Experienced Certified Medical Coder with extensive comprehensive experience in Medical Coding. Highly skilled in analyzing and reviewing patient data for correct coding of injection and infusion (I&I) codes, Same day surgery, Reoccurring Accounts, Same Day Visits, Emergency Department, and Evaluation and Management (E/M) levels and procedure categories.
TECHNICAL PROFICIENCIES Proficient with Microsoft Word 2007/2010 Horizon Patient Folder (HPF) | American Academy of Professional Coders (AAPC) PROFESSIONAL CERTIFICATION Certified Professional Coder - CPC |
Verify and ensure the accuracy, completeness, specificity and appropriateness of diagnosis codes based on services rendered. Review medical record information to identify all appropriate coding based on CMS HCC categories. Complete appropriate paperwork/documentation/system entry regarding claim/encounter information. Monitor Coding changes to ensure that most current information is available and being implemented. Demonstrate analytical and problem-solving ability regarding barriers to receiving and validating accurate I-10, CPT informationUsing, ICD-10-CM and/or HCPCS/CPT, primarily assigns, validates, and/or edits codes the following patient types: Same day surgery (SDC), Observation (OBV),
Outpatient Cardiac Cath. As needed also assign, validate, and/or edit codes for the following patient types: Emergency department (ED), Recurring (RCR), Clinical (CLI) records, and/or, Provider Office Visit (POV). Assigns, validates, and/or edits procedure categories, modifiers (when applicable). Initiates, validates, and/or edits physician queries in compliance with Company policy where appropriate. Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current. Utilizes the complete medical record documentation in code assignment, validation, and/or editing of codes. Follows all applicable coding guidance in assigning, sequencing, validation, and/or editing of codes. Meets all educational requirements as stated in current Company policy.
Practices and adheres to the “Code of Conduct” philosophy and “Mission and Value Statement”
Reviews, analyzes, and codes medical record documentation to include procedural information for the correct ICD-10, CPT and/or HCPCS codes to the greatest specificity. Reviews documentation for medical necessity. Assesses records and prepares reports. Primary coding responsibility is all Evaluation and Management (E/M) leveling along with additional ancillary services done in an ED setting. Trained in E-request edit corrections. Injection/infusion guidelines and procedure category assignment. Worked on special coding projects driven by my manager.
Ensured edit requests are handled within 72-hour window through the system/process. Ensures accounts are reviewed timely to ensure cash flow, sustain accuracy, and meet filing deadlines and claim submission deadlines utilizing various tools, daily edit review and completion of edit accounts or route to appropriate department for error correction. (e.g., e-Request, Bill 49 tool(s).
injection/infusion guidelines and procedure category assignment. Worked on special coding projects driven by my manager. Ensured edit requests are handled within 72-hour window through the system/process Ensures accounts are reviewed timely to ensure cash flow, sustain accuracy, and meet filing deadlines and claim submission deadlines utilizing various tools, daily edit review and completion of edit accounts or route to appropriate department for error correction. (e.g., e-Request, Bill 49 tool(s). Reviews all official data quality standards, coding guidelines, Company policies and procedures, and clinical/medical resources to assure coding knowledge and skills remain current. Utilizes ICD-10-CM and/or HCPCS/CPT, as applicable, codes on all patient types. Assigns ED E/M levels, and enters charges for ED, OB ED and/or observation (OV) infusions and or injections.
Review Trauma accounts to ensure level or critical care charges, procedure category charges and/or injections/infusions are captured per ACEP guidelines. Maintains or exceeds established productivity standards and coding accuracy. Utilizes the complete medical record documentation in code assignment
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