The Official Guidelines for Coding and Reporting for 2021 are bound into this book. This code book contains the complete updated 2021 code set along with updated guidelines.
The ICD-10-CM Professional for Physicians 2021, uses Optum360's hallmark features and format, making the challenge of accurate diagnosis coding easier. Developed specifically to meet the needs of physicians, the Optum360 code book contains the complete ICD-10-CM code set, which is the cornerstone for establishing medical necessity, determining coverage, and ensuring appropriate reimbursement. Symbols in the tabular section identify codes associated with CMS quality payment program (QPP) measures and CMS hierarchical condition categories (HCC) used in risk adjustment (RA) coding.
Enhanced features in Professional and Expert editions of 2021 ICD-10-CM for Physicians:
- Chapter 22. Codes for Special Purposes (U codes, COVID, Vaping)
- Complete list of new revised and deleted codes
- Conversion table identifying new codes
- Coding Tips specific physician and outpatient settings
- Introducing a new symbol in the tabular to identify diagnosis codes associated with QPP measures
- More definitions added for diagnostic terms
Key features and benefits of this ICD10 coding book:
- Optum360 Edge — Intuitive features and format. Visual alerts, including color-coding and symbols that identify coding notes and instructions, additional character requirements, placeholder X, Medicare Code Edits (MCE), manifestation codes, HCCs, QPP, and unspecified codes.
- Updated coding tips. Coding tips are reviewed and updated, and assist in appropriate code selection.
- Clinical definitions. Clinical definitions help provide a better understanding of complex ICD-10-CM diagnostic terms.
- List of code changes and conversion table. A list of all 2021 new, revised, and deleted codes to identify at a glance code changes, plus an ICD-10-CM conversion table from the new and changed codes to the code previously used.
- Updated index with shaded guides. The updated Index to Diseases and Injuries includes vertical shaded guides that show the indent levels for subentries under main terms.
- Guidelines with coding examples. Official Guidelines for Coding and Reporting including chapter-specific coding examples.
- Helpful illustrations. Detailed color anatomy illustration appendix. Plus many illustrations at the code level identifying specific code-related anatomy.
What is the difference between the Expert and Professional editions?
- Expert Edition: Spiral bound and appendixes which include: POA coding and reporting tutorial; pharmacology listings of common drugs with therapeutic classes and indications; and code lists for CC, MCC and PDx CC/MCC.
- Expert Edition: Downloadable files for CC Excludes PDx collection, POA exempt codes.
- The Professional edition does not include the above features.