Oxford Global Resources

Summary: Consult with physicians and other healthcare providers to obtain clarification documentation to assist with accurate and complete diagnosis and procedure code assignments. Project Details: Select, code, and sequence the principal diagnosis, principal procedure, complications and comorbid (CC) conditions, and other significant invasive and non-invasive procedures that should be coded according to ICD-9-CM official guidelines for coding and reporting, published by the U.S. Department of Health and Human Services (DHHS) and the AHA Coding Clinic for ICD-9-CM. Select, code, and sequence the principal procedure, other significant invasive and non-invasive procedures according to the coding conventions and guidelines outlined in the CPT code set, the National Correct Coding Initiative (NCCI), the Outpatient Coding Editor (OCE), and the AMA CPT Assistant publication. Where appropriate, apply Medicare Outpatient Prospective Payment System (OPPS) coding...

Summary: Review, analyze, and code medical record documentation to include, but not limited to, medical, diagnostic and procedural information for the correct ICD-9 and/or ICD-10 and/or CPT-4 HCPCS codes to the greatest specificity. Abstracts demographic and coding information into the information system accurately and completely. Reviews documentation for medical necessity. Audits orders and claims before submission for entirety and accuracy and to minimize claim denials. Assesses records and prepares reports. Develops effective working relationships with physicians and other stakeholders. Project Details: Evaluate medical record documentation and charge ticket coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflect and support the visit Compile necessary documentation prior to coding review; when documentation is not available, performs the appropriate steps to obtain the necessary...