AAPC & AHIMA Certified Coders
Medical Coding Services That Are Always Accurate
ProvidaRCM's certified medical coders translate every patient encounter into the precise ICD-10, CPT, and HCPCS codes that maximize your reimbursement and keep your practice compliant, every time.
- HIPAA Compliant
- AAPC Certified
- No Long-Term Contracts
- All 50 US States
Coder Certifications
CPC
Certified Professional Coder
AAPC American Academy of Professional Coders
CCS
Certified Coding Specialist
AHIMA American Health Information Management
RHIT
Registered Health Info Technician
AHIMA credentialed health data management
COC
Certified Outpatient Coder
AAPC outpatient and facility coding
99.2%
Average coding accuracy rate across all specialties
What Medical Coding
Actually Does for You
Medical coding is the process of translating physician documentation, diagnoses, procedures, services, and supplies, into standardized alphanumeric codes that insurance payers use to process and pay claims.
Get the codes wrong and you face denials, underpayments, or worse, audit exposure. Get them right with ProvidaRCM and you capture every dollar your practice has earned, compliantly.
Revenue Optimization
Under-coding is as damaging as over-coding, just quieter. Our coders ensure every service, add-on code, and modifier is assigned to maximize your legitimate reimbursement.
Audit Protection
Incorrect coding is the leading trigger for payer audits and recoupment demands. Our certified coders document every coding decision, making your claims fully defensible.
Annual Code Updates
CPT codes update annually in January. ICD-10 updates in October. Our coders complete mandatory CEUs and are trained on every update before it takes effect, no grace period, no errors.
HCC Risk Adjustment
For practices with Medicare Advantage patients, capturing accurate Hierarchical Condition Category (HCC) codes directly impacts your per-member reimbursement. We code every relevant HCC.
ProvidaRCM Code Assignment Engine
E11.65
Type 2 diabetes mellitus with hyperglycemia (diagnosis code assigned from physician documentation)
99214
Office/outpatient E&M visit, established patient, moderate complexity (procedure code)
Level 4
Medical decision making: moderate complexity, 2+ chronic conditions reviewed
G0108
Diabetes outpatient self-management training, individual, per 30 min (supply/service code)
-25
Significant, separately identifiable E&M service on same day as procedure
Every Code System. Mastered.
Our coders are certified across all major medical code sets, ensuring complete and accurate coding for every encounter, every service, and every supply.
ICD-10-CM / ICD-10-PCS
Diagnosis Coding
International Classification of Diseases, 10th Revision
ICD-10-CM codes identify patient diagnoses and are required on every claim to establish medical necessity. With 70,000+ codes, precise code selection directly impacts claim approval and reimbursement levels. ICD-10-PCS is used for inpatient procedure coding.
STEMI involving other coronary artery
Vertebrogenic low back pain
Major depressive disorder, single episode
Type 2 diabetes with hyperglycemia
CPT Category I, II & III
Procedure Coding
Current Procedural Terminology AMA
Office visit, high complexity E&M
Echocardiography, complete transthoracic
Arthroscopy, knee, with meniscectomy
Psychotherapy, 60 minutes
ICD-10-CM / ICD-10-PCS
Supply & Service Coding
Healthcare Common Procedure Coding System
HCPCS Level II codes cover drugs, durable medical equipment, supplies, ambulance services, and other services not included in CPT. Many practices miss significant revenue by neglecting HCPCS codes, our coders capture every applicable code.
Betamethasone acetate injection
Annual wellness visit, initial
Blood glucose test strips, per 50
Graftjacket tissue matrix, per sq cm
E&M 2021+ AMA Guidelines
Evaluation & Management
Office & Outpatient E&M Level Selection
The 2021 AMA E&M guideline overhaul changed how office visit levels are determined, shifting from history/exam to medical decision making or total time. Our coders apply the current guidelines correctly, capturing the highest defensible E&M level every time.
New patient, straightforward MDM
Established patient, moderate MDM
Established patient, high complexity MDM
New patient, high complexity MDM
Everything Included in
Our Coding Service
One comprehensive coding service covering every code type, every specialty, and every audit risk, with zero add-on fees.
ICD-10 Diagnosis Coding
Accurate, complete diagnosis code assignment from physician documentation. We capture primary diagnoses, secondary conditions, complications, and HCC-relevant diagnoses that impact risk-adjusted reimbursement.
CPT Procedure Coding
Precise CPT code selection for all office visits, surgeries, procedures, diagnostic tests, and ancillary services, including add-on codes and Category III codes that many coders miss entirely.
HCPCS Level II Coding
Coding for DME, drugs, supplies, and services covered under HCPCS Level II. Many practices routinely miss HCPCS codes, our coders capture every applicable code and maximize your reimbursement.
Modifier Application
Appropriate modifier assignment is critical for correct reimbursement and NCCI compliance. We apply modifiers -25, -26, -TC, -50, -59, -LT, -RT, -79, and all specialty-specific modifiers correctly every time.
E&M Level Selection
Precise E&M level assignment using 2021+ AMA guidelines, medical decision making and time-based coding. We audit your current E&M distribution to identify under-coded encounters and improve documentation.
Coding Audits & Education
Prospective and retrospective coding audits to identify gaps, correct patterns, and educate your clinical team. We provide provider-specific feedback reports and documentation improvement guidance.
Specialty-Specific Coding
For Every Field
Every specialty has unique coding rules, bundling requirements, and payer policies. Click a specialty to see how deep our coding expertise goes.
Cardiology Coding
Invasive, non-invasive, electrophysiology, and interventional cardiology procedures require precise coding with strict bundling rule compliance.
Key CPT Codes We Assign
93000
Coding Challenges We Solve
- Cardiac cath bundling rules, separating angiography from intervention codes correctly
- Professional vs. technical component splitting for echo and stress testing
- EP study code sequences, ablation, mapping, and 3D electroanatomic add-ons
- Remote cardiac monitoring coding (99091, 99457, 99458) consistently missed
- TAVR and structural heart procedure coding with correct modifier application
Orthopedic Surgery Coding
Joint replacement, fracture care, arthroscopy, and spine surgery coding with precise global period management and modifier application.
Key CPT Codes We Assign
27447
Coding Challenges We Solve
- 90-day global period management, tracking all post-op visits within the global
- Bilateral procedure coding with modifier -50 vs. two separate line items
- Workers' compensation orthopedic billing with state-specific fee schedules
- NCCI edit compliance for concurrent procedures in the same operative session
- Distinguishing staged vs. same-session procedures for separate coding
Psychiatry & Behavioral Health Coding
Psychotherapy, medication management, and behavioral health service coding with add-on code and mental health parity compliance.
Key CPT Codes We Assign
90837
Coding Challenges We Solve
- Split-bill psychotherapy + E&M rules, when to code separately vs. together
- Add-on code 90833/90836/90838 application for combined E&M + therapy visits
- Mental health parity compliance, ensuring commercial payer benefit parity
- Collaborative care model (CoCM) coding under 99492, 99493, 99494
- Telehealth behavioral health coding under permanent post-COVID rules
Emergency Medicine Coding
High-volume ED billing with critical care coding, facility vs. professional fee management, and trauma coding requires specialized expertise.
Key CPT Codes We Assign
99285
Coding Challenges We Solve
- ED E&M level assignment, medical decision making in unscheduled acute care settings
- Critical care time documentation, 30-minute threshold and add-on code 99292
- Observation vs. inpatient admission coding, when 8-hour rule applies
- Trauma activation coding, facility vs. professional component billing
- Concurrent care rules when ED physician and specialist both bill same date
How Our Coding Process Works
A rigorous 4-step coding workflow designed for accuracy, speed, and compliance.
1
2
3
4
Chart Review
We receive your clinical documentation, office notes, operative reports, or dictations, and assign a certified coder with expertise in your specialty.
Code Assignment
All ICD-10, CPT, HCPCS, and modifier codes are assigned based strictly on the documented encounter, with complete coding rationale recorded.
Quality Review
A second coder reviews all assigned codes for accuracy, NCCI compliance, and LCD/NCD coverage requirements before they are released for billing.
Claim Release
Coded encounters are released to the billing team within 48 hours (24h STAT). Provider feedback reports are generated monthly for documentation improvement.
What Our Clients Say
Real results from real healthcare providers across the United States.
Medical Coding FAQs
Everything you need to know about outsourcing your medical coding to ProvidaRCM. Don't see your question? Contact us directly.
Still have questions?
Our coding specialists are available to answer. We respond to all inquiries within one business day.
Medical coding is the process of assigning standardized codes (ICD-10, CPT, HCPCS) to a patient’s diagnoses and procedures based on clinical documentation. Medical billing is the process of submitting those coded claims to insurance payers and following up until payment is received. Coding happens first, accurate coding is the foundation of successful billing.
Our coders hold active certifications from AAPC (American Academy of Professional Coders) and AHIMA (American Health Information Management Association), including CPC (Certified Professional Coder), CCS (Certified Coding Specialist), RHIT (Registered Health Information Technician), and specialty-specific certifications including CPC-P for pathology, CRC for risk adjustment, and COC for outpatient facility coding.
Our standard coding turnaround is within 48 hours of receiving complete documentation. For STAT requests, such as same-day surgical cases or time-sensitive procedures, we offer a 24-hour turnaround. Volume-based agreements can provide even faster turnarounds for high-volume practices.
ProvidaRCM provides full audit response support. Our coders document the rationale for every code assigned, making your claims fully defensible. If a payer requests documentation for any claim we coded, we prepare the response package, pull the supporting documentation, and handle the audit communication on your behalf, at no additional charge.
Yes. ProvidaRCM provides coding for outpatient physician practices (professional fee coding using CPT/ICD-10-CM), outpatient hospital and ASC facilities (using APC grouping and HCPCS), and inpatient hospital coding (ICD-10-PCS procedure coding and DRG assignment). Our coders are trained in the specific code sets and rules applicable to each setting.
Yes, and this is one of the highest-value services we provide. Our coders generate monthly provider-specific feedback reports showing documentation gaps, under-coded encounter patterns, and specific documentation improvements that would support higher E&M levels or capture additional codes. We also offer on-site or virtual provider education sessions. Most practices see E&M revenue increase within 60 days of implementing our documentation recommendations.