What’s in scope.
The list below describes the standard work breakdown. Every engagement is scoped to client volume, line of business, and platform. Bespoke scope is the default, not the exception.
- 01
Inpatient (IP-DRG)
MS-DRG and APR-DRG assignment, POA indicators, ICD-10-CM & PCS coding to AHA Coding Clinic standards.
- 02
Outpatient (APC)
ED, ancillary, observation, and same-day surgical coding aligned to NCCI and OPPS edits.
- 03
Professional Fee
E/M (2021+ guidelines), surgery, anesthesia, radiology, pathology, and OB/GYN with modifier discipline.
- 04
HCC / Risk Adjustment
CMS-HCC v24 & v28, HHS-HCC, and Rx-HCC. Provider documentation gap callouts feed back into your CDI workflow.
- 05
CDI Concurrent Review
Real-time queries delivered into Epic, Cerner, Meditech, and Athena workflows. Average response time under 4 hours.
- 06
Coding Audits & QA
Internal QA II review on a sampled %, external audit support, and RADV-grade defensibility reports.