Professional Fee (Pro-Fee) Medical Coding Services

Physician Visit Coding

ZechionMed analyzes encounters with physicians and assigns the most accurate codes in accordance with:

• The patient's history and the examination records
• Medical decision-making complexity
• Time-based code requirements
• The chief complaint and the clinical assessment
• Treatment plans and documentation for follow-up
• Specialty-specific code guidelines

Physician Visit Coding · Supported Visit Types

• Visits to the new patient
• Established patient visits
• Visits to preventive care
• Consultations following follow-up
• Chronic care visits
• Telehealth encounters
• Transitional care management visits

Evaluation & Management (E/M) Coding

Services Include Our E/M experts make sure that we have a precise selection of visit levels while still ensuring the strictness of CMS and the guidelines for payers.

• Inpatients and Office E/M codes
• Hospital consultation Coding
• Emergency department E/M review
• Critical care coding
• Telemedicine E/M coding
• Validation of E/M time-based
• Analysis of medical decision-making
• Recommendations for improvement of the documentation

Evaluation & Management (E/M) Coding · Benefits

• Reduce the risk of undercoding and missing revenue
• Avoid compliance risks associated with overcoding
• Improve reimbursement accuracy

Procedure Coding

Our Procedure Coding Expertise Includes ZechionMed assigns precise CPT as well as HCPCS procedures codes to physicians who perform services.

• Surgery procedures
• Office procedures
• Diagnostic procedures
• Treatment procedures
• Injection procedures
• Imaging-related procedures
• Major and minor interventions

Modifier Assignment & Validation

Incorrect use of modifiers is one of the main causes for claims denials and delays. ZechionMed provides:

• Modifier 25 validation
• Modifier 59 review
• Global surgery modifier review
• Modifications to the bilateral procedure
• Multiple procedure modifiers
• Assistant surgeon modifiers
• Analysis of specialty-specific modifiers
• Our team is able to ensure that modifiers accurately are accurate and accurately reflect documented services as well as demands of payers.

Diagnosis Code Assignment (ICD-10-CM)

Our experts in coding assign precise diagnosis codes Based on:

• Provider documentation
• Clinical indicators
• The specificity of a disease
• Medical need needs to be met
• Risk adjustment requirements

Diagnosis Code Assignment (ICD-10-CM)

Services Include

• Primary diagnosis selection
• Secondary diagnosis assignment
• Chronic condition capture
• HCC documentation assistance
• Review of improvement in the specificity of the review

Medical Necessity Validation · Our Process Includes

ZechionMed examines documentation to ensure that the services are in compliance with medical requirement for necessity.

• Diagnosis-to-procedure linkage review
• Coverage guideline verification
• LCD/NCD check for compliance
• Payer policy evaluation
• Documentation gap identification

Medical Necessity Validation · Outcome

• Less medical necessity denials
• More favorable rates for claim acceptance
• Stronger payer compliance

Documentation Review & Coding Compliance · Includes

Our review of compliance focuses on identifying the risks in documentation prior to claims submission.

• Provider documentation audits
• Reviews of the accuracy of Coding
• Monitoring compliance
• Coding guideline updates
• Audit preparation support
• Physician feedback reports

Payer-Specific Coding Compliance · Our Team Manages

Healthcare payers are continuing to increase their claims that are subject to automated scrutiny and document requirements. ZechionMed helps providers adjust to the changing expectations of payers through code workflows that focus on payers.

• Medicare coding requirements
• Medicaid Coding requirements for Medicaid
• Commercial Payer policies
• Specialty changes to the payer
• Claim scrubber requirements
• The workflows to prevent denial

Reduce Administrative Burden

The practice team and doctors are often occupied with working with documentation and coding problems. ZechionMed allows providers to concentrate on:

• Care for patients
• Clinical operations
• Training for growth

Improve Revenue Capture

The precise code helps to determine:

• Unpaid charges
• In-person encounters that are coded
• Opportunities to document
• Leakage of funds

Reduce Coding Errors & Denials

The proactive process of reviewing assists to prevent:

• CPT selection error
• Diagnostic mismatches
• Modifier errors
• Medical necessity denials

Access Certified Coding Expertise

As opposed to hiring and educating staff within their own teams, medical companies have access to:

• Expert coders
• Expertise in a specific field
• Resources for compliance
• Monitoring quality

Scale Without Increasing Overhead

ZechionMed supports:

• Small-sized doctor practices
• The number of medical groups is growing.
• Multi-specialty organisations
• Enterprise healthcare networks