A denied claim tells you the code was wrong. An underpaid one doesn’t.

Why this drifts even in good practices

Your staff may well be trained on coding standards. The problem is that the standards do not sit still. Codes are added, retired and redefined; the requirements for using a specific code differ from year to year; modifier rules vary by payer and change without much fanfare. Training from three years ago is a liability rather than an asset.

That drift threatens two things at once: compliance, because incorrectly assigned codes are exactly what an audit looks for, and revenue, because the same error either denies the claim or quietly shaves the payment.

What CodeMAXX is

Access to certified professional coders who code your encounter notes to the national standards — ICD, CPT, CMS and HCPCS — and give you the current diagnosis codes, procedure codes and modifiers to enter into your billing system.

• Certified coders, not billers who also code
• Coded from your encounter notes, in your specialty’s conventions
• Current ICD, CPT and HCPCS sets with correct modifiers
• Consistency across providers, so two clinicians documenting the same encounter get the same code

Start with the free code review

Before anything else, send us your superbill or a list of the codes you use — CPT, HCPCS or CDT. You get back a professional code review report with the status of each code and a financial summary showing what the incorrect ones are doing to your cash flow, including income you are losing outright.

It costs nothing and you keep the report. For most practices it is the fastest honest answer to “is our coding actually fine?“