Notice ID: 36C26021Q0835
“The main objective is to be compliant and adhere to coding and regulatory guidelines, VA/VHA directives and handbooks in order to validate services provided.”
“Contractor shall:
- …Perform remote coding on all inpatient admissions and outpatient visits assigned by VA Portland Health Care System (VAPORHCS).
- Provide all labor, equipment and supplies for coding medical records from VA Portland HCS.
- Access VA Portland’s VistA/CPRS system to read and code medical records identified by Portland and enters codes into the approved coding application.
- Perform the services following coding guidelines and appropriate references.
- Create reports, monitor coders and make recommendations.
- Code all cases no later than 7 days after receipt (outpatient) or 7 days after discharge date (inpatient)…”
- Priority cases that are assigned will be required to be coded within one day of receipt. Priority cases are normally assigned because of a backlog and are high dollar amounts or cases that need to be coded quickly…”
“Specific Tasks:
Outpatient Encounters including Radiology, Lab or other Ancillary Services
Contractor shall ensure that all coders working on this contract:
- Carefully access and review health record documentation for all outpatient cases as provided by VAPORHCS.
- Use VA required coding software.
- Assign current and appropriate ICD and CPT/HCPCS codes at a 95% accuracy rate and enter the codes into the appropriate screen for the individual health encounter.
- Adhere to all coding guidelines as approved by the Cooperating Parties and accepted VA regulations.
- When assigning multiple CPT codes, verify they are not components of a larger, more comprehensive procedure that can be described with a single code.
- Assign modifiers as appropriate to override Correct Coding Initiative edits…”
“Inpatient Admissions
Contractor shall ensure that all coders working on this contract:
- Carefully access and review health record for all inpatient admission cases provided by VAPORHCS.
- Use VA required coding software.
- Assign current and appropriate ICD and PCS codes at a 95% accuracy rate and enter the codes into the appropriate screens for each patient treatment file (PTF).
- Adhere to all coding guidelines as approved by the Cooperating Parties and accepted VA regulations.
- Assign all ICD codes that are considered as possible or that affect current treatment…”
