Our Coding Compliance/Data Quality reviews place special focus on inpatient and outpatient coding accuracy, DRG/APC assignment and documentation practices. Coding audit includes an educational component to communicate results of the review as well as areas to focus on developing and maintaining components necessary for hospital coding compliance initiatives.

Diagnosis-Related Groups (DRG) and Ambulatory Payment Classifications (APC):
Our DRG and APC Audits verify the accuracy and consistency of your hospital's coding, billing and documentation practices specific to Medicare's Prospective Payment System guidelines. Reviews may be performed either retrospectively or on a pre-billing basis, using a random or focused approach to meet your needs.

Our review services include:

  • Pre-Billing reviews
  • Retrospective coding compliance reviews
  • Physician documentation reviews
  • Inpatient DRG validation
  • Outpatient APC validation
  • Discharge disposition reviews

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