The key to clinically appropriate coding and claims management

The Medcodelink API is like a magnifying glass, finding what needs to be found in a very scientific, clinically appropriate way - it serves as a compass to appropriate coding from pre-authorisation level up to processing the doctor's account.

It also serves as a dynamic coding look-up tool to a coder tasked to code/assess correctly for a healthcare service submitted for authorisation/already provided.

• The API is a dynamic coding tool guiding the user to look up, code, verify and use surgical, medical and ultrasound codes according to the client’s unique requirements.

• The API provides a dynamic look-up facility for ICD-10 codes – it guides the user to finding the correct and valid ICD-10 code(s).

• The API links the clinically appropriate ICD-10 codes to each definitive (primary) Local and CPT® procedure code.

• Associated information such as add-on codes, valid and invalid modifiers and additional information pertaining to a specific Local or CPT® code, is instantly available.

• The API not only provides clinical verification edits to prevent unbundling of Local and CPT® codes and clinically correct assessment and validation of claims for healthcare services provided, but also guides the user in a coding environment to accurate and clinical correct utilisation of ICD-10 codes.

Instant availability of appropriate procedures for a specific PMB code ensures accurate management of PMB conditions and enhances the client’s capability of improving its PMB protocols.

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