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Integrated CodeCheck

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Increase first-time claim validation rates with Integrated CodeCheck, Accuro's claim scrubbing application

Integrated CodeCheck reduces denials and re-work by enabling seamless integration of your healthcare information system with Accuro's code validation and

claim scrubbing

 capabilities. It generates alerts for each charge transaction, highlighting transactions that are contrary to current Medicare coverage rules.

Accuro's claim scrubbing application helps coders improve efficiency and maintain compliance

Integrated CodeCheck's claim scrubbing tool validates your claims against Part A and/or Part B edits and its workflow can accommodate online editing via XML, or it can operate in a batch code validation mode.

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Download a printer friendly version of the [Integrated CodeCheck Product Information Sheet]

ICD-9-CM code validation points:

  • Is the code valid?*
  • Is the code active based on date of service?*
  • Is the code limited for reporting as a secondary diagnosis only (manifestation code)?
  • If a gender-specific edit applies, does the gender match?*
  • If an age-specific edit applies, is the patient's age appropriate for the diagnosis?*

CPT/HCPCS code validation:

  • Is the code valid?*
  • Is the code active based on date of service?*
  • If there are multiple codes, are CCI edit issues based on date of service?*
  • If a gender-specific edit applies, does the gender match?*

CPT/HCPCS modifier validation:

  • If a modifier exists, is it valid?*
  • If a modifier exists, is it active based on date of service?*
  • If an E/M and a procedure are reported, is an E/M modifier present?
  • If a modifier is reported, is the modifier listed in the CPT/modifier crosswalk?
  • If E/M, does the date of service fall within the global period of a previously performed procedure?**

Sequencing CPT/HCPCS Codes:

  • If there are multiple codes, then codes are sequenced in order from highest to lowest RVU.*

LCD/NCD validation:

  • Is the CPT/HCPCS code listed in a Local Coverage Determination (LCD) for your state/carrier?*

    •       -If so, is the CPT/ICD-9 link flagged with a coverage issue?*
          -Integrated CodeCheck links the user directly to the LCD in question
  • Is the CPT/HCPCS code listed in a National Coverage Determination (NCD)?

    •       -If so, is the CPT/ICD-9 link flagged with a coverage issue?
          -Integrated CodeCheck links the user directly to the NCD in question

*This validation is available to claims clearinghouses
**Edit not available for WDDX users


For more information, call 1-877-937-3600 or e-mail [abi-info@accurohealth.com].

  
         

   
 
Accuro Healthcare Solutions 2803 River Road, Yakima, Washington 98902      1-(877) 937-3600   Fax 1-(509) 453-5570

*HFMA staff and volunteers determined that this product has met specific criteria developed under the HFMA Peer Review Process. HFMA does not endorse or guarantee the use of this product.  |  CPT® is a registered trademark of the American Medical Association.  |  AHA Coding Clinic is a trademark of the American Hospital Association.