EncoderPro.com Professional is an online, real-time code look-up application that delivers a higher degree of code detail and reference information on CPT®, HCPCS Level II, and both ICD-9-CM and ICD-10-CM and PCS codes. Monthly automatic code updates throughout the year will help practices that bill Medicare Part B and private payers reduce rejected claims due to improper coding. The Professional version includes CCI edits as well as Medicare and commercial payment and coding information.
Key Features and Benefits
- Local coverage determinations (LCDs) and Medicare’s Pub. 100 access. Check procedures for Medicare coverage instructions and medical necessity edits across all CMS MACs. Understand which ICD-9-CM (and ICD-10-CM) procedures define medical necessity and what the documentation guidelines are for successful claim submission. Gain insight into procedures and services that carry little or discretionary coverage and how to report them.
- Modifier crosswalk. Choose from a comprehensive array of modifiers for each procedure based on millions of claim scenarios to ensure correct modifier use when billing payers.
- Cross-coder relationships. Provides valuable content from 12 coding and billing specialty reference books in one powerful solution. Cross-reference procedures to radiology, path/lab, medicine codes, and more.
- Medicare CCI edits. Understand coding relationships for bundled and mutually exclusive procedures, and check your code combinations through a full year of CCI.
- ICD-10-CM and PCS– Includes mapping content from ICD9 v1v2, and v3 codes to ICD10-CM and PCS codes (as well as backward mapping) using the GEM (General Equivalency Mappings) and Optum360’s MapSelect clinical mapping content. Also includes ICD-10-CM and PCS searching and Optum tabular (ICD10-CM and PCS books) content.
Plus all of the valuable features of EncoderPro.com:
- Optum360 Edge—Powerful CodeLogic™ search engine technology. Keyword search across all code sets (including ICD-10-CM and PCS) simultaneously using up to four terms, acronyms, abbreviations, or even misspelled words.
- Optum360 Edge—Lay descriptions for procedures and HCPCS. Access comprehensive Coders’ Desk Reference descriptions for thousands of procedures and services to enhance your understanding of CPT® and HCPCS code differences.
- Optum360 Edge—Automatic monthly updates. Real-time application service delivers code changes before implementation and updates Medicare coverage information regularly for coding confidence.
- Color-coded edits. Reduce research time and improve coding accuracy with at-a-glance sex or age edits, Medicare coverage, and bundled procedures.
- User notes. Easily identify codes or code groups requiring more personal or company information.
- Notepad. Store your most frequently used codes for easy access and export your codes to Windows programs.
- Great value. Includes the content from more than 20 code and reference books in one powerful solution.
CPT® is a registered trademark of the American Medical Association.
The price EncoderPro.com Professional does not include add-ons. Add-ons sold separately.