Service Scope & Methodology
Four Pillars provides comprehensive ICD-10-CM coding exclusively focused on home health and hospice agencies across the United States. Under the Patient-Driven Groupings Model (PDGM), diagnosis coding and manifestation sequencing directly determine clinical grouping, comorbidity adjustments, and total agency reimbursement. Our credentialed coding specialists review referral documents, history & physical (H&P) reports, face-to-face encounters, physician orders, and OASIS documentation to establish accurate primary diagnoses and capture legitimate comorbidities while eliminating fatal claim rejections and ADR risk.
Key Scope of Work & Clinical Deliverables
Start of Care (SOC) & Resumption Coding
Comprehensive evaluation of admission notes, hospital discharge summaries, and referral records to assign primary and secondary ICD-10-CM codes.
Recertification & Follow-Up Coding
Rigorous review of ongoing episode documentation, therapy progress notes, and updated physician orders for continuing 60-day care periods.
Primary Diagnosis Sequencing
Precise alignment with PDGM clinical group definitions to ensure the primary diagnosis reflects the chief reason for home care and supports skilled need.
Comorbidity Adjustment Optimization
Identification and coding of secondary co-existing conditions to legitimately qualify for Low or High Comorbidity Subgroups without over-coding.
Manifestation & Etiology Pairing
Strict adherence to ICD-10-CM conventions, chapter-specific guidelines, and mandatory etiology/manifestation code sequencing rules.
Hospice Coding & Palliative Review
Specialized hospice coding capturing terminal diagnoses, related conditions, and comorbidity exclusions in strict compliance with CMS hospice regulations.
Supported Electronic Health Records (EHRs)
Our teams work natively inside your agency's existing EHR environment using secure, direct-access credentials with zero disruption to field clinicians:
Request a Chart Audit
Interested in Home Health Coding? Connect with our operations team for a confidential turnaround assessment and sample audit.