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 Hospital-acquired condition (HAC) alerts. Know which conditions when not present upon admission will not impact DRG assignment.
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Adjunct procedure code alert. Learn how to properly use ICD-9-CM ‘adjunct’ codes that provide additional procedure information and cannot be used alone.
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Color coding system. Increase coding accuracy and work efficiency with intuitive symbols and color coding to easily identify coding and reimbursement issues.
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MCC and CC codes paired with principal diagnosis exclusions. Identify at a glance if the assigned MCC or CC code will affect DRG assignment based on the established principal diagnosis (PDx).
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HIV major related diagnosis code alert. Understand when a diagnosis entered as a secondary diagnosis with HIV will group the case to a higher paying DRG 977 for improved reimbursement.
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New and revised code alerts with dated pages. Know which codes and instructions are new or revised, with dates on the page indicating when the change was made.
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Synopsis of code changes. Perform accurate retrospective claim audits with new code information for the year.
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Diagnoses Medicare Code Edit (MCE) alerts. Pinpoint 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, MSP, and manifestation codes.
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Procedure Medicare Code Edit (MCE) alerts. Improve claim accuracy with alerts to all major Medicare edits pertaining to procedures—valid OR procedures, non-covered, limited coverage, non-operating room procedures affecting DRG assignment, bilateral edits and sex edits.
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AHA’s Coding Clinic for ICD-9-CM references. Use citations to link to the official coding advice every coder in every healthcare setting must follow for ICD-9-CM.
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HIPAA compliance guidelines. Comply with HIPAA code set requirements. to avoid delayed or denied claims and costly fines for violations.
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Additional digit symbols. Recognize when a fourth or fifth digit is required for code specificity and validity to avoid invalid code submissions (provided in Index and Tabular Section).
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Manifestation code alert. Find and properly use codes that represent manifestations of underlying disease, know when two codes are required, and be alerted to sequencing rules.
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Age and sex edits. Understand which codes have restrictions on use based on age or sex. of the patient to prevent claim delays and denials..
- User-friendly page design and format. Locate information quickly with dictionary-style headers, quick-flip color tabs, and legend keys on each page.
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