The Single-Path ED Coder is responsible for accurate and compliant coding of both facility and professional (profee) services for Emergency Department encounters under the single-path coding methodology. This role ensures that all ED visits are coded comprehensively in one workflow, assigning diagnoses, procedures, and evaluation & management (E/M) levels following regulatory and payer guidelines.
Coding & Documentation Review
- Review ED provider documentation, nursing notes, diagnostics, medications, treatments, and interventions for coding completeness.
- Assign facility and profee ICD-10-CM diagnosis codes, CPT/HCPCS procedure codes, and E/M codes using single-path workflows.
- Apply coding guidelines from CMS, AMA, AHA, AAPC, and facility policies.
Compliance & Quality
- Ensure coding accuracy, completeness, and timely submission to support optimal reimbursement and reduce denials.
- Follow all federal and state regulations including NCCI edits, CCI bundling rules, and payer-specific policies.
- Participate in audits and implement corrective actions as advised by the QA team.
ED-Specific Expertise
- Understand ED workflows, high-acuity documentation, trauma coding, and critical care coding.
- Identify missing or unclear documentation and initiate physician queries when needed.
- Code for both ED Facility and Profee
Productivity & Turnaround
- Meet or exceed organizational productivity standards for ED single-path coding.
- Maintain required turnaround time (TAT) for coding completion.
Required Qualifications:
- Certification: CPC, CCS, CCS-P, or equivalent (mandatory).
- Minimum 2–3 years of ED professional and facility coding experience
- Strong knowledge of:
o ICD-10-CM
o CPT/HCPCS
o ED facility and Profee E/M leveling
o Critical care and procedural coding
- Working knowledge of EHR systems (e.g., Epic, Cerner, Meditech).
