Legion Healthcare Solutions

Medical Coding

The healthcare system is based on the complex narration of providers, and with rising information in system, we needed medical codes to condense the information for timely payouts. The provider’s payouts depend on what is learned, decided, and performed.

Legion Medical Coding is not only used for provider reimbursement but even to guarantee high-quality care throughout the care process. Any patient’s personal information must be easily stored and understood by any provider, considering each patient goes through procedures and hospitalization several times during their lifetime. The common language of medical coding is mandated by Health Information Portability and Accountability Act (HIPAA), allowing different providers to communicate with each other without any information loss. 

Medical coding transforms the healthcare diagnosis, procedures, medical services, and equipment into universal alphanumeric codes. Certified medical coders help providers to apply medical billing codes correctly during a medical billing process.

Each time a patient visits a provider, a list of code is generated, telling the payer about:

Patients’ diagnosis

Medical necessity for treatments, services, or supplies the patient received

Treatment and supplies are provided to the patient during and aftercare.

Any circumstances that might have affected patient care.

Medical coding services usa

Here is a list of all Medical Codes:

ICD-10-PCS is used by hospitals to describe surgical procedures in performing operations, emergency departments, and other settings. There are currently 130,000 alphanumeric codes used by hospitals.

Providers use these codes to report services performed during inpatient facilities. The code is maintained by American Medical Associations (AMA) and includes more than 8,000 five-character alphanumeric codes. Even most outpatient services are reported using the CPT system.

HCPCS level II's 7,000 plus alphanumeric codes are used for quality measure tracking, outpatient surgery billing, and academic studies. HCPCS was developed by Medicare, Medicaid, Blue Cross/ Blue Shield, and other providers to report procedures and bill for supplies.

CDT codes are owned and maintained by American Dental Association (ADA). Most of the dental and oral procedures are billed using CDT codes, with five-character codes starting with the letter D and used in dental section of HCPCS.

HCPCS Level II and CPT codes use hundreds of two-character alphanumeric modifier codes to add clarity. It indicates the status of the patient and service to be performed, a payment instruction, an occurrence that changed the service the code describes, or a quality element.

Step 1
Abstract the documentation 

Our medical coder gets a complete patient information using EHR via a secured connection or cloud. The coder might have to read the complete information: Procedure notes, history of medical reports, and operative steps to complete coding. 

Step 2
Audit the information/ documentation

In most cases, doctors might forget the flow of procedures performed, leading to denials during the claim process. Hence our certified coders recheck the complete story before coding.

Step 3
Assign codes

Our certified professional coders develop a detailed understanding when it comes to procedures and commonly used specific diagnoses and procedures. Coders do require in-depth research when dealing with new and unfamiliar medical terms. Medical coders rely on ICD-10 and CPT code books. 

Step 4
Audit the codes

Legion Quality Assurance team works 24/7 to implement 100 percent accuracy across all the coded procedures and diagnoses. A two-level-audit process by our specialty-specific coder helps legion healthcare coding solutions to remain error free.

Step 5
Report to provider

This is an automated process where the provider is informed about the claim submission to the payer.

Everyone of Legion Medical Coder is certified professional coder: CPC (Certified Professional Coder), COC (Certified Outpatient Coder), CIC (Certified Inpatient Coder), and Specialty coding certification

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