Capsa Coding
Capsa Coding suite · pediatric ambulatory revenue integrity

Capture every charge
you've earned.

Capsa Charge Capture reads the same note your coder reads and surfaces every billable code the chart supports — each one backed by the exact words that justify it. Missed codes are lost, compliant revenue. Capsa gets them back — defensibly.

Not a black box — every code cited to the chart Human-governed — your CDI nurses own the rules
Visit · well-child, 4 mo acct 5000004
Capsa recommends · evidence attached
90460
VAC-ADM-001
“…admin with counseling by physician; first component…”
billed
90686
VAC-PROD-014
“…Influenza, quadrivalent, 0.5 mL IM administered today…”
billed
96110
HS-DEV-001
“…ASQ-3 developmental screen completed, score recorded…”
caught
precision 96.9%recall 95.5% +1 missed charge recovered
96.9%
Vaccine coding precision
95.5%
Recall — SLA met
100%
Codes cited to verbatim chart text
34.8% → 94%
New skill, same framework
7
Coding categories built on one framework
The problem

Published coding guidelines are only half the job.

After a provider signs a note, a coder must bill every service performed — vaccines, screenings, vision and hearing checks. Easy to miss, inconsistent between coders, hard to audit later. Both ways it goes wrong are expensive.

Missed codes

Lost, compliant revenue — gone for good

Billable work the coder didn't capture is money you earned and won't see. At scale, a few missed codes per visit is a seven-figure annual leak.

Over-coded claims

Audit risk and clawback exposure

Codes billed without support in the chart invite denials and recoupment. “More billing” isn't the goal — the right amount, provably is.

See it in the product

The coder sees the code, the rule, and the chart text — together.

Capsa Charge Capture shows recommended vs. billed codes, the rule behind each recommendation, and the verbatim chart evidence — then scores itself against what your coders actually billed.

capsa · visit traceability
Visit traceability: AI-recommended vs coder-billed codes with match pills and the chart evidence behind each recommendation
Visit traceability. AI-recommended vs. coder-billed codes, with the rule and verbatim evidence behind every recommendation.
capsa · validation
Cohort validation dashboard with scope-aware precision, recall and F1 plus per-CPT and per-rule breakdowns
Validation dashboard. Scope-aware precision & recall, with per-CPT and per-rule breakdowns.
capsa · guidelines
Guidelines explorer: card grid of coding guidelines with rule, code, modifier and example counts and version badges
Guidelines explorer. Every coding category, versioned, with rule / code / example counts.

Explore Capsa Charge Capture

How it works

Read the note. Prove the code. Measure against what was billed.

01

Ingest

The signed note comes in from the EHR; augmenters fill known gaps like structured vaccine records.

02

Triage

A fast model decides which coding categories even apply, so effort goes only where it's needed.

03

Analyze

Each category runs an explicit, human-readable rule set and proposes codes with a plain-English reason.

04

Cite-check

Every quote is verified verbatim in the chart. Unsupported recommendations are dropped before a coder sees them.

05

Validate

Predictions are scored against what the coder actually billed — scope-aware precision and recall.

Why Capsa

Built to be defended in an audit — not just to find more codes.

Audit-defensible by design

Every code links to the rule that produced it, and every rule to the verbatim chart text that triggered it — at the exact version that ran. Answer “why this code?” in one click.

Versioned guidelines

Rules, codes, evidence, and worked examples are versioned together with full history and side-by-side diffs. When a payer changes a rule, the change is on the record.

Scope-aware measurement

Precision and recall are measured against the codes each skill actually owns — so the numbers mean what they say instead of being diluted by out-of-scope codes.

Clinician-governed loop

CDI nurses — not engineers — answer clarifying questions and approve rule updates through a guided workflow, with a complete audit trail. Capsa partners with coders; it doesn't replace them.

No black box, no fine-tuning

All clinical logic lives in explicit, human-readable rule sets. Nothing is hidden inside a model nobody can inspect or explain.

One framework, every category

The same engine runs every coding skill. Adding a new category is reuse, not a rebuild — proven across seven categories already.

The Capsa Coding suite

One coding engine. A growing family of products.

Capsa Charge Capture is live today and the foundation of everything that follows. The same measured, audit-defensible framework extends to the categories below — tell us which matters most and we'll bring you in first.

Available now

Capsa Charge Capture

Surface every billable code the signed ambulatory note supports, cited to the chart and scored against what coders billed.

Explore & book a pilot
Coming soon

Capsa E&M Coding

Defensible evaluation & management level selection from the documented history, exam, and medical decision-making.

Join the waitlist
Coming soon

Capsa ED Coding

Emergency-department facility and professional coding with the same evidence-cited, audit-ready approach.

Join the waitlist
Coming soon

Capsa CDI

Clinical documentation integrity that flags gaps before the claim goes out — governed by your CDI team.

Join the waitlist
Book a pilot on your data

See Capsa on cases your team already coded.

We'll run Capsa Charge Capture against your guidelines, your cohorts, and your paid claims — and show you scope-aware precision and recall on visits you've already billed. No rip-and-replace.

  • Pilot on a sample of your own visits
  • Precision & recall vs. what your coders billed
  • Every recommendation cited to the chart
  • No EHR rip-and-replace
pilots@capsacoding.com · capsacoding.com

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