Coding compliance software for people who code, not committees
Coding compliance software checks the codes you assign against the rules that govern them, before the claim is submitted rather than after it is denied. Medical Coding & Billing Pro checks every diagnosis set for Excludes1 conflicts, unfinished codes, and sequencing violations, and checks each code against the Medicare coverage policy for your state — and it shows you the government's own words for every rule it applies.
Or don’t take our word for it — paste a claim into the free scrubber and see what it finds. No signup.
The rules are published. Nobody surfaces them at the moment you need them.
Every rule we check is in the ICD-10-CM tabular list or a CMS coverage policy — public, free, and sitting in a PDF nobody opens mid-claim. The compliance failure is almost never that the coder did not know the rule existed. It is that the rule lives three tabs away and the claim is due. So we bring the rule to the claim: paste the diagnosis set, and every conflict comes back with the CMS sentence that makes it a conflict.
Excludes1 is the rule that costs you money
Excludes1 means two conditions can never be coded together. It is the most common ICD-10 denial there is, and it is invisible — the conflict lives in a note attached to one code and references another. We check every pair in your diagnosis set against every Excludes1 note, resolve the code families the notes actually reference, and tell you which two codes collide and why.
Medical necessity, by your state, updated weekly
Whether a diagnosis supports a service is decided by the Medicare Administrative Contractor for your jurisdiction, and it genuinely differs — E11.9 has thirteen applicable policy documents in Texas and eleven in Ohio. We reload the CMS Coverage Database every week and show you the release date on the screen, because stale policy data is the loudest documented complaint about the tools that cost twice this much.
Every finding cites its source
A compliance tool that says 'this is wrong' without saying why gets switched off the first time it is wrong. Ours quotes the ICD-10-CM note or names the coverage policy behind every single finding, so you can check our work — and so you can defend the code you chose when somebody asks.
What this is not
This is not an enterprise compliance-programme platform. There is no audit-committee dashboard, no policy-attestation workflow, and no consultant attached. It is a tool for the person actually assigning the codes.
We would rather lose the click than sell you a trial that disappoints you on the first afternoon.
Questions
- What does coding compliance software actually check?
- At minimum it should check that the codes you assigned are valid and complete, that they do not conflict with each other, that any sequencing instructions are satisfied, and that the diagnosis supports medical necessity for the payer. Medical Coding & Billing Pro does all four for ICD-10-CM and Medicare coverage policy.
- Does it check NCCI edits?
- Not yet. NCCI edits are procedure-to-procedure and the CMS files carry CPT codes, which require an AMA licence we do not hold. NCCI and MUE checking ship together with CPT support once that licence is in place. We are telling you plainly rather than implying otherwise.
- How current is the coverage data?
- We reload the CMS Medicare Coverage Database weekly, the day after CMS refreshes it, and every screen that shows you coverage data also shows you the release it came from.
It is all one product
There are no modules and no tiers. Everything below is the same $390.
Try it on a claim you already coded.
Paste a diagnosis set you submitted last week and see what comes back. That is the fastest way to find out whether this is worth anything to you.
$390/yr flat · 7-day free trial · no card required