LexiCode

To help your organization achieve the highest quality healthcare outcomes, LexiCode offers comprehensive support and partnership across various areas of Health Information Management and the Revenue Cycle, including coding, auditing, documentation integrity, interim management, and operational efficiency.

Leveraging in-depth data analysis and modeling, our experienced team of credentialed coding consultants and nurse consultants will support your organization’s mission by offering a wide range of consulting services.

Coding Compliance and Reimbursement Audits

Value of Audits:

Identify underpayment/overpayments
Ensure compliance/minimize risk
Identify root causes of coding issues for preventive action

Identify underpayment/overpayments
Ensure compliance/minimize risk
Identify root causes of coding issues for preventive action
Coder feedback is reviewed and discussed prior to finalization
Coder/provider education session with each audit, with AHIMA CE hours
Robust recommendations for improvement, with ability to execute and implement
Internal quality assurance ensures second level review of recommendations
Collaborative approach to achieve positive results
Concurrent/pre-bill or retrospective
Detailed trend reporting and analytics

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Types of audits:

Coder accuracy reviews, providing immediate feedback and education to coders
All DRG Methodologies: MS-DRG, APR-DRG/SOI/ROM
Comprehensive Inpatient Coding Audits (all codes and POA indicators validated)
Comprehensive Outpatient Coding Audits – all hospital/clinic record types and settings
Professional Fee/Physician-Based Audits – Evaluation & Management, Surgical Encounters – all settings
Specialty Audits
- Long Term Acute Care (LTAC)
- Behavioral Health/IPF-PPS
- Rehabilitation Audits/UB-04 post discharge IRF-PAI coding:
- Skilled Nursing Facilities
- Home Health/Hospice
- Ambulatory Surgical Centers
- Urgent Care Facilities

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Risk Adjustment / HCC Suite of Services

Combines data analytics and modeling with clinical documentation improvement and coding expertise
Achieve accurate and optimal RAF scores and member reimbursement

Education

Coder Education
Provider Education

Coder Education
- Courses for all skill levels: basic to expert
- Extensive course selection, including annual ICD-10/CPT updates
- Virtual classroom – all coursework online
- AHIMA CE hours (AAPC CE hours available upon request)
- Progress reports and assessments to measure progress
- Web-based education platform accessible from mobile devices
- Customized, targeted content development
Provider Education
- Focus on documentation best practices
- Diagnosis coding for risk adjustment
- Evaluation & Management fundamentals
- Understanding the query process

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Additional Consulting Services

Interim HIM or Coding Management
Health Information Management Operational Reviews
Denial Reviews and Appeals

Interim HIM or Coding Management
- short- or long-term management services to help with your management transitions
Health Information Management Operational Reviews
- A holistic approach to HIM Department improvement
- Identify and address gaps in workflow, processes, coding and documentation.
Denial Reviews and Appeals
- Proven success rate in appealing coding and clinical denials
- Inpatient, Outpatient and Professional Services
Clinical Documentation Improvement (CDI) Services
- Improve the accuracy of patient records to ensure accurate reimbursement
- Improve data quality, and enhance patient outcomes
- Inpatient and Outpatient CDI reviews
- Training for providers and staff on improving documentation quality
- Interim CDI Specialists
Coding Edit Resolution (Inpatient and Outpatient)
- Analyzing the specific edit message to identify the issue
- Ensuring the medical record adequately supports the codes
Nurse Reviews
- Applies clinical judgment to make determinations of medical information reviewed
- Medical necessity of inpatient/observation admissions utilizing clinical admission criteria
- Inpatient continued stays, applying intensity of service/severity of illness criteria
- Pre-service verifications
- Clinical quality measure assessments
- Patient safety indicator abstraction
- Clinical application of National Coverage Determinations (NCD)
- Workers Compensation or Accident Case Documentation
- Clinical review for drug and medical device adverse reactions
Customized projects
- Expert witness - coding related cases
- Research studies
- Third party determinations

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