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Outpatient Services Coding Reviews

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CMA offers Outpatient Coding validation reviews for emergency medical services, ambulatory surgery, clinic, laboratory, and radiology services.  Where applicable CMA will audit both facility and professional coding & billings.

CMA reviewers will examine all pertinent parts of the medical record for accuracy and completeness of information and validate the codes assigned in the records.  Validations include review of the clinical record documentation to ascertain it supports:
  • ICD-9-CM diagnosis code
  • CPT codes
  • HCPCS codes
  • Evaluation and Management codes
  • APC assignments
HIM coding summaries are compared with the 1500 and/or UB92 to ensure all the codes have been captured to ensure accurate reimbursement.
Copyright 2005 Case Mix Analysis, Inc.