Coding Analysis & Assessments

Reimbursement Coding

Reimbursement coding represents the link between what a provider does for a patient and how that provider is reimbursed by government and private payors for services rendered.

MCRA’s team of coding, coverage, and reimbursement experts can help your company understand how the current coding systems impact your technology or procedure, what challenges providers may face, and opportunities to better define your technology or procedure in the future.

Understanding Current Codes and Their Impact

  • Coding Analysis & Landscape Assessment:
    • Examine the Current Reimbursement Coding Pathways
    • Identify Reimbursement Challenges or Opportunities for the Product or Procedure
    • Explain How Current Reimbursement Codes Will Impact Product or Procedure Adoption

Strategizing for the Future

  • Strategic Reimbursement Coding Plans:
    • Incorporate Findings from the Coding Analysis/Assessment
    • Identify Options for Addressing Coding Deficiencies
    • Develop a Comprehensive Strategy to Secure Appropriate Coding Options
  • New Procedure Reimbursement Code Development – CPT, ICD-10-PCS:
    • Develop New Code Applications
    • Identify the Reimbursement Code Description
    • Identify Supporting Clinical Literature
    • Work with Specialty Societies to Gain Consensus
    • Identify Potential Stakeholder Questions or Objections
    • Submit New Reimbursement Code Request
  • New Product Code Development - HCPCS:
    • Develop New Code Applications
    • Identify the Reimbursement Code Description
    • Identify Supporting Clinical Literature
    • Work with Specialty Societies to Gain Consensus
    • Work with Payors to Gain Support
    • Submit New Reimbursement Code Request
  • Current Procedure Reimbursement Code Revision:
    • Identify the Change Needed to Include the Procedure
    • Work with Specialty Societies to Gain Consensus
    • Identify Potential Stakeholder Questions or Objections
    • Develop and Submit the Revised Reimbursement Code Request
  • Technology and Add-On Payment:
    • Secure Product-Specific Coding (HCPCS Codes)
    • Develop and Submit Medicare New Technology Add-On Requests
    • Perform Analyses to Determine Appropriate APC Assignment
View Contact
Timothy Hunter

Timothy Hunter

Vice President, Health Economics, Reimbursement & Public Policy