Specialities
Services
Resource Center
Pricing
About
Contact
Medical Coding and Audits That Protect Revenue on Both Sides
Coding errors cut revenue in two directions. Undercoding leaves reimbursement uncaptured. Overcoding creates compliance exposure and recoupment risk. MBC's AAPC-certified coders and systematic audit process eliminate both, across ICD-10, CPT, and HCPCS for 32+ specialty types.
What Coding Errors Actually Cost Your Practice
Coding inaccuracy is not a documentation problem. It is a revenue problem and a compliance problem simultaneously. The cost runs in both directions and accumulates silently until a denial pattern or a payer audit makes it visible.
Undercoding Suppresses Reimbursement Without Triggering Denials
Practices that habitually downcode E/M visits, miss billable secondary diagnoses, or fail to capture all performed procedures receive payment that is technically correct but systematically below what the documentation supports. Because the claim is paid and not denied, the pattern goes undetected for months or years.
Overcoding Creates Recoupment Exposure and Audit Risk
Upcoding, unbundling, and inappropriate modifier use generate short-term payment but create long-term liability. Payer post-payment audits and RAC reviews recover overpayments with interest, and patterns of overcoding can trigger OIG scrutiny that extends well beyond billing to the clinical documentation itself.
Annual Code Updates Introduce Errors Without Active Management
ICD-10-CM, CPT, and HCPCS code sets update annually. New codes are added, existing codes are revised, and deleted codes continue to appear in claims submitted by practices that have not updated their charge masters. Each cycle creates a fresh source of denial exposure that requires active monitoring to contain.
Specialty-Specific Coding Complexity Exceeds Generalist Capacity
Wound care debridement levels, orthopedic global surgery periods, ASC facility versus professional fee splits, and OB-GYN trimester-specific coding are not interchangeable knowledge. Generalist coders assigned to specialty billing produce coding patterns that are technically wrong in ways that compound over volume.
Coding Services and Audit Scope
MBC applies specialty-specific coding expertise at the point of charge entry and runs structured audits both prospectively before submission and retrospectively across historical billing to identify and correct coding patterns affecting reimbursement and compliance.
Specialty-Specific ICD-10 and CPT Code Assignment
AAPC-certified coders with discipline-specific training assign diagnosis and procedure codes from clinical documentation. Code selection reflects the full scope of services documented, including secondary diagnoses, complexity modifiers, and bundling rules specific to each payer and specialty.
Modifier Application and Bundling Compliance
Modifier use is validated against NCCI edits and payer-specific bundling policies before submission. Inappropriate modifier stacking and unbundling errors are identified at charge entry, preventing the denial and recoupment exposure they generate when they reach the payer.
Annual Code Set Updates and Charge Master Review
MBC monitors annual ICD-10-CM, CPT, and HCPCS updates and applies changes to the coding workflow before the effective date. Charge masters are reviewed for deleted codes, revised code descriptions, and new code opportunities that affect reimbursement for your specialty.
Backlog Coding Resolution and DRG Validation
Practices carrying uncoded encounter backlogs from staff turnover, system transitions, or volume surges receive structured backlog resolution with accurate code assignment across all pending encounters. Hospital and inpatient coding includes DRG validation to confirm that principal diagnosis selection and procedure coding yield the correct MS-DRG assignment.
Audit Scope: Prospective and Retrospective
All coding and audit work is performed or supervised by AAPC-certified professionals with specialty-specific coding credentials.
What Provider Groups Report After MBC Takes Over Coding and Audits
"Our retrospective audit identified that we had been consistently downcoding complex office visits for over two years. MBC's analysis showed we were using 99213 for encounters that clearly supported 99214 based on documented medical decision-making. Correcting the pattern going forward recovered approximately $180,000 in annualized revenue without a single additional patient visit."
"We had a UnitedHealthcare audit flag our orthopedic group for modifier 59 usage patterns. MBC conducted an internal review before we responded, identified the specific encounters with documentation gaps, and helped us prepare a structured response. The audit closed without recoupment. The prospective review they put in place afterward has kept us clean since."
"Our wound care practice relies on accurate debridement level coding for the bulk of our revenue. When our in-house coder left, we had 60 days of uncoded encounters. MBC resolved the backlog in 11 business days with specialty-certified coders who understood selective versus non-selective debridement distinctions. No encounters were miscoded and none were missed."
Coding and Audits: Frequently Asked Questions
Coding and Audits Within MBC's Complete Revenue Cycle
Ready to Fix What Your Coding Is Missing?
MBC's AAPC-certified coders and structured audit process identify undercoding, overcoding, and compliance gaps across your specialty. Speak with a revenue cycle specialist about a coding assessment for your practice.