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Medical coding · Coding audits
Outsource medical coding to CPC, CHONC and CRC certified coders who each work one specialty. Our AI suggests codes on every chart, and a certified coder in that specialty approves every chart before it is billed. We started in oncology, where drug units, waste modifiers and infusion rules make coding hardest, and brought the same discipline to every specialty we code.
Illustrative example with sample data
The basics
Medical coding services translate what the clinician documented into the codes a payer pays on: ICD-10-CM diagnosis codes, CPT and HCPCS procedure and drug codes, and the modifiers that explain them. An outsourced coding team reviews each chart, assigns and checks the codes against payer and coding rules, flags documentation gaps for the provider, and audits its own work, so claims go out accurate and defensible.
E/M levels, procedures, infusions and injections, drugs and modifiers, coded by a coder who knows your specialty.
Hospital outpatient and ASC claims, with implant lines, device codes and multiple-procedure rules.
Pre-bill or retrospective audits with an error rate by provider, the dollar impact and the patterns to fix.
Risk adjustment coding and chart reviews by CRC-certified coders, so documented conditions are captured and supported.
Oncology coding
One chemotherapy claim can carry several drugs billed by the unit, an infusion hierarchy, waste modifiers and an authorization that covers only some cycles. Our CHONC-certified coders and RegimenIQ check all of it before the claim goes out.
Drug units calculator
Try itBilled units
340HCPCS unit
0.5 mg340 units of J9263. If none of a single-dose vial was discarded, Medicare requires the JZ modifier; discarded drug is billed on its own line with JW.
Illustrative. Units follow the HCPCS descriptor; payers set their own rounding and waste rules.
Initial, sequential and concurrent services coded in the right order, by drug and by time.
Required by Medicare since July 1, 2023 for single-dose containers: JZ when nothing is discarded, JW for the discarded amount.
RegimenIQ matches each cycle to the authorization on file and flags renewals before they lapse.
Treatment planning, simulation, delivery and management coded across the full course.
How a chart is coded
The software makes our coders faster. It never bills a chart on its own.
Signed notes come from your EHR into the coding queue, sorted by specialty and filing deadline.
AI medical coding proposes CPT, HCPCS and ICD-10 codes, each linked to the sentence in the note that supports it.
A CPC, CHONC or CRC coder in that specialty checks every code, modifier and unit, and corrects what the AI missed.
NCCI edits, coverage policies and each payer's rules run before the claim is built.
Documentation gaps go back to the provider as short, specific queries, not a monthly lecture.
A sample of every coder's charts is re-audited each month, and the error patterns feed back into training.
Free coding audit
A certified coder in your specialty reviews 50 of your recent charts and sends a written report. It is the fastest way to see how accurate your coding is today, without changing anything.
Medicare's own testing found that 7.66% of fee-for-service payments in fiscal 2024 were improper, mostly because the documentation did not support what was billed (CMS, FY2024 improper payments). An audit shows where your charts stand.
Charts with an error
11 of 50Revenue impact
$8,940Providers reviewed
6What the report covers
Specialties and systems
Each coder works one specialty, so the rules they apply are the rules your payers use.
Medical and radiation oncology, hematology and infusion centers. CHONC-certified coders.
Oncology billing services →Psychiatry, psychotherapy add-ons with E/M, and sleep studies.
Behavioral health billing →EMG and nerve conduction by study count, EEG and chemodenervation.
Neurology billing services →Biologic infusions billed by unit, joint injections and E/M.
Rheumatology billing services →Professional and facility coding, global periods, implants and multiple procedures.
ASC and surgical billing →EHR and practice management systems we code in
The systems we work in every day
We log in to your system; nothing about it changes for your team.
Claims, rejections and remittances worked through your clearinghouse.
Submissions, status checks and renewals in each payer's own portal.
| In-house coders | PhysiAssist coding team | |
|---|---|---|
| Specialty depth | One or two coders cover every specialty you see | Coders work one specialty each: CHONC for oncology, CRC for risk adjustment |
| Coverage | Charts wait when a coder is out or leaves | A team with backups, so the queue keeps moving |
| Technology | Codebooks, encoders and memory | AI suggestions on every chart, then a certified coder's approval |
| Quality checks | Occasional external audits | Monthly re-audits of every coder, with patterns fed back to providers |
| Visibility | Reports when someone builds them | Coding status and corrections visible in RevCore |
In-house coding works well for a single, stable specialty with low turnover. Outsourcing helps when volume grows, specialties multiply or coders are hard to keep.
Pricing
As part of full revenue cycle management: coding is included in one rate of 2.8% to 5% of net collections. Where you land depends on monthly collections, specialty, the scope of services, and your AR backlog and payer mix.
Coding only: we quote in writing after reviewing your volume, specialties and systems.
Estimate your rate →Reviewing each chart, assigning ICD-10-CM, CPT and HCPCS codes and modifiers, checking them against coding and payer rules, sending documentation queries to providers, and auditing the coding regularly. We cover professional fee, facility and ASC coding, coding audits and HCC risk adjustment.
AI suggests codes on every chart and links each one to the documentation behind it. A certified coder in that specialty then reviews and approves every chart before it is billed. The AI makes coders faster; it never bills a chart on its own.
Our coders hold AAPC credentials: CPC (Certified Professional Coder), CHONC (Certified Hematology and Oncology Coder) and CRC (Certified Risk Adjustment Coder). Each coder works one specialty.
A certified coder reviews 50 of your recent charts and sends a written report: errors by provider and code family, undercoded and overcoded visits with the dollar impact, missing modifiers and units, documentation gaps, and the patterns worth fixing first.
Charts are coded within 24 hours of a signed note, and the same business day when the note is signed by noon Eastern. Charts closest to a filing deadline are worked first.
Yes. We sign a business associate agreement with every client, are ISO 27001 certified, and log every access to patient data.
Epic, athenahealth, eClinicalWorks, NextGen, OncoEMR, iKnowMed, ARIA, MOSAIQ, AdvancedMD, Valant, TherapyNotes, SimplePractice, Dentrix, CharmHealth, Elation and others. We work inside your system.
Within full revenue cycle management, coding is included in one rate of 2.8% to 5% of net collections. Coding-only engagements are quoted in writing after a review of your volume, specialties and systems.
A free 50-chart audit by a certified coder in your specialty, with a written report you keep.