Intelligent coding & compliance
Medical coding you can defend.
Pinotage derives ICD-10-CM diagnoses during the visit and CPT and HCPCS procedures at finalization, checks every code against real CMS and ICD-10 rules, and shows the reasoning behind each one. A clinician reviews and approves before anything reaches billing.
How it works
Coding drawn from the encounter, checked before anyone sees it.
Because the codes originate from the same captured visit as the note, what reaches billing is already structured and compliance-checked. Nothing is guessed after the fact.
- ICD-10-CM diagnoses and CPT / HCPCS procedures from the same encounter
- Built-in safeguards enforce real ICD-10 rules, and only ever remove codes
- Built-in NCCI edits (PTP bundling, per-day caps, add-on parent checks)
- Highest-value supportable coding, fee-schedule aware, with evidence-cited modifiers
- Compliance issues flagged while the encounter is still open, before the claim goes out
Coding you can trust
Hard guardrails around every suggested code.
The platform proposes and justifies. It never bills on its own, and it can only ever remove a code, not invent one.
Safeguards that can only remove codes
Every diagnosis code is checked against the current ICD-10 master and the official coding guidelines before it reaches a claim. Codes that conflict, hedge an uncertain diagnosis, sit in the wrong order, or mismatch anatomy or laterality are flagged or removed. The safeguards can never invent a code.
NCCI compliance edits, applied before submission
On the finalized procedure set, Pinotage runs the CMS National Correct Coding Initiative checks payers run: procedure-to-procedure (PTP) bundling, Medically Unlikely Edit (MUE) per-day unit caps, and add-on code (AOC) parent validation.
Evidence-cited modifiers, highest-value ordering
Modifier choices (-25, -59, -50, -RT and others) must cite the specific clinical or fee-schedule evidence that justifies them. Suggested codes are ordered so the highest-value supportable coding leads, aware of the current fee schedule.
Guardrails against known over-coding errors
Known over-coding traps, like the G2211 visit-complexity add-on, are suppressed whenever CMS conditions disqualify them, defending against the most common misuses before a payer ever sees the claim.
Clinician in the loop
A clinician reviews and approves every note and every code. The AI never bills autonomously.
Questions
AI medical coding, answered.
- What code sets does Pinotage support?
- Pinotage derives ICD-10-CM diagnosis codes during the visit and CPT and HCPCS procedure codes at finalization, drawn from what actually happened in the encounter.
- Can the AI invent codes or upcode on its own?
- No. The safeguards can only ever remove codes, never invent them, and NCCI edits are applied before submission. A clinician reviews and approves every code, so the platform proposes and justifies but never bills on its own.
- How does Pinotage keep coding compliant?
- Every code is checked against real CMS and ICD-10 rules and the NCCI procedure-to-procedure, per-day, and add-on edits payers use. Compliance issues are flagged while the encounter is still open, so they can be resolved before the claim is submitted.
See your own coding, defended.
We'll walk through a single visit end to end: the note, its codes, and the rationale behind each one, ready for your EHR.
HIPAA compliant · No commitment · 30-minute call