Hospitals typically audit coding to make sure it is accurate, complete and compliant with national correct coding guidelines. Audits are usually retrospective and often focus on high volume diagnoses, procedures or diagnosis-related groups (DRGs). Audits may also include a random sample of inpatient and outpatient coding.
Coding audits are a valuable tool for educating coders and improving coding quality and compliance. However, the sample sizes are frequently insufficient to identify problematic patterns that result in lost revenue.
Our Coding and Revenue Enhancement Analytics and Services (nCREAS™) targets specific kinds of coding to assess the extent to which revenue is lost to incomplete or inaccurate coding. JTS then works with key organizational stakeholders to create the following: