Medical Coding | Quantum Lake

Medical Coding Services

Accurate medical coding is essential for proper billing and compliance. Our expert medical coding services ensure that your claims are coded correctly, reducing the risk of denials and ensuring you receive the maximum reimbursement. We stay up-to-date with the latest coding guidelines and regulations, so you don’t have to.

Why Choose Our Medical Coding Services

Certified Professionals
Our team consists of certified coding specialists with extensive experience in various medical specialties.
Accuracy
We prioritize precision in coding to minimize errors and maximize reimbursements.
Compliance
We adhere to the latest ICD-10, CPT, and HCPCS coding guidelines, ensuring your practice remains compliant.
Efficiency
Our streamlined processes and use of advanced coding software ensure quick turnaround times.
Training and Support
We provide ongoing education and support to keep your staff informed of coding updates and best practices.

Quantum Lake

Coding Specialities

IP-DRG Coding
ED facility Coding
ED Professional Coding
Single Day Surgery-SDS
Diagnosis Coding- HCC
Multiple Surgery
Evaluation & Management- Inpatient
Evaluation & Management- Outpatient
Observation
Nephrology
Dental Coding
Physical Medicine(Physical & Occupational Therapy)

Urgent Care
Spinal Surgery
Labor & Delivery Coding
Ob- Gyn
Podiatry
Psychiatry
Radiology
Interventional Radiology( IVR)
Pathology & laboratory
Anesthesia
Denial Management
Toxicology
Pain Management

All Quantum Lake coders are certified CCS/ CIC / CPC / COC / CRC and other specialty coders from AHIMA or AAPC.

What our coders do ?

Ongoing analysis of medical records, analyzes provider documentation to assure the appropriate assignment of DRG’s, PCS, CPT, ICD-10, ICD-9, HCPCS Procedure codes following AMA, AHIMA, CMS coding guidelines
Review and approval of the coded reports by checking accuracy and maintaining records at individual Coder level on daily basis through a stringent Auditing plan to achieve absolute accuracy.
Detailed evaluation of Outpatient, Inpatient surgery reports to assign appropriate DRG’s, CPT, PCS, ICD-10, ICD-9, HCPC codes.
Demonstrating analytical and problem-solving approach in achieving daily production goal while maintaining accuracy.
Working on Error Report/Claim edit from various work Queues
Users are up-to-date with all coding updates including AMA, AHIMA, CMS coding guidelines with all insurance requirements and compliance
E&M CMS 1995/1997 guidelines, appropriate use of Modifiers etc.
Working on NCCI conflicts and other modifier uses, Validation of LCD & NCD edits etc.
Determining Medical Necessity, Patient’s insurance Coverage, identifying Pre-Authorization etc.

Our Medical Coding Process

Documentation : Assess documentation for completeness and clarity
Analysis : Coder checks a variety of sources within the patient’s medical record, doctor’s notes, ordered laboratory tests, requested imaging studies and other sources) to verify the work that was done.
Abstraction : Abstract the diagnoses and procedures
CPT Verification : Verify the correctness of auto captured procedure codes (CPT) and diagnosis codes (ICD-10)
DP Verification : Verifying that diagnoses and procedure codes (DP) are linked to demonstrate medical necessity.
Modifiers : Verify correct usage of modifier
EDITS : Resolve any edits and resolve and ensure that the diagnosis and procedure codes are correctly linked to the patient's condition and the services rendered.
Deliver : Release the completely coded and verified documents for billing

Accurate and Compliant

Assess documentation for completeness and clarity.
- Is documentation complete ?
- Is documentation legible ?
- Are diagnoses clearly stated with supporting detail ?
Determine provider, patient type, place, and payer.
Abstract the diagnoses and procedures.
Assign accurate, complete codes.
- Diagnoses and procedure codes should be linked to demonstrate medical necessity.
- Codes must be based on documentation; not on coders assumption.
- Codes must be accurate under HIPAA:
  - Must be current
  - Must be consistent with HIPAA code sets
Verify codes are compliant
- Compliance = Satisfying requirements, regulations, and policies for correct coding and verification of codes.
Release codes for billing