A Proactive Approach to Coding Quality Toolkit

Download a practical toolkit designed to help healthcare organizations proactively identify coding risks before they become larger problems. This resource helps leaders prioritize focused reviews, uncover reimbursement opportunities, and turn audit findings into meaningful action.

Key Features:

• High-Risk Coding Opportunities Checklist: Identify areas that may benefit from focused quality reviews, including new technology, Coding Clinic updates, denial trends, quality measures, and operational changes.
• Focused Review Planning Worksheet: Organize review topics, risk categories, priority levels, record scope, expected outcomes, and follow-up needs.
• Quarterly Review Calendar: Plan proactive coding quality reviews throughout the year with suggested focus areas by quarter.
• Reimbursement & Compliance Focus Areas: Evaluate high-dollar DRGs, NTAP procedures, new ICD-10-CM/PCS updates, rebill trends, and case mix fluctuations.
• Quality Measure Review Guidance: Monitor PSI, HAC, mortality, readmission, and POA-related coding opportunities before they impact reporting.
• Education & Action Planning: Turn audit results into targeted coder, CDI, provider, or team education.
• Continuous Improvement Framework: Move beyond routine accuracy checks with a more proactive approach to coding quality, compliance, and reimbursement integrity.