- New Feature! Ingenix Exclusive — Hospital Acquired Condition (HAC) Alerts. Know which conditions when not present upon admission will not impact DRG assignment.
- Ingenix Edge—Color coding system. Improve coding accuracy and efficiency with intuitive symbols and color codes that alert you to crucial coding and reimbursement issues.
- IPPS compliance symbols. Quickly identify all major Medicare Code Edits (MCE) for diagnoses used to audit claims submitted under the new MS-DRG classification system—unacceptable PDx, questionable admission PDx, age, sex, CC and MCC, and manifestation codes.
- Procedure Medicare Code Edit alerts. Improve claim accuracy by being alerted to ALL the major Medicare edits for the new MS-DRG system pertaining to procedures; valid OR procedures, noncovered, limited coverage, nonoperating room procedures affecting DRG assignment, valid OR procedures, bilateral edits and sex edits.
- Ingenix Edge—CC and MCC condition symbol with principal diagnosis exclusions listed right with the code. Quickly identify complications and comorbidities that affect MS-DRG assignment. Know at a glance if the CC or MCC code you are assigning will affect MS-DRG assignment based upon the principal diagnosis being reported for the case—helping to improve the accuracy of DRG selection and improved reimbursement.
- Ingenix Edge—Additional digit symbol in the tabular section and the disease and procedure indexes. Color-coded symbols alert the coder when the code is invalid without a fourth or fifth digit.
- Ingenix Edge—DRG alert symbol. Know if you’re assigning a DRG targeted by the OIG as having potential for “upcoding”—reducing the risk for audits and potential fines.
- HIV major related diagnosis code alert. Know when a diagnosis entered as a secondary diagnosis with HIV will group the case to the higher-paying DRG 974–976, helping to improve reimbursement.
- Definitions and illustrations. Verify correct code selection using clinically oriented definitions and illustrations that give the user an in-depth understanding of anatomy and disease processes.
- Manifestation code alert. Clearly identify and properly use codes that represent manifestations of underlying disease, and be alerted when two codes are required, improving coding accuracy and reducing denied claims.
- New and revised code symbols and dated pages. Quickly identify new code information and the date of the most recent change so you can perform accurate retrospective claim audits.
- Dictionary-style headers, QuickFlip™ color tabs, legends and keys on each page. Save time and improve coding efficiency by locating a specific section more quickly.
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