Certified coders read your full clinical documentation, assign ICD-10-CM, CPT and HCPCS codes from what is actually recorded, and check every combination against NCCI edits and payer policy before the claim reaches billing.
A claim that pays is not always a claim that paid correctly. When the code understates what your provider documented, the payment posts, the balance closes, and nothing ever flags it.

Medical coding is the translation of a documented clinical encounter into the code sets a payer adjudicates against. A coder reads the record, assigns ICD-10-CM diagnoses, CPT and HCPCS Level II procedures, applies modifiers, links each diagnosis to the procedure it justifies, and verifies the combination against payer policy before anything reaches a claim form.
Coding and billing are sold together and they are not the same discipline. Coding decides what the claim says. Billing moves the claim and collects on it. A biller cannot recover revenue that a coder never asked for, which is why the two are separated here and why coding sits upstream of everything in your revenue cycle.
| Handled by medical coding | Handled by medical billing |
|---|---|
| Reading the full clinical record before code assignment | Building and transmitting the claim |
| ICD-10-CM, CPT and HCPCS Level II assignment | Clearinghouse rejection handling |
| Modifier application and bundling review | Payment posting and remittance reconciliation |
| Diagnosis-to-procedure linkage | Denial appeals and payer follow-up |
| Provider queries on insufficient documentation | Accounts receivable recovery |
| Coding audits and compliance review | Patient statements and balances |
MedAura provides both. See our full medical billing and RCM services.
Explore Medical Billing ServicesCoding errors rarely announce themselves. A denial at least tells you something went wrong. The four failures below do not generate denials, alerts or reports. They generate payments that look correct and are not.
When documentation does not clearly support the level billed, most coders drop a level and move on. The claim goes out clean, the payer pays it, and the balance closes. There is no denial, no rework queue and no alert. The gap between what the provider did and what the claim asked for is absorbed into your revenue and never appears as a coding problem, because from every system's point of view the claim was a success.
A superbill lists what the provider remembered to check. The operative report, the procedure note and the full encounter often contain more: a secondary procedure, a complicating condition managed during the visit, an injection given, a device applied. A coder who works from the superbill instead of the record codes what was ticked, not what was done. We read the full note first, then the superbill.
Medical necessity is established by linkage, not by presence. A diagnosis sitting in the chart does nothing for a claim unless it is pointed at the procedure it supports. Unlinked or wrongly ordered diagnosis pointers produce medical necessity denials that look like clinical disputes and are actually clerical, and they repeat on every claim of the same type until somebody fixes the pattern.
AMA CPT guidance and a payer's published reimbursement policy are not always the same, and where they differ the payer policy governs payment. A coder working from the CPT manual alone can submit a technically correct claim that pays below what the contract allows on every single encounter with that payer. It never surfaces as an error. It surfaces as a payment that looks fine.
Find out what your coding is leaving behind. The Free Coding Audit reviews your recent encounters against the documentation that supports them.
Get a Free Coding AuditCertified coders assigned by specialty, working from your documentation rather than your superbill, on every encounter.
Fast enough to keep your revenue cycle moving. Structured enough to catch the error before the claim leaves.
The coder reads the entire record, whether it arrives through your EHR, as a superbill or as clinical documentation sent directly. A coder who jumps to the diagnosis misses secondary conditions, complicating factors and procedures that are billable but never made it onto the superbill.
ICD-10-CM, CPT and HCPCS codes are assigned from the clinical documentation. Every diagnosis is linked to the procedure it supports, every modifier is applied only after the underlying service is verified in the note, and every combination is cross-checked against NCCI edits, MUEs and the Excludes1 and Excludes2 conventions.
If the record does not support the code, the coder raises a specific, non-leading query identifying what is missing and which code it affects. The encounter does not move forward on an assumption and it does not get downcoded without the provider knowing.
Where a payer publishes a reimbursement policy that differs from AMA CPT guidance, the payer policy is applied for payment purposes and the difference is documented on the encounter. This protects the claim and creates the record you need if the coding is ever questioned.
Every completed encounter is reviewed before it moves to billing. Diagnoses checked against procedures, modifiers verified against payer and specialty rules, global period days confirmed on any surgical encounter. This step is not optional and it is not sampled.
The encounter goes to billing with codes, modifiers and documentation linkage already established. If a payer later denies and asks for clinical justification, the coding rationale is already on file and nothing has to be reconstructed after the fact.
When CMS or the AMA publishes a change, it is verified through the primary source and applied to active accounts rather than held for a quarterly training cycle. Clients are notified so your team is not surprised by a policy change that already affected a submission.
The specialties with the highest denial rates usually share one cause: the coding was done by whoever was free, not by someone trained in it. We assign coders by specialty, so your orthopedic charts are not coded by someone who spent the morning on behavioral health.
Global surgical period modifier management across 58, 78 and 79, per-level spinal add-on code stacking, implant coding and laterality on every procedure.
Catheterization and electrophysiology component coding, device monitoring intervals, and the NCCI bundling edits that fire when E/M and a procedure are billed on the same day.
Time-based psychotherapy code selection, same-day E/M add-on pairing, interactive complexity, and the session and authorization limits that differ by carve-out plan.
Chemotherapy and infusion administration hierarchy, initial versus sequential versus concurrent sequencing, J-code units and drug wastage documentation.
Professional and technical component splits, contrast versus non-contrast documentation, and place of service accuracy on remote reads.
The screening versus diagnostic distinction on the same procedure, modifier PT application, and anesthesia pairing rules by payer.
Lesion excision coded by size and site measured before removal, repair classification, Mohs staging, and the cosmetic versus medically necessary boundary.
Base units, time unit calculation, medical direction ratios and concurrency, plus the qualifying circumstances and physical status modifiers that are routinely omitted.
Place of service accuracy, S codes where the payer recognizes them, after-hours coding, and the procedures performed during a visit that get folded into the E/M by default.
Global maternity package inclusions, antepartum visit counting, delivery-only and postpartum-only scenarios when care transfers, and gynecologic surgical bundling.
Routine foot care exclusions, Q7 to Q9 class findings, LOPS documentation, and the modifier 25 and LT/RT combinations that drive podiatry denials.
HCPCS Level II assignment, RR, NU and KX modifier logic, capped rental month tracking and the documentation a payer requires before delivery rather than after.
Do not see your specialty? We likely code for it. Raise it during the audit.
See all specialties
Coding accuracy is a number most vendors quote and few define. These are the measures we actually report, and what each one is for.
| Measure | What it means | Why it matters |
|---|---|---|
| Coding accuracy rate | The share of audited encounters where every code, modifier and linkage was correct against the documentation | This is the headline number. Ask any vendor how theirs is calculated and on what sample size. |
| Inter-rater reliability | Agreement between two independent coders on the same chart | A high accuracy rate from a single reviewer proves consistency with themselves, not with the guideline. |
| Coding turnaround time | Time from documentation completion to release to billing | Every day here is a day added to days in A/R, before billing has touched the claim. |
| Discharged not final coded | Encounters complete clinically but still awaiting coding | A rising DNFC number is a coding backlog turning into an A/R problem two weeks before it shows up in A/R. |
| Query rate and query response time | How often documentation needs clarification, and how long providers take to respond | A rising query rate is a documentation pattern, not a coder problem. It is usually fixable with one conversation. |
| Denial rate attributable to coding | Denials traced to a code, modifier or linkage issue rather than eligibility or authorization | Separates what coding can fix from what it cannot. Most vendors never make this split. |
CONFIRM: Add target values once you can evidence them, for example a stated accuracy rate and the sample size it is measured on. Publishing an accuracy percentage without naming the sample and the audit method is the single most common unverifiable claim in this category.
Compliance is not a separate review step at the end. It is built into the coding workflow on every encounter, because a coding pattern is what an auditor finds, not a single claim.
Upcoding creates repayment and penalty exposure. Downcoding creates revenue loss and, in risk-adjusted arrangements, a panel that looks healthier than it is. Both are patterns an audit will find. We code to what the documentation supports, in both directions, and we query when it supports neither.
Whether it is a Recovery Audit Contractor review, Targeted Probe and Educate, a CERT sample or a commercial payer Additional Documentation Request, the coding rationale for every encounter we touched is already on file with the documentation that supports it. We assist with response preparation, identify what is defensible and what is not, and work the correctable claims still inside their appeal window.
CONFIRM: Confirm the scope of audit support: response preparation only, or representation. Do not imply legal representation. If MedAura will not support audit response, cut this H3 rather than softening it.
This is the conflict that costs practices the most and gets discussed the least. AMA CPT guidance describes how a code should be reported. A payer's reimbursement policy describes what that payer will pay for. When the two differ, the payer policy governs the payment, and quoting the CPT manual back at them does not change the remittance.
Our coders verify payer-specific rules through the official provider manual and published policy bulletins before coding, so claims are built around what the payer will actually reimburse rather than what the CPT book says in isolation. Where a conflict exists, it is documented on the encounter: which rule was applied, which source it came from, and why. That record is what protects you if the coding is ever questioned, and it is what tells you when a payer policy is worth disputing rather than absorbing.
Your charts are coded by credentialed coders assigned to your specialty, not by a shared queue that rotates through whatever arrives.
Credentials held across our coding and compliance team:
| Body | Credentials | Function |
|---|---|---|
| AAPC | CPC, COC, CIC, CRC, CPMA, CPCO, CDEO, CPB | Physician, outpatient facility, inpatient facility, risk adjustment, auditing, compliance, documentation and billing |
| AHIMA | RHIA, RHIT, CCS, CCS-P, CDIP | Health information management, hospital and physician-based coding, clinical documentation integrity |
| AMBA | CMRS | Medical reimbursement |
| NHA | CBCS | Billing and coding |
| HFMA | CRCR | Revenue cycle |
Credentials are applied to the function they belong to. Coding decisions are made by coders, audits by credentialed auditors, and risk adjustment work by coders credentialed for it. Continuing education is maintained on an active cycle, which is what keeps a credential current rather than historical.
CONFIRM: Cut every credential nobody on staff actually holds. This table is the highest-trust element on the page and also the easiest to disprove. One credential listed that no employee holds undermines the whole table.

No migration required. We code inside the system you already use, with the access level you grant, so your clinical documentation workflow does not change and your providers keep working the way they do now.
Systems we work in: {{EHR_LIST}}
Queries, flags and guideline notices are communicated through your practice management system in real time, so your team sees an open documentation issue while it is still open, not in a summary at the end of the week when the claim has already gone.
Medical coding is included at no additional charge in our full-cycle engagement, which is priced at 5% of monthly collections and covers eligibility, coding, submission, posting, denials, A/R and patient billing.
Standalone coding, for practices that keep billing in-house and want only the coding function outsourced, is priced {{CODING_PRICE}}. Coding audits and retrospective backlog reviews are scoped separately against volume.
What moves the rate: encounter volume, specialty mix, share of surgical or facility encounters, whether risk adjustment coding is included, and whether a backlog needs clearing at the start.
CONFIRM: Supply the standalone coding price and its unit: per encounter, per chart, per hour or per coder FTE. Per-encounter is the most common and the easiest for a buyer to compare, so use it unless there is a reason not to.
Before we work a single active chart for a new client, we audit what has already been coded. It costs nothing and the findings are yours whether you engage us or not.
Coding volume and complexity change what the right arrangement is.
Usually no dedicated coder at all, with providers coding their own encounters between patients. The risk is not volume, it is that nobody is checking the pattern.
Several specialties running at once, each with different rules. A generalist coder covering all of them will be accurate in one and approximate in the rest.
Operative note coding, global periods, multi-surgeon scenarios and implant coding, where a single missed component is material revenue per case.
Uncoded encounters accumulating behind a vacancy or a leave. Every one of them has a deadline attached and the shortest windows are rarely the ones at the top of the list.
Medicare Advantage, ACO and value-based arrangements where diagnosis specificity determines RAF score and attributed revenue, not just claim payment.
MedAura Medical Billing codes for practices in all 50 states from our office in Piscataway, New Jersey. Coding rules are national, set by the AMA, CMS and the ICD-10-CM guidelines, so the code sets do not change state to state. What does change is coverage: state Medicaid programs publish their own coverage and documentation policies, and Medicare Administrative Contractors issue Local Coverage Determinations that differ by jurisdiction. Both are configured at onboarding against the payers you actually bill.
The Free Coding Audit reviews a sample of your recent encounters against the documentation behind them and returns a written summary: accuracy findings, downcoding and upcoding patterns with the revenue impact of each, missed billable components, linkage and modifier errors, and a deadline-ordered map of anything still correctable. It costs nothing and obligates nothing.