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Surgical Coding

Our surgical coding services provide end-to-end support for both outpatient and inpatient procedures, encompassing the full surgical episode—from pre-operative assessments to intraoperative documentation and post-operative care. Our certified coders apply accurate CPT®, ICD-10-PCS, and HCPCS codes, along with precise modifier usage and bundling logic, in strict alignment with payer-specific rules, NCCI edits, and surgical coding guidelines. We ensure that all procedures are thoroughly documented and coded to reflect complexity, reduce denials, and maximize reimbursement. Whether for single-specialty practices or complex surgical departments, our expertise supports both compliance and revenue integrity.

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ACA Commercial Risk Adjustment Coding

We support accurate and compliant risk adjustment coding for Affordable Care Act (ACA) exchange-based plans by capturing all eligible diagnoses that impact a member’s Risk Adjustment Factor (RAF) score. Our certified coders conduct thorough medical record reviews and detailed abstraction to identify and document all relevant chronic and high-impact conditions. By aligning with HHS-HCC risk models and payer-specific requirements, we help health plans enhance RAF scores, ensure appropriate premium transfers, and maintain compliance with regulatory standards—ultimately supporting both financial performance and care quality.