Services

ZHealth Consulting offers a broad range of consulting services to assist in the coding and billing of interventional radiology, cardiovascular, and endovascular procedures. Our scope of services range from standard chargemaster reviews, to advanced coding audits and complex medical necessity reviews. Our goal is to assist providers with billing services performed in compliance with Medicare guidelines.

Coding Audit

ZHealth’s coding audits provide a comprehensive review of your most challenging outpatient CPT coding cases in our specialty areas. Our physician coding experts determine accuracy of your billed CPT codes.

o A review of physician documentation to determine the accuracy of your billed CPT codes
o A formal on-site presentation of findings and recommendations by a ZHealth physician
o A 3-4 hour education session for coding and billing staff (CEU credits for attendees)

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Outsourced Coding

ZHealth’s outsourced coding provides a reliable coding solution for your most challenging outpatient cases in our specialty areas. Our physician coding experts exclusively code these complex procedures.

o Physician coders review procedure documentation and assign appropriate CPT codes
o Detailed reports provided for each case
o Reports may be used as an educational resource for your coding staff

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On-Site Education

Customized educational sessions for your coding and billing staff in our complex coding areas, led by Dr. Zielske, a physician and coding expert.

o Case reviews enable Dr. Z to tailor the education to your facility’s specific needs
o CEU credits for unlimited attendees
o Physician peer-to-peer documentation education, including ICD-10 readiness

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Ongoing Education (ESIP)

The ESIP program continually identifies coding issues, provides on-going education, and increases your confidence in coding and charging interventional radiology, cardiovascular, and endovascular surgical procedures.

o Coding Reviews (pre/post bill)
o Education (Webinars, Seminars, Customized Newsletters, Books, Charts, etc.)
o Quarterly physician teleconferences

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Medical Necessity Review

ZHealth’s medical necessity reviews determine a facility’s accuracy and risk associated with the billing of certain medical procedures based on the evaluation of Procedure Medical Necessity, Inpatient Medical Necessity, and Imaging-based Medical Necessity. Stay compliant in this high-risk area targeted by the OIG, RAC auditors, and Medicare.

o A review of physician documentation to determine medical necessity
o A comprehensive report, detailing all recommendations
o A formal presentation of findings and recommendations by a ZHealth physician either on-site or by phone

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Best Practices Program

ZHealth’s Best Practices Program evaluates your revenue process and charge tools and then provides an action plan to facilitate correct coding and charging. In this area known for high billing errors, stay compliant and achieve appropriate reimbursement.

o On-site review of the current revenue cycle and all charge tools
o Creation of a Single Point of Accountability Team to ensure correct charging and reimbursement
o A formal presentation of findings with a comprehensive report, detailing all recommendations
o Educational support through on-site sessions by ZHealth coding experts and a maintenance program (ESIP)

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Chargemaster Review

Due to continually changing nature of CPT/HCPCS codes, constant monitoring and updating of your chargemaster is required. ZHealth’s Chargemaster Review analyzes your CDM to verify accuracy and completeness.

o Audit of each existing line item to verify that it is current, active, and correct
o Staff interviews to verify code usage
o Detailed report, including recommended revisions, additions, and deactivations for your chargemaster

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ICD-10

To accurately code ICD-10-CM and ICD-10-PCS cases, advanced education is needed for physicians as well as coding staff. ZHealth offers several services to accommodate these educational needs:

o ICD-10 Readiness – Review of physician documentation for ICD-10 specificity requirements
o On-site Education – ZHealth physicians and ICD-10 trainers provide on-site education for documentation, anatomy/physiology, & ICD-10 code applications

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