The Key to HealthCare Reimbursement
We speak the Language underlying our Healthcare system fluently. Making sure you are reimbursed.
Medical Coding
Cracking the code that fuels our Healthcare
Don’t let staffing shortages, seasonal fluctuations, or coding reimbursement updates affect your bottom line. QualCode’s expert coders have experience in a wide range of healthcare environments and are available on a full- or part-time basis to meet the needs of your organization. Our goal is to help your organization achieve revenue integrity through accurate and compliant coding.
Medical Coding
The Language under our Healthcare system is Medical Code. All information from before, during and after treatments will be collected, translated, processed and prepared for the reimbursement process.
‘We are fluent in Medicode!’
Client Case Studies
Selection of our esteemed clients:
“QualCode has been an enormous help to our company during our transition into the coding arena. They provide ongoing coding education and training for our employees in both group and one-on-one settings, audit reporting to ensure accuracy, ensure we are up to date on industry standards and make sure we stay updated on the progress of our staff as they continue their coding education. They are true professionals, helpful and dedicated, and we would strongly recommend their services.”
— Executive Management NRS, Inc.
“QualCode provides consistent professional services with knowledgeable coders. QualCode’s Administrative staff are well organized and professional.”
— T.S., Director of Health Information Management NUMC
You want to make sure you get reimbursed.
Let’s walk you through how to get that done.
MediCode in-depth
All coding services are available on a remote, per diem, and/or interim basis.
Inpatient Coding
ICD-10-CM/PCS coding is all about specificity. QualCode’s experienced and credentialed coders go the extra mile to assign the most accurate and specific diagnosis and procedure codes. The result? Comprehensive and compliant coding that aligns with rules and regulations. Our staff stay on top of annual coding updates and quarterly updates to Coding Clinic, helping you avoid payer denials and take full advantage of the specificity inherent in ICD-10.
Outpatient Coding
Outpatient coding requires an intimate knowledge of sequencing rules as well as the ability to distinguish between a definitive diagnosis and symptom—and know whether one or both should be coded. It also requires proficiency across a wide range of services performed in a variety of settings, including emergency departments (ED), ambulatory surgery centers (ASC), outpatient clinics, and diagnostic testing centers. QualCode’s expert outpatient coders are well-versed in medical necessity, claims denials, bundling, and charge capture. They’ll correctly complete the CMS-1500 for ASC services and the UB-04 for outpatient services by applying all appropriate diagnosis codes, procedure codes, and modifiers.
ED Coding
In the fast-paced environment of an ED, coders must essentially be prepared for anything and everything—and be able to correctly apply all ICD-10-CM, CPT, and HCPCS Level II codes and modifiers. QualCode’s seasoned ED coders are experts at coding observation cases, capturing common surgical procedures (e.g., thoracentesis, laceration repair, fracture care, and foreign body removal), and reporting more obscure and less common diagnoses and procedures.
ASC Coding
ASC coding requires a thorough understanding of ICD-10-CM/PCS, CPT, and HCPCS Level II coding as well as the ability to capture ancillary procedures that can be assigned in addition to surgical procedures. Coders must also understand ASC reimbursement rules related to multiple, device-intensive, and/or discontinued procedures. QualCode’s experienced ASC coders dig into and dissect operative reports to correctly apply all codes and modifiers, helping your ASC collect the revenue to which it’s entitled.
Clinic Coding
Clinic coding requires an in-depth knowledge of specialty-specific procedures and diagnoses. QualCode’s coders have honed this knowledge over time to ensure accurate and complete claims. Coders are well-versed in anatomy and physiology as well as the medical terminology that your specialists use most frequently. They dive into office visit notes and operative reports to assign the most specific ICD-10-CM/PCS, CPT, and HCPCS Level II codes along with any necessary modifiers.
Professional Coding
Accurate pro-fee coding is all about knowing the ins and outs of the 1995 and 1997 E/M guidelines. Coders must understand the three key components of assigning and E/M code and also be able to apply Medicare rules and regulations related to National Correct Coding Initiative Edits, incident-to services, shared visits, consultations, global surgery, and more. QualCode’s pro-fee coders comb through physician documentation to ensure that every E/M code submitted will pass payer and auditor scrutiny, helping providers retain the revenue they generate.
Wound care Coding
Compliant wound care coding requires the ability to identify wound size, depth, and severity, append modifiers when necessary, and interpret coding guidelines correctly. QualCode’s experienced wound care coders locate appropriate diagnosis codes for wound care local coverage determinations (LCD), identify documentation gaps that increase compliance risk, assign accurate combination codes, append modifier -59 vs. -X (EPSU) for wound care procedures. Our staff mitigate compliance risk for this service line that continues to be a target for CMS’ Targeted Probe and Education (TPE) program and Office of Inspector General (OIG).
HCC Risk Adjustment Coding
Did you know you can raise your Medicare reimbursement by as much as 20% by increasing the accuracy of your Medicare Advantage member coding? QualCode’s HCC coding experts review your medical record documentation, assess HCC capture, and assign ICD-10-CM diagnosis codes based on CMS guidelines.
Interventional Radiology Coding
Interventional radiology coding is perhaps one of the most difficult and complex specialties, requiring an in-depth knowledge of anatomy and physiology, including proficiency in different families and levels of vessels. QualCode’s expert interventional radiology coders review long and detailed operative reports to assign accurate ICD-10-PCS codes for neuro-interventional, endovascular, peripheral vascular, angio-interventional, gynecological interventional, and nephron-interventional surgeries.
Injection & Infusion Coding
Compliant coding for injections and infusions requires the ability to report specific CPT codes based on the timing and route of administration. QualCode’s experienced coders ensure coding compliance by focusing on initial vs. sequential vs. concurrent administration, reporting hydration services correctly, identifying and correctly reporting services that cross the midnight hour, appending modifiers when needed, adhering to CPT’s hospital outpatient drug administration hierarchy, and identifying documentation gaps that increase compliance risk.
