ICD-9-CM Expert for Hospitals and Payers provides accurate and comprehensive coverage for diagnosis coding and reimbursement. Optum experts study industry changes and trends while seeking feedback from coding professionals to ensure your code book provides accurate and up-to-date information in an easy-to-use, intuitive format. Remain a step ahead with a resource that's designed to enhance performance in your daily work.
Key Features and Benefits:
Exclusive to the Expert edition:
- Optum Edge —ICD-10 Spotlight. Preview ICD-10 codes with the most frequently reported ICD-9-CM codes to learn as you work.
- Optum Edge —Present on admission (POA) indicator tutorial with source documentation table. Access additional explanation and examples to help simplify POA, plus official guidelines regarding use of information in the medical record.
- Optum Edge —Dx/MDC/DRG list. Enhance overall reimbursement and reduce potential fine risks with information concerning the MDC and MS-DRG that a specific principal Dx group is under in the new MS-DRG system.
- Optum Edge —10 Steps to Correct Coding. Receive step-by-step instructions to improve coding accuracy and more effectively use ICD-9-CM conventions.
- Optum Edge —Intuitive color-coded symbols and alerts. Identify critical coding and reimbursement issues quickly with alerts on the same page as the code you need.
- Optum Edge —Hallmark page design and features. Locate information quickly with a user-friendly page design, including dictionary-style headers, QuickflipTM color bleed tabs, and legend keys.
Includes these traditional hallmark features plus many more:
- Highlighted coding instructional and informational notes. Recognize important code usage guidance for specific sections more easily with highlighted notes.
- AHA's Coding Clinic and official coding guideline tips. Use citations to link to the official coding advice every coder in every health care setting must follow.
- Symbols identify MCC and CC conditions. Ensure appropriate reimbursement by reporting patient severity correctly. Know when conditions are considered a complication or comorbidity, as well as which are major CCs that impact MS-DRG assignment.
- Hospital-acquired condition (HAC) alerts. Know which conditions, when not present upon admission, will not impact DRG assignment.
- Additional digit required symbols. Know when an additional fourth or fifth digit is required for code specificity and validity to avoid invalid code submissions (provided in Index and Tabular Section).
- Diagnosis and Procedure Medicare Code Edit (MCE) alerts. Color-coding and symbols identify all major Medicare Code Edits (MCE) used to audit claims submitted under the inpatient prospective payment system (IPPS) for diagnosis, including unacceptable PDx, questionable admission PDx, age, sex, CC and MCC, and manifestation codes. Also MCEs related to valid OR procedures, non-covered, limited coverage, non-operating room, bilateral edits and sex edits.
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