CODING & DOCUMENTATION REVIEW
Coding guidelines change.
Your reimbursement shouldn't suffer for it.
Medical coding and documentation requirements have undergone comprehensive changes in recent years, and staying current is both a compliance requirement and a revenue imperative. KHC helps healthcare facilities and providers develop strategies that ensure regulatory compliance while optimizing reimbursement across every specialty.
Coding accuracy is a revenue integrity issue, not just a compliance one.
Medical coding and documentation guidelines are dynamic and have undergone a comprehensive overhaul in the past several years. Evaluation and Management (E/M) coding changes, updated NCCI edits, and evolving payer requirements mean that what was compliant two years ago may be generating denials or audit risk today. Staying current isn't optional. It directly affects both your reimbursement and your exposure to regulatory scrutiny.
DRG Validation, HCC Coding, and Specialty Coding
KHC provides MS-DRG and APR-DRG validation, including but not limited to LTAC, SNF, inpatient, and outpatient coding, ensuring that your facility's DRG assignments accurately reflect the clinical complexity of the patients you're treating. KHC also provides Hierarchical Condition Category (HCC) coding services, a critical component of risk adjustment that directly affects capitation payments under Medicare Advantage and other value-based payment models. Our consultants have extensive experience in facility, professional fee, and risk adjustment coding across a wide range of specialties, bringing clinical and coding expertise together in a way that purely administrative reviews cannot.
Evaluation and Management Coding Audits
E/M coding is a high-risk area for many provider organizations. The 2021 AMA changes to office and outpatient E/M guidelines introduced new documentation requirements that many organizations have not fully implemented.
KHC conducts comprehensive E/M coding audits across facility and professional fee settings, identifying patterns of undercoding, overcoding, and documentation deficiencies that affect both reimbursement accuracy and compliance posture.
Physician Education and Documentation Support
KHC provides targeted physician education and training that addresses the specific documentation gaps identified in our audits, helping clinical staff understand the connection between their documentation and both patient quality metrics and reimbursement accuracy. Our education programs are tailored to your organization's specific risk areas and payer mix, not generic compliance training. Physicians and clinical staff receive practical guidance they can apply immediately in their documentation workflow.
We don't just consult on healthcare. We've worked inside it.
KHC's coding and documentation review services are designed to identify exactly where your organization's coding practices diverge from current requirements and to build the education, monitoring, and workflow adjustments that bring them into alignment permanently.
Our team includes:
Certified Coders • Physicians • Registered Nurses • Compliance Officers • Billers & Reimbursement Specialists • Pharmacy & Laboratory Technicians • CPAs
Not sure where your coding risk is concentrated?
A KHC consultant will review your coding profile, identify your high-risk areas, and outline what a coding and documentation engagement would look like. Find out where your coding risk is before a payer audit does.
