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Coding and code-mapping services for healthcare providers

Medical Coding & Code Mapping Services

Service and medication codes mapped, reviewed and kept traceable.

Medical coding services for healthcare providers: mapping internal service and medication codes to the code sets and reference data you bill and dispense against, with every mapping recorded by relationship type and reviewed where a direct match is not appropriate.

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  • service-code mapping
  • SBS version mapping
  • service master-data normalization
  • medication-code mapping
  • GTIN relationships
  • DRG grouping readiness review
  • exception handling and human review

What the service covers

  • Provider service codes to standard code sets

    Crosswalks from your internal service catalogue to the applicable standard code set, including Saudi Billing System codes. Services that need more clinical detail before a single code can be chosen are flagged for review rather than guessed.

  • Saudi Billing System version mapping

    Moving service codes from one SBS version to the next, such as Version 2.0 to Version 3.0, with the version map published by the Council of Health Insurance as the reference, and a record of every code that changes or has no direct successor.

  • Service master data and crosswalk maintenance

    Normalizing duplicate or inconsistent service entries before mapping, and keeping crosswalks current as your catalogue and the code sets change.

  • Medication codes and SFDA reference data

    Aligning your internal medication codes with SFDA registered-drug reference data, using trade name, strength and dosage form where they decide the match. Entries that no longer match the current SFDA drugs list are flagged for your pharmacy team to review.

  • Drug identifiers and GTIN

    Linking registered drug products to the GTINs of their packs. One registration can carry more than one GTIN, so each relationship is recorded rather than assumed.

  • DRG grouping readiness review

    A DRG is assigned by grouper software to an admitted episode of care, from its diagnoses, procedures and patient details such as age and discharge status. A service code alone does not determine a DRG, so this is a review of whether the coded episode data is ready for grouping, not a code conversion.

How mapping relationships are recorded

Codes rarely line up one-to-one. Every mapping records the kind of relationship it is, so a reviewer can see exactly where a decision was needed.

  • Exact match
  • One-to-one
  • One-to-many
  • Many-to-one
  • Conditional
  • Version-dependent
  • Context-dependent
  • No confident match
  • Manual review required

How the mapping work runs

Each step leaves a record. Where a match cannot be decided from the data and the code set's conventions, it goes to a person.

  1. Source data

    Code lists and sample records from your systems.

  2. Normalization

    Duplicates, formatting and inconsistent descriptions resolved.

  3. Code set and version identification

    Confirming which code set and version each list follows.

  4. Candidate mapping

    Proposed target codes, each with its relationship type.

  5. Rule and context checks

    Each candidate checked against the code set's conventions and the service context.

  6. Exception detection

    No confident match, conflicting candidates and codes without a successor.

  7. Human review

    A qualified reviewer decides the cases the data and the conventions cannot.

  8. Approved mapping output

    A traceable record of source, target, relationship, decision and reviewer.

Is this right for you?

Items in the second list indicate requirements that may fall outside the product's supported scope or require separate assessment.

This may fit if

  • You maintain internal service or medication codes that have to line up with standard code sets and reference data.
  • You are moving a service catalogue from one Saudi Billing System version to the next.
  • You can share code lists and sample records in a structured format such as a spreadsheet or CSV.
  • Clinical, coding or pharmacy staff on your side can review and approve proposed mappings.

This may not fit if

  • You expect every code to have a single exact equivalent.
  • You need a guaranteed claim outcome, reimbursement result or coding accuracy figure.
  • You want codes assigned without clinical or coding review.
  • You need a direct connection to a payer or a national platform as part of this work.

What we need to understand

  • Which code sets and versions are you mapping from, and to?
  • How many service codes and medication items are in scope?
  • In what format are your code lists held today?
  • Which Saudi Billing System version do your current codes follow?
  • Who on your side will review and approve mappings?
  • How will approved mappings be loaded into your systems?
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Standards & References

Public sources for the code sets, identifiers and classification rules this service works with. They are listed for reference only and do not indicate endorsement of, or partnership with, SkyEagle.

Pricing

Pricing depends on coding scope, source systems, data volume, mapping complexity and required review.

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