ICD-10 coding review is a process of assessing the accuracy and completeness of medical coding using the International Classification of Diseases, Tenth Revision (ICD-10) coding system. This review is usually performed by certified medical coders or auditors to ensure that medical claims are coded correctly, and healthcare providers are reimbursed accurately for the services they provide.
What happens during a review?
During an ICD-10 coding review, the medical coder or auditor examines the medical documentation and compares it to the codes that were assigned to the patient’s diagnosis and treatment. They check for errors and omissions, ensuring that the codes used are specific and accurate. They also review the medical necessity of the services provided and ensure that the documentation supports the codes assigned.
Why ICD-10 Coding Reviews Are Important
ICD-10 coding reviews are important because they help to ensure that healthcare providers are properly reimbursed for their services and that patients receive the appropriate care they need. They also help to identify areas where providers may need additional education or training to improve their coding accuracy.
How often should reviews be performed?
ICD-10 coding reviews can be performed on a periodic basis, such as annually or quarterly, or they can be conducted as needed, such as in response to an audit or investigation. The reviews can be conducted internally by healthcare organizations or outsourced to third-party coding and auditing firms.
Overall, ICD-10 coding review is an essential part of the medical billing and coding process, and it helps to ensure that healthcare providers are delivering high-quality care while being reimbursed accurately for their services.