Freestanding clinic / office, outpatient center experience
Infusion coding experience
Plusses
Incident TO billing experience
Day to Day
Review outpatient provider and nursing documentation for infusion services and E/M encounters.
Assign accurate CPT, HCPCS, and ICD‑10‑CM codes for outpatient infusion, injection, hydration, and clinic visits.
Apply correct time‑based infusion coding (initial, subsequent, concurrent) and appropriate drug J‑codes.
Determine appropriate E/M levels using medical decision‑making or time‑based guidelines.
Ensure correct use of modifiers (e.g., ‑25) when billing E/M services with infusion procedures.
Validate coding against CMS outpatient guidelines, payer policies, and NCCI edits.
Identify documentation gaps and submit provider queries as needed.
Partner with billing and revenue cycle teams to resolve outpatient claim denials and appeals.
Maintain productivity and accuracy standards in a high‑volume outpatient setting.
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