Medical Code Auditing Software

Outpatient Auditing Software

OPPS


The OPPS (Facility Outpatient) auditing module is part of ReviewMate auditing suite and provides:

  • Accuracy rates for all elements including: APC, CPT/HCPCS, E&M, non-E&M, Modifier, Revenue Code, Service Units, Diagnosis, Discharge Disposition (optional), Procedure Provider, Procedure Date, and HCC
  • APC and fee schedule pricing and grouping
  • ICD-10-CM, ICD-10-PCS (optional) and CPT/HCPCS procedure code sets
  • Code look-up
  • Accuracy rates by Patient Type (observation, ED, Clinic, etc)
  • Ability to assign responsibility on the line-item level to obtain individualized accuracy rates for the different contributors to the UB-04 (coder, charge team, radiology, etc)
  • Full suite of references including Coding Clinic for HCPCS, CPT Assistant, Coding Clinic, Clinotes, Coders' Desk Reference and the AHA Coding Handbook
  • Support for Pro Fee audit within the OPPS module
  • Identification of line items that were recalculated as a result of another line item revision
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