Practice Audits

Is Your Practice Prepared for RAC Audits?

L S Coding & Education LLC Audit & Compliance Services

Approximately one-fourth of all medical practice income is lost due to under-coding, missed charges, or un-reimbursed claims. Twenty-five percent of all chart audits uncover coding errors resulting in non-payment. This can result in scrutiny by payers such as Medicare and result in your practice being audited for under-coding and for over-coding of services. Both under-coding and over-coding can be considered as a fraudulent practice.

ICD-10-CM and CPT coding audits help providers and practitioners of all sizes to appropriately assign procedure codes, reduce up-coding & down-coding liability, and mitigate denials and suspensions.

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Outpatient Auditing Solutions

L S Coding & Education’s audit philosophy focuses on compliant coding practices as well as on accuracy, quality of coding and physician documentation. Our entire staff consists of certified professional coders who bring the most value to your facility.

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Pre-billing Chart Audits

Typically 10 charts are audited per provider for accuracy of CPT, ICD-10-CM codes and HCPCS Level II Supplies and Service codes. Documentation by the provider is reviewed to determine that the levels of services about to be billed are supported by the providers chart note or dictation. Appropriate use of CPT and HCPCS Modifiers is also reviewed.

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Education

At the completion of the coding review and audit, L S Coding & Education LLC provides post-assessment reports for the practice and for each individual provider with recommendations. A general education session is provided for all providers and each provider receives an individualized educational session to discuss the particulars of their own documents.

Sessions are designed to include a review of case-specific data and include personalized education regarding opportunities for improvement. Session duration is defined by the client in collaboration with L S Coding & Education.

Coding & Billing Staff Members will also receive an education session to address pertinent coding and billing issues.

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Post-billing Chart Audit

L S Coding & Education LLC provides litigation support in the event a practice is being audited or a law suit has been initiated by a payer. The charts that have been audited by the payer are reviewed by L S Coding & Education to determine the accurate level of service provided and the accuracy of all codes that were submitted on the claim.

A full report is provided to legal counsel as to the accuracy or inaccuracy of codes selected by the provider and billed by the practice.