Coding and Compliance Services
Healthcare coding and compliance services help organizations maintain accurate documentation, meet regulatory requirements, and protect revenue integrity. For physician practices, hospitals, and healthcare organizations navigating Medicare and Medicaid rules, even small gaps in coding or documentation can lead to audits, denied claims, or compliance exposure.
LBMC assists healthcare providers in building and maintaining effective coding and compliance programs grounded in real-world operations. Our professionals bring hands-on field experience, nationally recognized credentials, and deep knowledge of federal healthcare regulations. We focus on practical guidance that strengthens compliance, supports accurate reimbursement, and helps organizations operate with confidence.
How Coding and Compliance Services Work in Practice
Coding and compliance engagements are structured to provide clarity, reduce risk, and support sustainable improvement without disrupting daily operations. The focus is on understanding where you are today, identifying what matters most, and helping you move forward with confidence.
- Discovery and current-state review: We start by understanding how documentation, coding, billing, and compliance functions operate today, including workflows, policies, and regulatory exposure.
- Coding and compliance assessment: Our team conducts targeted coding, billing, and compliance reviews to identify gaps, risks, and opportunities for improvement.
- Prioritization and remediation roadmap: Findings are organized into a clear, actionable roadmap based on regulatory risk, financial impact, and operational realities.
- Advisory support and education: We provide guidance, training, and remediation support to help address identified issues and strengthen internal processes.
- Ongoing analytics and monitoring: Many organizations engage us for continued analytics and advisory support, allowing compliance efforts to evolve alongside regulatory changes and business growth.
Why Healthcare Organizations Seek Coding and Compliance Support
Healthcare organizations often turn to coding and compliance services when regulatory pressure, audit activity, or revenue concerns begin to strain internal teams. These engagements are typically driven by operational realities rather than theoretical risk.
Common reasons organizations seek coding and compliance support include:
- Audit notices or increased payer scrutiny
- Documentation gaps affecting reimbursement accuracy
- Complexity around E/M coding and time-based rules
- Medicare and Medicaid compliance requirements
- HIPAA privacy and security concerns
- Limited internal compliance resources or expertise
- The need for independent, defensible reviews
Coding and compliance services help organizations reduce uncertainty, strengthen controls, and address issues before they escalate into larger compliance or financial challenges.
Questions About Coding and Compliance Services?
If you’re navigating audits, documentation challenges, or compliance requirements, our team can help you understand your options and identify next steps.
LBMC Coding and Compliance Services
LBMC delivers comprehensive coding and compliance services that combine audit, advisory, and analytics capabilities. Our approach is designed to support both immediate compliance needs and long-term program effectiveness.
Compliance and Program Support
- Compliance program development and implementation
- Compliance plan audits and gap analysis
- HIPAA privacy and security audits
- Independent Review Organization (IRO) services
Coding and Documentation Reviews
- Inpatient and outpatient coding reviews, including CPT, HCPCS, and ICD-10
- Medical necessity reviews to support appropriate reimbursement
Audit Defense and Regulatory Support
- ZPIC audit support
- Independent audit and compliance review services
Education and Analytics
- Coding and billing education and training
- HealthLine Compliance Analytics Suite for ongoing monitoring and insight
Our services are designed to work together, helping organizations reduce audit fatigue, strengthen compliance efforts, and support revenue cycle management.
Local Expertise, Wherever You Are
With offices in Chattanooga, Memphis, Louisville, Nashville, Knoxville and Charlotte, plus remote offices, LBMC partners with businesses across the region and beyond.
Why Choose LBMC for Coding and Compliance?
LBMC combines healthcare-focused expertise with a practical, advisory-driven approach to coding and compliance.
- Healthcare compliance professionals with nationally recognized credentials
- Extensive Medicare and Medicaid regulatory experience
- Integrated audit, compliance, advisory, and analytics support
- Practical recommendations grounded in real-world provider operations
- Flexible engagement models, from targeted reviews to ongoing advisory
Our goal is to help organizations strengthen compliance while supporting accurate documentation and sustainable financial performance.
If you’re navigating coding, documentation, or compliance challenges, our healthcare advisors can help you prioritize next steps with clarity. Start with a conversation focused on your risks, reimbursement goals, and operational realities.
Types of Healthcare Organizations We Support
LBMC works with a broad range of healthcare organizations, with a strong focus on physician practices while maintaining deep experience across the care continuum.
- Independent and employed physician practices
- Hospitals and health systems
- Academic medical centers
- Specialty clinics and outpatient providers
- Ambulatory Surgery Centers
Our team understands the unique regulatory and operational challenges each organization type faces and tailors guidance accordingly.
Whether you’re assessing risk, preparing for compliance, or strengthening your security program, LBMC can help you move forward with clarity and confidence. Start with a conversation focused on what matters most to your organization.
FAQs About Coding and Compliance Services
What do coding and compliance services include?
Coding and compliance services include coding audits, documentation reviews, compliance program assessments, regulatory support, education, and ongoing monitoring. These services help ensure healthcare organizations meet regulatory requirements while supporting accurate reimbursement.
When should a healthcare organization seek coding and compliance support?
Organizations often seek support when facing audits, payer scrutiny, documentation challenges, regulatory changes, or limited internal compliance resources.
How do coding audits support revenue cycle management?
Coding audits help identify documentation gaps, coding errors, and compliance risks that can affect reimbursement, denials, and audit exposure.
How does LBMC support audit defense?
LBMC provides independent reviews, ZPIC audit support, and advisory guidance to help organizations respond to audits with confidence and clarity.
How do I get started with coding and compliance services?
The first step is a conversation to understand your organization’s needs, risks, and priorities. From there, our team recommends a tailored approach.
Leadership Team
