CPT and billing review
Specialty-specific coding checklist with commonly missed codes, modifier traps, and a 30-day fix list.
What you'll get
7–12 under-coded CPT codes for your specialty, each with an annual recovery estimate ($)
Assumes: Recovery = (industry-typical billing rate − your reported rate) × your reported encounter volume × current reimbursement; conservative side of the range.
Per-code documentation requirements + EHR macro suggestions to support proper billing
Assumes: Macro syntax shown for Epic, Athena, eClinicalWorks, and DrChrono; adapt for other EHRs manually.
Modifier + coverage matrix for the 4 largest national payers (Medicare, BCBS, UHC, Aetna)
Assumes: Based on 2024 published policies; regional BCBS plans may vary — flagged where they typically do.
30-day action plan: which 3 codes to fix first and the exact biller hand-off script
Assumes: Prioritized by recovery $ × ease-of-fix; assumes you have a biller (in-house or service) who can implement.
AMA CPT descriptor + payer policy citation for every recommendation
Assumes: So your biller or compliance officer can verify every claim before changing workflow — no black boxes.
Sample output
We identified 7 codes your specialty typically under-bills. Estimated recovery: $58K/year at your visit volume.
Who this is for
- Practices that haven't had a coding audit in 12+ months
- Owners suspecting their billing service is leaving codes on the table
- Clinics adding new services without a coding refresh
Not the right fit if
- Practices that completed a formal coding audit in the last 6 months
- Hospital-employed providers (billing is handled by the system)
How we build it
- 1We compare your specialty's common visit mix against your reported coding patterns to surface under-coded categories.
- 2Recovery estimates are intentionally conservative — we use your reported visit volume, not aspirational growth.
- 3Every recommendation cites the AMA CPT descriptor and major-payer policy reference so your biller can verify.
What we'll ask in intake
- Specialty and provider count
- Approximate annual encounter volume
- Top 5 CPT codes you currently bill (rough is fine)
- Whether you use an in-house biller or external service
No PHI required. Aggregates, percentages, and estimates are enough.
Frequently asked questions
7 questionsDidn't answer your question? Email us — we reply within 4 business hours.