Medical Administrative Solutions

Countdown to ICD-10 Has Begun

Are You Ready?

Are you absolutely confident that your staff is not overcoding or undercoding? According to a published report on the Hospital Payment Monitoring Program, there continues to be a significant amount of overcoding and undercoding. In a recent study by the Department of Health and Human Services Office of Inspector General, there continues to be a significant problem with the assignment of modifier 25 and modifier 59. Are you at risk?

At MAS our Auditing Team can help you determine if you are at risk in overcoding or undercoding or modifier assignment. Our auditing team is lead by our Auditor Manager which has over 25 years in Inpatient and Outpatient coding and coding reviews. Our auditing team will ensure that an adequate sample size is reviewed based on established audit criteria. We can provide the following audits:

DRG Audits: Targeting compliance, reimbursement, OIG fraud and abuse initiative through retrospective, concurrent or ongoing monitoring
Hospital Payment Monitoring Program Audits (HPMP)
APC Audits: Review of CPT codes as they relate to APC Assignment
Evaluation and Management (E&M) Facility or Physician Based
Modifier 25 and 59
Emergency Room Audits
Outpatient Diagnostic Audit with emphasis on medical necessity review and APC assignment where appropriate
Long Term Acute Care Audits with emphasis on DRG assignment and the coding of interrupted stays
Documentation Audits for Long Term Acute Care

If you are looking for a partner to help with your compliance program, call us today. We can provide onsite auditing or offsite via our centralized auditing center or remote via our HIPPA compliance web site.