ESMSEF has over 40 years’ experience in providing coding and DRG validation services to providers and payors in all settings. Health records are reviewed by certified coders and board-certified physicians currently in active practice. Our certified coders are extensively trained and have many years of coding experience.
After reviewing all clinical documentation submitted for the case, ESMSEF will validate ICD-10-CM and ICD-10-PCS codes assigned, and validate the DRG based on the Grouper Version requested by the client. If the issue involves a clinical decision, a Board-Certified physician will be involved in the review. Nationally recognized coding guidelines are referenced and followed for all cases submitted for review.
Our organization has strict policies in place to guard against any conflict or perceived conflict of interest when assigning staff/physician specialists to a review. The Foundation is experienced in meeting stringent timeframes with respect to the coding and DRG validation process.