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HCPCS Level II Expert (updateable)

HCPCS Level II Expert (updateable)

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Receive quarterly HCPCS code change, addition, and deletion updates for accurate reporting of supplies and services in physician, hospital outpatient, and ASC settings with the updateable HCPCS Level II Expert. Be prepared for the code set changes that occur throughout the year with an updateable, comprehensive resource for the HCPCS code set that focuses on management of reimbursement. This user-friendly reference will guide any coder confidently through current modifiers, code changes, additions, and deletions with information as dictated by the Centers for Medicare and Medicaid Services (CMS). This edition is ideal for payers and other individuals that use their book daily and need to keep up with changes as they happen.

Key Features and Benefits

Exclusive to the Expert Updateable edition:

Quarterly updates. Keep apprised on the numerous changes to the HCPCS Level II code system throughout the year.

Optum Edge—Medically Unlikely Edits (MUEs) appendix. Improve accuracy of claims by ensuring compliance with the CMS program through easy access to codes and their associated MUE units.

Optum Edge—National Average Payment Tables. Access information to improve claim accuracy and ensure proper reimbursement.

Optum Edge—Expanded index with quarterly updates. Ease code look-up with additional ways to locate codes, updated quarterly for each code change. 

Optum Edge—Glossary of terms. Increase your understanding of HCPCS codes to improve coding accuracy.

Optum Edge—Special appendices updated quarterly. Get additional information with appendices for the National Average Payment Table for HCPCS and MUEs; PQRS code listing; also includes a Deleted Codes Crosswalk Appendix.

Most complete HCPCS code set available. Find information on codes from sources that generates HCPCS codes, including CMS, OPPS addendum B, and the physician fee schedule.

Table of Drugs with quarterly updates. Locate both generic and brand name drugs and their corresponding codes, based on the amount and route of administration.


With traditional hallmark features:

PQRS icons. Recognize potential for Medicare quality reporting bonus payments with icons denoting which HCPCS codes fall under the Physician Quality Reporting System.

Comprehensive code updates. Access all HCPCS, MPFS, and OPPS files for HCPCS Level II, as well as deleted codes.

APC status indicators and ASC designation symbols. Determine which codes are payable under OPPS, which codes enable billing using ASC groupings and how to accurately use each to help ensure appropriate billing and reimbursement.

DMEPOS icon. Distinguish codes paid under the DMEPOS fee schedule to improve efficiency when coding for supplies that should be submitted under the system to durable medical payers.

In-depth illustrations. Enhance your coding process and accuracy for supplies and services with detailed visual references.

AHA Coding Clinic for HCPCS references. Receive added support with articles on difficult-to-code HCPCS Level II codes or sections.

Color-coded bars and icons. Spot important information to help reduce inaccurate and denied claims with informative flags signaling Pub. 100 references, age and gender edits, quantity alerts, new/deleted/revised code changes, and government coverage and rules for each code.

User-friendly appendixes. Navigate additional information easily with structured references and excerpts, including the National Coverage Manual and additional Pub. 100 references.

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