Coding

Compliant Codes from
Clinical Documentation

ICD-10-CM coding that follows current guidelines, validates face-to-face encounters, and flags discrepancies before they become denials.

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app.nestmed.com/coding/diagnosis/patient/28471VisitsQA ReviewCodingBillingRESOURCESPatientsDiagnosis CodingHelen Martinez · 01/15/2026 - 03/15/2026 · Day 1 of 60 · Sunrise Home Health2 Docs1 AudioF2FACTIVE (2)I50.9Heart failure, unspecifiedE11.65Type 2 diabetes w/ hyperglycemiaNEEDS REVIEW (5)Z48.89Encounter for surgical aftercareStrongR33.9Retention of urine, unspecifiedN99.3Prolapse of vaginal vault...I13.0Hyp hrt & chr kdny dis w hrt...N18.9Chronic kidney disease, unsp✕ REJECTED (1)Z48.89Encounter for other specified surgical aftercareNeeds reviewAcceptRefineRejectPhysician order foundDiagnosis supported by documentation"...post surgery related to RETENTION..."EVIDENCEStrong matchPatient is receiving home health services forpost-surgical monitoring following...H&P"...planned colpectomy, levator myorrhaphy..."NOTE DETAILS"COLPOCLEISIS LEVATOR MYORRHAPHY..."VISIT TRANSCRIPT"She had a hysterectomy. She had her..."Automatically suggested based on visit documentation
Source DocumentsReferral.pdfH&P.pdf3 evidence extractions • 2 strong matches
Works for both insourced and outsourced coding teams. Contact us to learn more.
Performance Metrics
100%

Guideline Compliant

Every code follows current ICD-10-CM Official Guidelines and sequencing rules.

3x

Faster Coding

Reduce coding turnaround from days to hours with AI-assisted workflows.

22%

Fewer Denials

Catch specificity gaps and documentation mismatches before claim submission.

AI-Powered Coding

Built for Compliance

Face-to-Face Review

Admission packets reviewed in seconds. Nestmed analyzes face-to-face encounter documentation against certification requirements. Invalid F2F encounters are flagged immediately so you can contact the certifying physician before the claim is submitted.

Admission Packet
Analyzing...
Physician Certification
Signed 01/15/2024
Homebound Status
Documented
F2F Encounter Date
Within 90 days
Skilled Need
Missing documentation
Primary Diagnosis
Confirmed
Review Status
Valid0
Flagged0
Action Required
Contact physician

Ensure F2F matches focus of care.

When the focus of care documented in the face-to-face differs from what's conducted in the start of care visit, Nestmed flags the discrepancy. Misaligned diagnoses get caught at intake, not at audit.

Face-to-Face
Focus of Care
I50.9
Heart failure
Comparing
Start of Care
Primary Diagnosis
I50.9
Heart failure
Focus of care mismatch detected

F2F documents Low back pain, but SOC visit shows Hip fracture

Focus of care aligned

Always coding to the latest guidelines.

ICD-10-CM updates quarterly. Nestmed stays current with Official Coding Guidelines, sequencing rules, and code-specific instructions. Coding follows the rules as published, not outdated references.

Official Guidelines
ICD-10-CM FY2024
Coding Rules Applied
Sequencing: Principal diagnosis first
Specificity: Code to highest level
Manifestation codes: Use dual coding
Excludes1: Never code together
Latest Updates
FY2024 Q4
new
T50.911A
revised
F32.A
FY2024 Q3
new
U09.9
deleted
R05
Auto-updated quarterly

Every code backed by evidence.

Every diagnosis code comes with full justification. Codes are cited and sourced directly from admission packets, face-to-face documentation, and visit notes. Auditors see the evidence trail—no guesswork, no unsupported claims.

Evidence Trail
Fully Cited Codes
E11.621Type 2 DM with foot ulcer
Verified
Supporting Evidence
Face-to-Face
"Patient presents with diabetic foot ulcer, right heel..."
SOC Visit Note
"Wound measured 2.3cm x 1.8cm, stage II..."
Full audit trail available
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