Medical Coding
Certified coders applying ICD-10, CPT, and HCPCS rules with specialty-specific compliance review — fewer denials, no over-coding risk.
Why it matters
The hidden cost of getting this wrong
Coding is where most billing companies cut corners — assigning whatever code matches the documentation literally, without catching missed modifiers, downcoded E/M visits, or unbundled services. Our coders are AAPC-certified and specialty-trained. Every chart is reviewed against the actual documentation, not just what the provider checked in the EMR. The result: fewer denials at the front, fewer audits at the back, and the right level of E/M billed every time.
What's included
Everything in this service
AAPC-certified coders (CPC, CPC-H, CCS, specialty credentials)
ICD-10-CM diagnosis coding with specificity review
CPT/HCPCS procedure coding with modifier accuracy
Specialty-specific code sets (cardiology, pulm, peds, neph, etc.)
E/M level review against 2021 AMA guidelines (MDM-based)
Modifier 25, 59, 26, X{ESPU} documentation review
Quarterly compliance audit with feedback to providers
Common pitfalls
What we see go wrong elsewhere
Patterns we run into when we audit incoming practices. If any of these sound familiar, your current setup may be leaving money on the table.
Always coding 99213 by default — leaving 99214/99215 revenue on the table when documentation supports it
Missing modifier 25 on E/M-plus-procedure same-day visits
Auto-assigning ICD-10 codes from EMR drop-downs without specificity review
Skipping CCM (99490) and AWV (G0438/G0439) opportunities for primary care panels
Not catching unbundling rules where multiple codes get billed when one comprehensive code is required
Performance benchmarks
What we hold ourselves to
Industry medians shown where applicable. We track these every week and report them to you, in writing.
98%+
Coding accuracy (audited)
<3%
E/M downcoding rate (vs documentation)
<1%
Modifier denial rate
Frequently asked
What practices ask before they switch
Do I have to use your coders for the whole revenue cycle?+
No — coding can be a standalone service. Some practices already have a biller they like and only need certified coding support. We can also do periodic coding audits for in-house teams.
Will providers have to change how they document?+
Not unless they want to. We code from existing documentation and flag patterns where small documentation changes would justify higher E/M levels. Whether providers act on those patterns is up to them.
How do you handle compliance risk?+
Quarterly internal audits, annual external audits, and continuous education for our coders on payer policy changes (especially CMS LCDs and Medicare Advantage plan rules in Texas). We also document every code decision so anything is defensible if audited.
Want to know what medical coding is costing you?
Get a free Revenue Leakage Analysis — a one-page report with three specific revenue leaks at your practice and what they're costing per year. Delivered in 3 business days. No sales pitch.