Encoder Pro Professional Online
Encoder Pro Professional Online is an online, real-time code look-up application that delivers a higher degree of code detail and reference information on CPT®, HCPCS Level II, and ICD-9-CM codes. Automatic code updates throughout the year will help practices that bill Medicare Part B and private payers reduce rejected claims due to improper coding. The Professional version includes CCI edits as well as Medicare and commercial payment and coding information.
Key Features and Benefits
- Local coverage determinations (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 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.
- ICD-10-CM – Includes ICD9 v1 and v2 codes mapped to ICD10-CM codes using the GEM (General Equivalency Mappings) and Ingenix clinical content. Also includes Ingenix Tabular (ICD10-CM book) Content and Ingenix mapping logic.
- Optum Edge—Powerful CodeLogic™ search engine technology. Keyword search across all code sets simultaneously using up to four terms, acronyms, abbreviations, or even misspelled words.
- Optum 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.
- Optum Edge—Automatic monthly updates. Real-time application service delivers code changes before implementation and updates Medicare coverage information regularly for coding confidence.
- Color-coded edits. Reduce research time and improve coding accuracy with at-a-glance sex or age edits, Medicare coverage, and bundled procedures.
- 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.
- Great value. Includes the content from more than 20 code and reference books in one powerful solution.