Duties:
Ability to interpret progress notes, operative reports, discharge summaries, x-rays, MRI’s, casting and DME to determine services provided and assign the appropriate CPT and ICD codes based on current coding guidelines.

Verify accuracy, completeness, specificity of diagnosis codes based on services rendered and assigns appropriate modifiers based on insurance rules.

Knowledge of Local and National Coverage Determinations for medical necessity, CCI edits and auditing standards.

Ensures provider documentation is in compliance with third party and regulatory guidelines.

Performs edit checks on data entered prior to transmittal and correction of such errors as indicated.

Stay current on all orthopaedic coding guidelines and coding changes by monitoring professional publications, payor publications and websites.

Contacts physicians/staff as needed to clarify documentation.

Perform regular auditing of provider notes/coding for practice and communicate findings to the manager.

Qualifications:

2 years’ experience with orthopaedic surgery coding and E&M coding

Good working knowledge of medical terminology and anatomy requiredCPC or equivalent required (CCA, CCS, CCS-P, etc)