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Facility claims rarely fail on the diagnosis.
They fail on the resource detail behind it. With Nivaran facility coding, charts are reviewed against CMS and payer rules before the claim moves, so the record supports what was billed.
Key Challenges
Facility revenue depends on details that are easy to miss
Undercaptured resource use
Operating room time, supplies and nursing intensity are often documented but never reflected in the code set.
Denials on outpatient claims
ED levels, observation stays and ASC procedures are among the most frequently challenged claim types.
Staffing that cannot flex
Hiring and training facility coders takes months, so volume spikes and vacancies turn into backlog.
At A Glance
Built for documentation and coding workflows at scale
10M+
Transactions processed annually across documentation, coding and revenue workflows
400+
Health organizations served
50+
EMR integrations supported
Security & Compliance
Areas of Expertise
Facility coding across the settings hospitals actually run
Inpatient & Outpatient Coding
Full ICD-10-CM, ICD-10-PCS and CPT coding for admissions and outpatient encounters.
- MS-DRG assignment and review
- CC/MCC capture supported by documentation
- Concurrent or post-discharge workflows
- Second-level review before submission
Emergency Department Coding
Coding for ER visits, observation stays and trauma cases, including facility level assignment.
- Facility E/M level assignment
- Observation and trauma activation coding
- Procedures performed in the ED
- Payer-specific level criteria applied
Ambulatory Surgery Center Coding
Procedure classification for ASCs and hospital outpatient surgery.
- CPT and HCPCS assignment for procedures
- Modifier application and sequencing
- Implant and supply capture
- Support for ASC payment groupings
Radiology, Pathology & Ancillary
Coding for diagnostic imaging, lab and other ancillary services.
- Technical and professional component rules
- TC and 26 modifier handling
- Ancillary service inclusion or exclusion by scope
- Documentation checks before billing
How We Help
Facility coding support that protects the claim before it leaves
Capture the full resource picture
Charts are reviewed so documented resource use reaches the claim.
Reduce preventable denials
Two-level review catches level and modifier issues before submission.
Scale without hiring
Coverage flexes with volume, new service lines and new locations.
Frequently Asked Questions
Which facility settings does Nivaran code for?
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Do your coders work inside our system?
Can Nivaran handle both facility and professional coding?
How do you handle documentation gaps?
Can you support a backlog as a one-time project?