Facility/Observation Charge Capture and Coding

Facility Charge Capture and Coding

We utilize the CMS Guiding Principles to offer a choice of proprietary methodologies to determine and assign appropriate level charges.

  • Intervention-Based Algorithm: Maps highest level of intervention completed during a visit
  • Point-Based & Pediatric Point-Based Algorithms: Mapped by a cumulative score based on the types of resources provided and patient acuity

Reporting includes a summary report to highlight displays percentage, numbers and graph of patients visits. A quarterly trending report is provided to display a clear comparison of each calendar or fiscal quarter by year.

Injections & Infusions Calculator

Our Injections and Infusions Calculator offers multiple department and IV site capabilities with a built-in hierarchy for chemotherapy, medication infusions, as well as initial and subsequent injections.

Reporting includes a no infusion stop time report, which is designed to increase revenue and documentation best practices. Each infusion and hydration with a mission stop time will be displayed with its chart number, nurse’s name and observation department, if applicable.

Procedure/Radiology/Drug/Supply Charge Capture

Guide your understanding of where documentation deficiencies occur and improve on existing opportunities through this offering.

Key features:

  • CPT and HCPCS Coding enhanced with build-in NCCI modifier edits
  • Quick search ability by procedure description, CPT code, billing code, word, letter or number
  • CPT category grouping for easy find
  • Mapping capability for “procedure levels”, configurable to CPT or Charge Codes

Observation

Our custom-designed proprietary calculator allows easy capture of observation hours including observation date, order and discharge time entry. It’s equipped with procedure carve out capabilities and has the ability to distribute charges across multiple observation departments.

It provides an observation detail report to showcase details on total observation hours, exclusion hours and observation arrival source, by averaging observation hours and exclusion hours per visit.

Diagnosis, ICD 10 PCS, and DRG

The Diagnosis Encoder is integrated with industry standards and guidelines, includes a local and national coverage determination (LCD/NCD) scrubber, ICD-10-PCS mapping and DRG validation. This includes determining the correct principle diagnosis, comorbidities, complications, secondary conditions and surgical procedures.