in modifiers
ICD-10 SWAT analysis Shared/split visit documentation

Our certified coders have experience in the following areas:

Hospital acute care (DRG and APC) Skilled nursing facility RUG
Inpatient psychiatric Ambulatory surgery center
Rehabilitation CMG Evaluation and management
Multi-specialty practices

Not only can our team access provider CPT, DRG, and APC utilization and benchmark against CMS by specialty, we can further identify and analyze  coding patterns, deleted code usage, problems with modifiers, and patient acuity.

Coding Education Services

KHC’s coding education seminars thoroughly cover CPT coding concepts including evaluation and management coding, modifiers, surgical CPT coding, and much more. Our coding team conducts a thorough training course for providers, appropriate staff, and administrators. As needed, we arrange individual sessions for each provider to discuss the detailed findings of a coding audit. Additionally, we often “shadow” providers during a clinic day to provide additional training and observation. Our programs are approved through AHIMA and AAPC for CEU credits.

Kraft Healthcare Consulting’s team has an AHIMA-certified ICD-10 trainer on staff. We can educate your staff on foundational knowledge such as anatomy and physiology and medical terminology, as well as provide technical training for ICD-10 that includes ICD-10 CM/PCS guidelines and implementation guidance.

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