VA/VHA RFQ: Medical Coding Services (Outpatient and Inpatient)

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…”

Read more here.

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