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EncoderPro.com Expert provides online access to a powerful search application for all CPT ® , HCPCS and ICD-9-CM code sets and Ingenix and Medicare coding guidelines to ensure coding accuracy, improve billing performance and reduce rejected claims. Complementary updates let you code confidently throughout the year. The Expert version also includes a compliance editor to review your code selections and a fee calculator to compute the Medicare reimbursement rate for your region.
- Expert Exclusive—Fee calculator. Calculate the adjusted Medicare reimbursement rate for your area.
- Exclusive—Compliance editor. Check your work by running your selected codes through an edit check to ensure proper unbundling, correct modifiers, complete diagnoses and more. Includes an 18-month historical content database for use during claim adjudication.
- Local medical review polices/local coverage determinations (LMRPs/LCDs) and Medicare’s Pub 100 access. Check procedures for Medicare coverage instructions and medical necessity edits. Understand which ICD-9-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 your 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.
- Ingenix Edge—Powerful Ingenix CodeLogic™ search engine. Time-wasting searches through multiple code books are a thing of the past. Simultaneously search across CPT®, HCPCS and ICD-9-CM code sets using up to four common or clinical terms, acronyms, abbreviations and even misspelled words.
- Color code edits. Reduce research time and improve coding accuracy with at-a-glance sex or age edits, Medicare coverage and bundled procedures.
- Ingenix 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.
- Ingenix Edge—Automatic quarterly updates. Real-time application service delivers code changes before implementation and updates Medicare coverage information regularly for coding confidence.
- User notes. Easily identify codes or code groups requiring more personal or company information.
- Notepad. Preview a completed CMS-1500 form before submission and export your codes to Windows programs.
