Kodia processes each case in stages: it analyzes the clinical documentation, retrieves the relevant positions, applies TARDOC, outpatient flat-rate, and ICD-10 rules, then checks the consistency of the result before presenting its sources.
Each case is decomposed into the codes, rules, and relationships that actually need resolving — before a single answer is formed.
Positions, cumulation tables, qualifications, and intrinsic values are consulted in structured references that are kept up to date.
The agent checks its result against the rules in force and flags uncertainty so that it can be reviewed by a human.
Every Kodia analysis follows the same four steps: read the report, consult the references, apply the rules, and present the sources.
| Type | Extracted fact |
|---|---|
| Procedure | MRI of the neurocranium (brain) |
| Contrast | Gadobutrol 7.5 ml (gadolinium), IV |
| Technique | Native + dynamic post-contrast T1 series — complex |
| Finding | 2 enhancing nodular lesions |
| Diagnosis | Brain metastases |
| Cat. | Code | Description | Points |
|---|---|---|---|
| TARDOC | GP.00.0010 | MRI of the neurocranium | 171.72 |
| TARDOC | GP.00.0020 | + Suppl. additional MRI series (post-contrast) | 114.48 |
| TARDOC | GP.10.0020 | Complex MRI examination (/min) | 5.72 |
| TARDOC | GP.00.0030 | + Medical service before/during | 11.27 |
| TARDOC | GP.15.0010 | Interpretation and report | 74.06 |
| TARDOC | GA.05.0010 | RIS and PACS | 10.36 |
| TARDOC | AR.05.0080 | Change time, MRI | 57.24 |
| ICD-10 | C79.3 | Brain / meningeal metastases | diag. |
| Flat rate | — | No flat rate — billed fee-for-service | ✕ |
| Medic. | gadobutrol | Contrast → medication list, outside TARDOC | separate |
| Rule checked | Result |
|---|---|
| Cumulation GP.00.0010 + codes | ✓Cumulable |
| Intrinsic value / qualif. | ✓Radiology 1600 |
| Post-contrast series GP.00.0020 | ✓"MRI series" condition met |
| Complex code GP.10.0020 | ✓Tumor + dynamic |
| Add-on (+) GP.00.0030 / .0020 | ✓Attached to GP.00.0010 |
| Quantity limitations | ✓≤ 1×/session respected |
| Contrast agent | ✓Billed separately GI-25 |
| Code | Description | Qty | Pts |
|---|---|---|---|
| GP.00.0010 | MRI of the neurocranium | 1 | 171.72 |
| GP.00.0020 | + Suppl. additional MRI series | 1 | 114.48 |
| GP.10.0020 | Complex MRI (/min) | 12 | 68.64 |
| GP.00.0030 | + Medical service | 1 | 11.27 |
| GP.15.0010 | Interpretation and report | 1 | 74.06 |
| GA.05.0010 | RIS and PACS | 1 | 10.36 |
| AR.05.0080 | Change time | 1 | 57.24 |
| TARDOC total | 507.77 | ||
| C79.3 | Diagnosis — metastases | — | justif. |
| gadobutrol | Contrast — outside TARDOC | — | separate |
Kodia analyzes the entire clinical document, including the most complex reports, to extract the genuinely billable elements: procedures, products, materials, findings, and diagnoses. Free text is turned into structured information, directly usable for coding.
Kodia consults the TARDOC, outpatient flat-rate, and ICD-10 references to identify the positions and rules relevant to each extracted item.
Cumulation tables, qualifications, intrinsic values, and limitations are checked automatically. Kodia presents the rules considered so you can verify the result.
You receive a referenced result: codes are clickable in Chat, while Audit and Review reports display the corresponding official references.
Case — Consultation with a same-day phone follow-up. Which positions apply?
Illustrative example — Kodia presents the verifiable steps in its analysis
The difficulty of ambulatory coding lies less in finding a code than in understanding how rules, exclusions, and conditions interact. Kodia structures this analysis to make it more systematic and verifiable.
Try referenced answers in Kodia Chat, or have your billing examined at scale with Kodia Audit.
