Audit Across Major Code Sets with More Consistency

CPT^® codes, HCPCS Level II, NCCI edits, ICD-10 — the updates land quarterly, and the compliance exposure lands right along with them. Audit Manager+ is built to handle every code set your organization touches, in one place, without rebuilding your workflow each time the landscape shifts.

The problem with point-in-time coding tools

Most audit tools are built around a single code set or a snapshot in time. When new wound management matrices get HCPCS A codes, when brand-specific J codes appear for epinephrine and vancomycin, when NCCI adds 3,700+ procedure-to-procedure edits in a quarter, or when a new mandatory CMS payment model like TEAM creates an entirely new category of reporting requirements , and those tools require manual intervention to keep pace.

The real risk isn’t missing a single code. It’s that new codes are where bad habits form. High-volume, high-dollar services billed under a new code with no audit in place can compound into months of incorrect claims before anyone catches it. Getting it right from day one (with a workflow built to absorb updates) is the sustainable approach.

What Audit Manager+ handles

Audit Manager+ supports every major code set in a single audit platform. Whether you’re auditing a physician practice, a health system, a DME supplier, or a dental practice, the tool adapts to the code set, not the other way around.

• Professional & Outpatient (CPT^®): MDM checklists, time-based billing logic, and documentation gap flagging. Updated to reflect new remote monitoring thresholds, revised E&M codes, and new CPT^® additions each cycle.
• HCPCS Level II: For example, Drug J codes including brand-specific epinephrine and vancomycin codes, wound management A codes, compression wraps, urinary catheters, and more — refreshed quarterly alongside CMS releases.
• Hospital inpatient: DRG-based templates with admitting diagnosis, principal DX with present-on-admission indicators, CC/MCC, severity of illness, and ICD-10-PCS codes in a full inpatient workflow.
• Dental and Specialty: CDT codes with oral cavity, quadrant, tooth number, and tooth surface fields. Plus specialty-specific templates for HCC risk, behavioral health, and compliance walk-throughs.

How it works for new and complex codes

When unfamiliar codes enter your audit workflow, Audit Manager+ gives your team what it needs to audit confidently from the start, not after months of trial and error.

• The full code definition surfaces in the audit worksheet so auditors can compare documentation against requirements without leaving the platform.
• Over 65 pre-built documentation checklists trigger automatically based on the code with the ability to create custom rules for codes with unique requirements.
• Documentation gaps auto-generate audit comments, keeping findings consistent and actionable across every auditor on your team.
• A queue dashboard routes work and tracks status across all audit types, so nothing falls through the cracks when multiple code sets are in play at once.
• Date-of-service accuracy is maintained throughout, which is critical when audits or appeals involve claims from prior quarters under different code sets.

Go deeper: recent coding update webinars

These three sessions from Healthicity’s compliance webinar series cover the 2026 code changes in detail — and show exactly the kind of coding environment Audit Manager+ is built to keep pace with.

• CPT® 2026 updates: key additions, revisions, and what they mean
  • Includes a live demo of Audit Manager+ across code sets
• Understanding 2026 HCPCS Level II code updates: J codes, A codes, drug-specific additions, and wound management
• A closer look at April’s HCPCS and NCCI updates: Quarterly edits, compliance implications, and operational process

See how Audit Manager+ handles your code sets

Get a personalized demo and see how audit templates, documentation checklists, and quarterly code updates work together in your environment.

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