Medical Coding

๐Ÿ’Š AAPC-Certified ยท ICD-10 & CPT ยท 21+ Specialties

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AAPC Certified All coding staff
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24-Hr Turnaround Same-day review
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Audit-Ready Every code justified
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Free Audit First No obligation
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Medical Coding Services That Are Precise Enough to Survive Any Audit.

Professional ICD-10, CPT & HCPCS coding services for healthcare providers nationwide

One wrong code doesn’t just cause a denial โ€” it can trigger a payer audit, require repayment of previously collected claims, and create a compliance liability that takes months to resolve.ย Theiatrics’ AAPC-certified medical coding team assigns the most accurate, most defensible code for every encounterย โ€” maximizing your reimbursement while protecting your practice.

Optimize Operations for Maximum Efficiency

Contact us to explore how our consulting can position your business as a frontrunner.

UNDERSTANDING THE SERVICE

What Are Medical Coding Services
โ€” and Why Precision Matters More Than Speed

DEFINITION

Medical coding services translate clinical documentation โ€” physician notes, operative reports, lab results, and discharge summaries โ€” into standardized ICD-10-CM diagnosis codes, CPT procedure codes, and HCPCS Level II codes used by insurance payers to determine reimbursement. Every claim submitted to an insurer is built on a foundation of these codes.

The codes assigned to a patient encounter determine exactly how much your practice gets paid โ€” and whether the claim gets paid at all. A code that is too vague results in a lower reimbursement than you've earned. A code that doesn't match the documented diagnosis triggers an automatic denial. A code that consistently over-represents the severity of encounters flags your practice for a payer audit.

Accuracy isn't optional in medical coding โ€” it's the difference between collecting what you've earned and spending months in a compliance review. Our AAPC-certified coders bring specialty-specific expertise to every encounter, assigning the most accurate, most specific, and most defensible code supported by the clinical documentation.

Unlike generalist coders who rotate across specialties, our teams are permanently assigned to the specialty they know. The coder reviewing your gastroenterology encounters has coded GI procedures โ€” and nothing else โ€” for years. That depth of expertise is what produces a 99.1% coding accuracy rate and coding-related denial rates under 1.2%.

Optimize Operations for Maximum Efficiency

Contact us to explore how our consulting can position your business as a frontrunner.

WHAT WE CODE
Three Code Systems. One Team That Masters All of Them.
Every claim requires the precise use of three different coding systems working together. A mismatch between any of them โ€” even a correct code in the wrong context โ€” is enough to trigger a denial or a compliance flag.
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DIAGNOSIS CODING
ICD-10-CM Coding โ€” Why You Were Seen
ICD-10-CM codes describe the patient's condition โ€” every active diagnosis, comorbidity, and relevant history that affected the encounter. Selecting the most specific code available isn't just best practice. It's the difference between a clean claim and a denial for "unspecified diagnosis." We assign the correct code to the highest level of specificity every time.
  • K57.30 โ€” Diverticulosis NOS
  • E11.65 โ€” DM2 w/ Hyperglycemia
  • I25.10 โ€” Atherosclerotic IHD
  • M17.11 โ€” Primary OA, Knee
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PROCEDURE CODING
CPT & HCPCS Coding โ€” What Was Done
CPT codes describe the services and procedures performed. Assigning the right CPT code โ€” and the right level of that code โ€” requires clinical judgment and specialty knowledge that goes far beyond a fee schedule lookup. We capture every billable service, apply the correct modifiers, and ensure no procedure is undercoded or left unbilled because it wasn't on the superbill.
  • 99215 โ€” E/M Level 5
  • 45378 โ€” Colonoscopy DX
  • 93306 โ€” Echo w/Doppler
  • 27447 โ€” Total Knee Arthroplasty
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MODIFIER ASSIGNMENT
Modifiers โ€” Unlocking Additional Reimbursement
Modifiers are two-digit add-ons to CPT codes that tell payers something important about how a procedure was performed โ€” bilateral, repeat, assistant surgeon, distinct procedural service. Incorrect or missing modifiers are among the most expensive and preventable coding errors. They routinely cost practices thousands in denied additional reimbursement every month.
  • Mod-50 โ€” Bilateral
  • Mod-59 โ€” Distinct procedure
  • Mod-25 โ€” Significant E/M
  • Mod-26 โ€” Professional component
โ— THE REAL STAKES
Bad Medical Coding Doesn't Just Cost You a Claim. It Can Cost You Your Practice.

Most providers think about coding errors in terms of individual claim denials. The real risk is much larger. Systematic coding inaccuracies โ€” whether from overcoding, undercoding, or code-diagnosis mismatches โ€” can trigger payer audits, OIG investigations, and repayment demands that cover years of previously collected claims.

At the same time, consistent undercoding quietly drains revenue that you've legitimately earned โ€” often without your knowledge or your billing team's. Research shows the average practice undercodes by 7โ€“12% of its collectible revenue, simply because their coders assign conservative codes rather than the most specific and accurate ones the documentation supports.

Check My Coding Accuracy โ€” Free โ†’
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Undercoding โ€” Losing Revenue You've Already Earned
โ–ฒ 7โ€“12% of revenue lost silently by average practice

When a coder assigns a lower-level E/M code than the documentation supports โ€” or misses a billable procedure โ€” you simply collect less than you're owed. There's no denial. No report. The revenue just never materializes. Most practices that switch to professional medical coding services discover immediate, measurable revenue improvement from this one fix alone.

Payer Audits Triggered by Unusual Coding Patterns
โ–ฒ Payers run automated audits on billing outliers

Insurance payers use advanced data analytics to compare your coding patterns against specialty peers. If your E/M level distribution skews significantly higher than average, or if certain high-value codes appear at unusual frequency, your practice gets flagged โ€” triggering a pre-payment or post-payment audit that can result in repayment demands covering years of claims.

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Coding-Related Denials โ€” The Most Preventable Category
โ–ฒ 30โ€“40% of all denials trace back to coding errors

Diagnosis-to-procedure mismatches, non-covered diagnosis codes, invalid code combinations under NCCI edits, and missing modifier information are all coding-level denials. They're entirely preventable with the right expertise โ€” and our coding-related denial rate of under 1.2% proves that precise, specialty-specific coding eliminates most of this loss before a claim is ever submitted.

HOW IT WORKS
From Clinical Documentation to Claim-Ready Code in 24 Hours
Every encounter follows the same rigorous five-step coding process โ€” designed to capture every billable service, apply every appropriate modifier, and produce a code set that is both accurate and fully defensible to any payer or auditor.
1
Documentation Review
Complete clinical notes reviewed for coding clarity and completeness
2
Diagnosis Assignment
Most specific ICD-10-CM codes assigned for all active conditions
3
Procedure Coding
CPT, HCPCS, and modifiers applied for every billable service
4
Compliance Check
NCCI edits, LCD/NCD policies, and payer rules verified
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Claim-Ready Output
Code and documentation returned within 24 hours
01โ€“02
Documentation Review & Diagnosis Coding
Our coders receive every encounter note, operative report, or superbill and review all clinical content before assigning a single code. We identify every active condition documented in the encounter โ€” including comorbidities, complications, and relevant history โ€” and assign the most specific ICD-10-CM code available.
โ†’ All active diagnoses captured, maximum specificity
03โ€“04
Procedure Coding, Modifier Assignment & Compliance Verification
Every service performed is coded with the correct CPT or HCPCS code, at the correct level. Modifiers are applied systematically โ€” bilateral procedures, multiple surgeries, distinct services, and professional/technical components โ€” and verified against NCCI bundling edits, local and national coverage determinations, and payer-specific policies.
โ†’ Zero NCCI violations, every modifier justified
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24-Hour Return & Full Documentation
Coded encounters are returned to your billing workflow within 24 hours, with full coding rationale documented for every code assigned. If a payer ever questions a code choice, our documentation gives your team the clinical justification needed to respond immediately and effectively.
โ†’ 24-hour turnaround ยท Full rationale documented
21+ SPECIALTIES

Specialty-Specific Medical Coding โ€” Not One-Size-Fits-All

Gastroenterology coding requires deep knowledge of endoscopy bundling rules and polyp-removal add-on codes. Anesthesia coding uses a completely different time-unit model. Cardiology coding involves dozens of procedure-specific documentation requirements. A coder who handles all three is almost certainly doing all three poorly.

Every specialty we serve has its own dedicated coding team. They code your specialty exclusively โ€” which means they know your procedures, your payer quirks, and your most common coding challenges better than any generalist pool ever could.

Discuss Your Specialty โ†’
Donโ€™t see your specialty listed?

Weโ€™ve coded for over 30 distinct specialties. Call us and weโ€™ll confirm our experience and team availability for your specific practice type within 24 hours.

๐Ÿ“ž +1713-281-4490
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Gastroenterology
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Cardiology
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Anesthesia
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Pain Management
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Oncology
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Neurology
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Orthopedics
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Radiology
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Dermatology
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Family Medicine
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OB/GYN
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Mental Health
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Urology
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Podiatry
๐Ÿฉน
Wound Care
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Internal Medicine
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Skilled Nursing
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ASC
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Home Health
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Behavioral Health
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DME
WHY THEIATRICS

Why Professional Medical Coding Services Outperform In-House Every Time

In-house coders are often asked to handle multiple administrative functions in addition to coding. They may not specialize in your specific procedures.

Professional medical coding services bring dedicated specialists with ongoing credentialing, specialty-specific training, and access to the most current payer policies.

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AAPC-Certified Coders โ€” All Staff, Always Every coder on our team holds active AAPC or AHIMA certification.
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Specialty Exclusivity โ€” Your Coder Knows Only Your Specialty We donโ€™t rotate coders across specialties.
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Annual Code Updates Handled Automatically ICD-10 and CPT codes are updated every October.
Start With a Free Coding Audit โ†’
Capability โœ“ Theiatrics In-House / Generic
AAPC/AHIMA certified coders โœ“ All staff ~ Sometimes
Specialty-exclusive coding teams โœ“ Always โœ— Generalists
Annual code update management โœ“ Automatic ~ Manual / delayed
Coding accuracy rate โœ“ 99%+ ~ 85โ€“90% avg.
Coding-related denial rate โœ“ Under 1.2% โœ— 5โ€“15% typical
Audit-ready documentation โœ“ Every encounter ~ Inconsistent
24-hour turnaround โœ“ Guaranteed ~ Varies widely
No overhead / benefits cost โœ“ Service fee only โœ— Full employee cost
Free coding audit on start โœ“ Always included โœ— Not available
PROVEN RESULTS
What Accurate Medical Coding
Actually Delivers.
These numbers are quarterly averages across our active client base โ€” not cherry-picked case studies. We publish them because accuracy is only meaningful when it's verifiable.
99%
Coding accuracy rate verified by internal audit across all specialties
โ†’ vs. 85โ€“90% industry average
1.2%
Coding-related denial rate for our clients (industry avg: 30โ€“40% of all denials)
โ†’ Under 1.2% consistently
24hr
Average coding turnaround time from documentation receipt to claim-ready output
โ†’ Same-day for urgent
31%
Average collections increase within 90 days of switching to Theatrics coding
โ†’ Documented per client
โ˜…โ˜…โ˜…โ˜…โ˜…

We had no idea how much we were leaving on the table from conservative E/M coding. Theatrics reviewed our last six months of encounters and found we had undercoded on nearly 18% of them. Within the first quarter of switching, our collections were measurably higher โ€” and we hadnโ€™t changed a single clinical process.

18% of encounters were undercoded
Internal Medicine โ€“ Austin, TX
โ˜…โ˜…โ˜…โ˜…โ˜…

Gastroenterology coding is genuinely complex. Add-on codes, bundling rules, modifier requirements for multiple polyp removals โ€” our previous coder was getting most of it wrong because she coded everything from hospitals to dermatology. Theatricsโ€™ GI-specific team got it right from day one. Our denial rate dropped from over 14% to just over 2% within three months.

GI denial rate: 14% โ†’ 2.1%
Gastroenterology Practice โ€“ Houston, TX
โ˜…โ˜…โ˜…โ˜…โ˜…

I was worried about a payer audit because our billing had been inconsistent for years. Theatrics did a full coding audit before we started, corrected our historical patterns, and set up a compliant coding framework going forward. A year later, weโ€™ve had zero audit issues and our reimbursements are the most consistent theyโ€™ve ever been.

Zero audit issues after coding correction
Cardiology Group โ€“ Dallas, TX
COMMON QUESTIONS

Everything You Should Know About Professional Medical Coding Services

Straight answers to the questions every practice asks before entrusting their coding to an outside team โ€” including the ones most billing companies avoid.

Have a specific charge entry question? Our certified coding team responds to direct questions within 4 business hours. No generalist support staff โ€” you talk directly to a coder.

๐Ÿ“ž Call Our Charge Team
What are medical coding services and what do they include?
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Medical coding services translate clinical documentation into standardized codes used by insurance payers to determine reimbursement. A full-service coding team handles ICD-10-CM diagnosis coding, CPT procedure coding, HCPCS Level II coding, modifier assignment, E/M level determination, and coding compliance verification.

At Theiatrics, our coding service also includes a free initial coding audit, charge capture review, annual code update management, and full documentation of coding rationale for every encounter โ€” so your practice is always audit-ready.
What is the difference between ICD-10 coding and CPT coding?
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ICD-10-CM codes describe the patient's diagnosis โ€” the medical reason for the encounter (e.g., chest pain, Type 2 diabetes, essential hypertension). These codes tell the payer why the patient was seen.

CPT codes describe the procedure or service performed โ€” what the provider did during the encounter (e.g., office visit 99214, colonoscopy 45378, echocardiogram 93306). Both are required on every claim, and mismatched ICD-10 and CPT codes are among the most common triggers for claim denial.
Why do I need AAPC-certified medical coders rather than general billing staff?
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AAPC-certified coders (CPC, CCS, specialty-specific credentials) have passed rigorous knowledge exams and are required to complete 36 continuing education units per year to maintain their certification. This means they stay current with annual coding guideline changes, new code releases, payer-specific policy updates, and specialty-specific coding requirements.

General billing staff assigning codes from a fee schedule or superbill alone miss the coding nuances that cost practices thousands per month โ€” either from undercoding (leaving revenue behind) or from incorrect code combinations that trigger denials. Theiatrics uses only AAPC or AHIMA-certified coders, all assigned to specialties they know exclusively.
What is undercoding in medical billing and how much is it costing me?
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Undercoding means assigning a less specific or lower-level code than the clinical documentation actually supports. The most common example is coding a Level 3 office visit (99213) when the documentation โ€” the complexity of the medical decision-making, the time spent, or the history and examination โ€” clearly supports a Level 4 (99214) or Level 5 (99215).

Research shows the average practice undercodes on 7โ€“12% of encounters. For a practice doing $500,000 in annual collections, that represents $35,000 to $60,000 in uncollected revenue per year โ€” with no denials, no flags, and no indication from your billing reports that anything is wrong. A free coding audit from Theiatrics will show you exactly how much of this applies to your practice.
How can wrong medical codes trigger a payer audit?
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Insurance payers use sophisticated data analytics to compare your billing patterns against statistical norms for your specialty and region. If your E/M level distribution is significantly skewed higher than peers, if you consistently bill certain high-value procedures at unusual rates, or if your diagnosis-to-procedure ratios fall outside normal ranges, your practice gets flagged as a statistical outlier.

Once flagged, payers may initiate a prepayment review (holding payment pending documentation review), a post-payment audit (demanding repayment of previously collected claims), or โ€” in severe cases โ€” an OIG referral. Systematic coding inaccuracies can result in repayment demands covering multiple years of claims. Accurate, specialty-specific coding is the most effective audit prevention strategy available.
How long does it take to get coded encounters back?
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Our standard turnaround is 24 hours from receipt of complete clinical documentation. For urgent encounters โ€” same-day billing requirements, end-of-day batching deadlines, or priority cases โ€” we offer same-day turnaround. We integrate directly with your EHR so documentation is received and returned electronically, with no manual file transfers and no workflow disruption for your clinical staff.
What is a medical coding audit and should I get one?
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A medical coding audit is a systematic review of a practice's recently coded claims compared to the original clinical documentation โ€” checking whether the codes assigned accurately reflect what was documented and whether the documentation supports the reimbursement claimed.

If your practice has a denial rate above 5%, hasn't had a coding review in over 12 months, recently changed coding staff, or is concerned about audit risk, a coding audit is strongly recommended. Theiatrics provides a free coding accuracy audit for all new clients โ€” reviewing a sample of recent encounters and identifying specific coding errors, undercoding patterns, and compliance risks before we begin ongoing coding services.
Do your medical coding services work with my existing EHR?
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Yes. Theiatrics integrates directly with Epic, Cerner, Athenahealth, eClinicalWorks, Kareo, DrChrono, Greenway Health, Allscripts, NextGen, and 30+ additional EHR and practice management systems. Your clinical documentation workflow stays exactly the same โ€” we receive encounter notes electronically and return coded, claim-ready output without requiring your team to change any process or software.
FREE CODING ACCURACY AUDIT

Find Out Exactly How Much Your Coding Is Costing or Protecting You

Before we ask you to trust us with your coding, we'll show you what accurate, specialty-specific coding looks like applied to your own encounters. Our free audit reviews a sample of your recent claims, identifies undercoding patterns, flags compliance risks, and quantifies the revenue impact โ€” all before you make any decision.

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Real encounter review
โ€” your actual claims, not demo data
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Revenue impact quantified
โ€” exact dollar amount of undercoding found
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Compliance risks identified
โ€” audit triggers spotted before they're triggered
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Results within 24 hours
โ€” delivered by a certified coder, not a salesperson
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Zero cost, zero obligation
โ€” even if you don't proceed with our service
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