Surgery/ IPDRG

Key Responsibilities:

Surgery Coding:

• Assign accurate ICD-10-CM and CPT codes for multi-specialty surgical procedures
• Apply modifiers, ensure correct sequencing, and adhere to NCCI edits
• Review operative reports and apply appropriate global periods and surgical packages
• Ensure coding is compliant with CMS, AHA Coding Clinic, and client policies

IPDRG Coding:

• Review inpatient medical records, assign ICD-10-CM & ICD-10-PCS codes
• Assign MS-DRGs or APR-DRGs using encoder tools
• Validate principal diagnosis, secondary conditions, POA indicators, and procedures
• Ensure documentation supports the assigned DRG and meets coding guidelines

Qualifications:

• Education: Degree in Life Sciences / Paramedical / Nursing / Allied Health
• Certifications: CPC, CCS, CIC (AHIMA or AAPC) – Mandatory
• Experience:
• 2–6 years in Surgical and/or Inpatient DRG coding
• Experience with 3M Encoder, Optum CAC, EPIC, Cerner (preferred)

Skills Required:

• Expert in ICD-10-CM, ICD-10-PCS, CPT, and HCPCS
• Strong knowledge of DRG grouping methodologies (MS-DRG/APR-DRG)
• Familiarity with coding guidelines, MCE edits, and query processes
• Attention to detail and ability to handle complex cases with minimal supervision
• Strong analytical, communication, and documentation skills