Medical Office, Hospital & Payer March 2009————————————————————————————————————————————————————————————————
Code Changes now in effeCt!
ICD-10NewsFlash!see page 9for details.
2010 produCts now available on www.shopingenix.Com
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Complete your coding reference library with must-have 2009 editions.
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2009 Billing Companion for OB/GYN Item # 2284 Available: Now
ISBN: 978-1-60151-228-4 $199.95
Table of ContentsP For use by Physicians & Clinics H For use in Hospitals & Facilities
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Products contained in this catalog are made in the USA.CPT is a registered trademark of the American Medical Association.
CEU For a complete list of Ingenix products and edition years that qualify for The American Academy of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA) continuing education units and submission/testing details, visit www.shopingenix.com/continuingeducation, or www.aapc.com/education/ceu-vendors-list.aspx
P H Y N E W P R O D U C T S
1 • • • Billing Companions1 • • • Coders’ Desk Reference: Opthalmology
Diagnoses2 • Expert Briefings: Understanding RACs2 • • • Ingenix Learning: Online Coding Tests
P H Y P R I N T C O D I N G P R O D U C T S3 • • • Current Procedural Coding Expert3 • • • AMA CPT® Standard Edition4 • ICD-9-CM Code Books for Physicians6 • ICD-9-CM Code Books for Hospitals6 • ICD-9-CM Expert for Home Health
Services, Nursing Facilities and Hospices
8 • • HCPCS Level II Code Books
P H Y I N G E N I x E S S E N T I a l S9 • • • Coding, Billing, and Compliance
Conference
P H Y I C D -10 C O R N E R9 • • ICD-10-PCS9 • • • ICD-10-CM
P H Y O N l I N E S O l U T I O N S10 • EncoderPro.com Suite10 • • • IngenixExpert.com11 • • RevenueCyclePro.com11 • ChargemasterAnalyzer.comTM
12 • • • ASCExpert.com12 • • • DrugReimbursement.com
P H Y S P E C I a lT Y C O D I N G 13 • • • Coding Companions®
14 • • • Coding and Payment Guides14 • • • Code Pathways15 • • • Cross Coders15 • • Procedural Cross Coder15 • Coding Guide for Dental Services
P H Y C O D I N G , B I l l I N G a N D PaY M E N T
16 • • • Fast Finders16 • • E/M Fast Finder17 • Encoder Pro Desktop Suite17 • • • Code It Fast I-918 • • • Coders’ Desk Reference for Procedures18 • • • Coders’ Desk Reference for Diagnoses18 • • Coders’ Desk Reference for ICD-9-CM
Procedures19 • • • Coders’ Desk Reference for HCPCS
Level II19 • • Insurance Directory19 • • Physicians’ Guide to Implementing the
Medicare Quality Reporting Initiative20 • • Coders’ Dictionary20 • • • Auditing Tool Kit20 • • • CPT® Changes: An Insider’s View21 • HIPAA Tool Kit21 • Denial Management Tool Kit22 • • DRG Expert22 • DRG Desk Reference23 • • Uniform Billing Editor23 • Outpatient Billing Expert24 • Hospital Professional Billing Editor24 • • Facility Guide for Interventional
Radiology25 • Hospital Chargemaster Guide25 • OPPS Manager
P H Y E D U C aT I O N & T R a I N I N G26 • • • Ingenix Learning: Coding and
Reimbursement Education
P H Y P H Y S I C I a N P R I C I N G 27 • Customized Fee Analyzer27 • FeeAnalyzer.com28 • • RBRVS Plus28 • • • Ingenix Data Files
P H Y M E D I C a R E S E R V I C E S 29 • • Medicare Desk Reference for Hospitals29 • • Medicare Desk Reference for Physicians
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2009 Billing CompanionsThe Billing Companion provides practical guidance for billing professional services
to commercial and public payers. This manual compiles essential billing rules and
demonstrates correct and incorrect claim form entries, reviews potential billing
errors, and explains modifier issues and coverage rules impacting your practice.
» Quickly find specialty-specific billing instructions for surgical, imaging, diagnostic
and E/M services with user-friendly content arrangement.
» Improve claim accuracy and prevent payment delays.
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2009 Billing Companion for Orthopaedics Item # 2236 Available: Now
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Quickly find specialty-specific billing instructions.
2009 Coders’ Desk Reference: Ophthalmology DiagnosesBoost coding accuracy with the
new Coders’ Desk Reference:
Ophthalmology Diagnoses.
» Provides detailed clinical data for
more than one hundred of the most
commonly used ophthalmology
diagnoses.
» Optimizes reimbursement through
correct diagnoses coding.
» Supports medical necessity with
clinical background.
ODRD P H Y
2009 Coders’ Desk Reference: Ophthalmology DiagnosesItem # 1279 Available: Now
ISBN: 978-1-60151-246-8 $129.95
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Ingenix learning: Coding Knowledge assessmentPartner with Ingenix for an objective and
convenient way to assess new and existing
staff’s coding skills and identify potential
training requirements.
Quantify coding skills quickly and easily.
New
Expert Briefings: Understanding RACsExpert Briefings: Understanding RACs is a set of 75
Microsoft® PowerPoint slides that can be used for
printed handouts or presentations. Be prepared for
audits with information such as typical errors, clinical
cases likely to be reviewed by auditors, and more.
Plus, question & answer slides test audience retention
of the presentation.
Expert Briefings includes:
» Suggested narration and talking points.
» Customizable slides can include your content.
» Official citations for all facts and figures.
EbRAC H
Expert Briefings: Understanding RACs Item # 1554 Available: Now
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New
Online Coding Tests
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Course Skill Level Item#
Assessment for Diagnosis Coding Novice Z1000Assessment for Evaluation & Management Coding Professional Z1001Assessment for Medical Terminology Novice Z1002Assessment for Guidelines for Coding from the Operative Report Master Z1003Assessment for Medical Coding basics Novice Z1004Assessment for Auditing Physician Services Master Z1005Assessment for Procedure Coding Novice Z1006Assessment for Supplies & Services Coding Novice Z1007Assessment for Understanding and Using Modifiers Professional Z1008Assessment for Denial Management Master Z1009
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2009 Current Procedural Coding Expert (Compact)
Item # CEC09 Available: Now ISBN: 978-1-60151-197-3 $89.95
2009 Current Procedural Coding ExpertThis expert resource includes valuable information and new resources in an easy-to-
navigate, logical format designed for coders by coders.
» Just Added Medically Unlikely Edits (MUEs) Appendix.
» New Format Option! Tab dividers with pre-printed headings help you quickly find frequently
used information.
» New Body system headings on each page and detailed Ingenix subheadings for each section.
» New Includes Medicare global/follow-up days.
» New Identifies brand name vaccinations associated with CPT® codes.
CE P H Y CEU
Over 700 CPT® Code Changes
for 2009!
2009 Current Procedural Coding Expert with Tab Dividers (Spiral)
Item # CET09 Available: Now ISBN: 978-1-60151-196-6 $104.95
2009 CPT® Standard Edition
» Official CPT® products include all 2009
codes and modifiers, so you’re covered for
the coming.
» Sample cases demonstrate how to use and
assign the codes properly.
» Comprehensive index for rapidly finding
the code you need.CbST P H Y
2009 CPT® Standard Edition (Softbound)
Item # CB09 Available: Now ISBN: 978-1-60359-063-1 $74.95
CPT is a registered trademark of the American Medical Association.
We listened. Our 2009 editions have been updated with new valuable, customer recommended features.
2009 Current Procedural Coding Expert (Spiral)
Item # CE09 Available: Now ISBN: 978-1-60151-196-6 $99.95
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» Ingenix edge® Hallmark color coding and
symbols. Identify critical coding and
reimbursement issues, including V code
sequencing restrictions and additional
digit requirements for specificity and
validity.
» Ingenix edge® Code alerts for ‘unspecified’/
’other specified’ diagnosis codes.
» Ingenix edge® Summary of new and revised
codes. Avoid the frustration of searching
for the new and revised codes. Use this
convenient list to locate the codes that
will impact your coding practices.
» Ingenix edge® V Code Alerts. Symbols
identify primary- and secondary-only use
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» Manifestation code alert. Know when
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» Coding efficiency and accuracy.
Definitions, illustrations, hallmark color
coding and intuitive symbols integrate
coding and reimbursement into a single
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» Change symbols identify what code
information has changed. Don’t be caught
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when for more efficient coding practices.
» HIPAA code set compliance. Official
code set, complete coding guidelines
and AHA’s Coding Clinic for ICD-9-CM
references.
2009 ICD-9-CM for Physicians, Volumes 1 & 2
Why work harder? Work smarter.
2009 ICD-9-CM Professional for Physicians, Vols 1 & 2 (Compact)
Item # IPC09 Available: NowISBN: 978-1-60151-123-2 $74.95
Softbound Compact (6x9)
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2009 ICD-9-CM Professional for Physicians, Vols 1 & 2 (Softbound)
Item # IPB09 Available: Now ISBN: 978-1-60151-122-5 $86.95
Over 500 ICD-9-CM
code changes for 2009.
When placing your order on www.shopingenix.com, use source code 121739 to ensure your package discount.
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Why work harder? Work smarter.
Exclusive to the Expert editions:
» New Format Option! Spiral edition with
exclusive tab dividers featuring detailed
clinical information and coding tips
with scenarios for all the new codes by
chapter makes training and referencing
the code changes quick and easy.
» Ingenix edge® Exclusive coding tables
simplify coding for complex diagnoses.
» Ingenix edge® Valid three-digit code list.
Exclusive to the Updateable edition:
» Ingenix edge® Three updates a year included
in a subscription.
» September—Full text update with
new codes and AHA’s Coding Clinic
references and summary of current
topics.
» February—Update with new
illustrations and definitions, plus AHA’s
Coding Clinic references and summary
of current topics.
» July—Code Report 2010, a list of all the
new codes for 2010.
IPET P CEU
2009 ICD-9-CM Expert for Physicians, Vols 1 & 2 with Tab Dividers (Spiral)
Item # IPT09 Available: Now ISBN: 978-1-60151-125-6 $99.95
2009 ICD-9-CM Expert for Physicians,
Vols 1 & 2 (Spiral)Item # IPS09 Available: Now
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ICD-9-CM Expert for Physicians, Vols 1 & 2 (Updateable binder)
Item # 3534 Available: Now$169.95
Also available: ICD-9-CM Expert for Payers.Visit www.shopingenix.com for details.
New Format Option: Spiral edition with Snap-in Tabs places critical new code information and coding tips at your fingertips.
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2009 ICD-9-CM for Hospitals, Volumes 1, 2 & 3New Feature Ingenix Exclusive—Chapter by chapter, detailed clinical and coding
information with coding scenarios for all the new codes adopted for 2009.
IHPCIHP H CEU H CEU
2009 ICD-9-CM Professional for Hospitals, Vols 1 & 2 (Softbound)
Item # IHB09 Available: Now ISBN: 978-1-60151-127-0 $94.95
2009 ICD-9-CM Professional for Hospitals, Vols 1, 2 & 3 (Compact)
Item # IHC09 Available: Now ISBN: 978-1-60151-128-7 $84.95
Softbound Compact (6x9)
2009 ICD-9-CM Expert for Home Health Services, Nursing
Facilities and Hospices, Volumes 1, 2 & 3
Item # IHHS09 Available: Now ISBN: 978-1-60151-133-1 $154.95
» New Feature Ingenix Exclusive—Hospital
acquired condition alerts.
» Ingenix edge® Critical MS-DRG code edits.
» Ingenix edge® CC and MCC condition symbol
with principal diagnosis exclusions.
» Ingenix edge® Includes color-coded symbols
and alerts, illustration and definitions,
and updated AHA’s Coding Clinic
references.
IPHYR H CEU
Comprehensive package option—Spiral Expert edition PLUS a CD packed with additional resources covering coding guidelines, billing requirements for each PPS, documentation, benchmarking data, patient assessment form tips, and quality initiatives specific for each post acute facility. Companion CD may be purchased separately.
2009 Coding, Reporting and Documentation Guidance for Home Health Services, Nursing Facilities
and Hospices CDItem # XIHH09 Available: Now
ISBN: 978-1-60151-134-8 $119.95
Over 500 ICD-9-CM
code changes for 2009.
2009 ICD-9-CM Expert for Home Health Services, Nursing Facilities and Hospices, Volumes 1, 2 & 3 with
Companion CDItem # IHHR09 Available: Now
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» New Feature Ingenix Exclusive—
Chapter by chapter, detailed clinical
and coding information with coding
scenarios for all the new codes
adopted for 2009.
» Ingenix edge® Features for home health
agencies include excerpts from the
Home Health PPS, coverage issues
and alerts.
» Ingenix edge® Features for skilled nursing
facility include descriptions of the
RUG-III system.
» Ingenix edge® Features for Hospice
include alerts for noncancer diagnosis.
» Ingenix edge® Email alerts for special
reports.
2009 ICD-9-CM Expert for Home Health Services, Nursing Facilities and Hospices, Volumes 1, 2 & 3
IHEU H CEU
ICD-9-CM Expert for Hospitals, Vols 1, 2 & 3 (Updateable binder)
Item # 3539 Available: Now $174.95
IHES H CEU
2009 ICD-9-CM Expert for Hospitals, Vols 1, 2 & 3 (Spiral)
Item # IHS09 Available: Now ISBN: 978-1-60151-129-4 $99.95
Exclusive to the Updateable edition:» Ingenix edge® Three updates a year included
in a subscription.
» September—Full-text update with new codes, updated edits and updated AHA’s Coding Clinic references with a summary of Coding Clinic topics.
» February—Update with new illustrations and definitions, plus updated AHA’s Coding Clinic references and Medicare code edits.
» July—PPS Alert Newsletter with new code list and summary proposed
changes to the IPPS for 2010.
Exclusive to the Expert editions:
» Ingenix edge® Present on admission indicator
tutorial with source documentation table
and list of POA Exempt codes.
» Ingenix edge® Dx/MDC/DRG list and DRG
mapping.
» Ingenix edge® Valid three-digit code list,
complete CC and MCC code lists and
pharmacological listing.
» Ingenix edge® Email alerts for special
reports.
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2009 HCPCS level IIPQRI Ready! Icons denoting which HCPCS codes and their denominators are part of the
Physician Quality Reporting Initiative help you get your bonus.
» Ingenix edge® Comprehensive code updates.
» Ingenix edge® Comprehensive table of drugs.
» Ingenix edge® AHA Coding Clinic for HCPCS references.
» Ingenix edge® Reference color-coded icons indicating Pub. 100 references; DMEPOS; age and sex edits; new, deleted or revised code changes; and government coverage and rules.
» Detailed Illustrations.
» APC status indicators and ASC designation symbols.
Expert Advantage:» Appendixes for National Average
Payment, Medically Unlikely Edits (MUEs), Deleted Code Crosswalk and Glossary.
Updateable Advantage:» Easy-to-follow information helps identify
reimbursement based on Medicare and commercial fee data.
» Keep current with the latest codes and regulations through quarterly updates.
HES P H CEU HEC P H CEU HEU P H CEU
2009 HCPCS Level II Expert (Spiral)
Item # HS09 Available: Now ISBN: 978-1-60151-155-3 $99.95
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Item # HC09 Available: Now ISBN: 978-1-60151-157-7 $86.95
HCPCS Level II Expert (Updateable)
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Stay on top of the 394 HCPCS changes in 2009.
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Item # HB09 Available: Now ISBN: 978-1-60151-159-1 $72.95
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ICD-10-CM Source Data File
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The Department of Health and Human Services published a final rule setting a compliance date of October 1, 2013 for replacing the 30-year-old ICD-9-CM code set with ICD-10-CM and ICD-10-PCS.
For more information on the proposed rule and the Ingenix resources to help guide you through ICD-10, visit http://www.shopingenix.com/content/ICD10/.
ICD-10 Corner
Preview the ICD-10-CM (diagnoses) and ICD-10-PCS (inpatient procedures) classification systems.
» Prepare for the future of coding.
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» Use the complete official guidelines to apply the coding rules correctly.
» Facilitate code searches with easy to use format in both tabular and index.
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CPT is a registered trademark of the American Medical Association.
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EncoderPro.comEncoderPro.com is the essential online lookup tool for
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» Quickly access all current CPT® and HCPCS codes, ICD-9-CM codes, DRGs, APCs, fee schedules and wage indexes for inpatient and outpatient services.
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Chargemasteranalyzer.com™Having the right resource for CDM
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CPT is a registered trademark of the American Medical Association.
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» Organized by CPT® code for easy and
logical lookup.
» Get information faster with crosswalks
to ICD-9-CM diagnosis, procedure and
anesthesia codes.
» Minimize claim denials and help
avoid audits with Medicare Pub. 100
guidelines for follow-up days and
assistant-at-surgery.
» Medicare RVUs for surgery and
diagnostic procedures included.
» Quickly identify newly prohibited coding
and billing combinations and reduce
audit risk with CCI edits delivered to your
desktop via e-mail.
2009 Coding Companions®
Boost your coders’ efficiency with Coding Companions®, specialty-specific books
that offer the most up-to-date coding information in a quick-search format. These
valuable resources contain 2009 CPT® and ICD-9-CM code sets specific to your
specialty. Find all the information you need for each code on a single, illustrated
page: clear, concise descriptions, as well as coding tips, terminology, cross coding,
Medicare RVUs and Pub. 100 references.
AGEN APEDATObAENTP H Y P H Y P H Y P H Y
Simplify coders’ jobs with these quick-find reference guides.
CPT is a registered trademark of the American Medical Association.
New for 2009
2009 Coding Companions® Title Item No. ISbN Coding Companion® for Cardiology/Cardiothoracic Surgery/Vascular Surgery A1645 978-1-60151-164-5Coding Companion® for Emergency Medicine A1751 978-1-60151-175-1Coding Companion® for ENT/Allergy/Pulmonology A1713 978-1-60151-171-3Coding Companion® for General Surgery/Gastroenterology A1690 978-1-60151-169-0Coding Companion® for Neurosurgery/Neurology A1768 978-1-60151-176-8Coding Companion® for OB/GYN A1621 978-1-60151-162-1Coding Companion® for Oncology/Hematology A1720 978-1-60151-172-0Coding Companion® for Ophthalmology A1638 978-1-60151-163-8Coding Companion® for Orthopaedics—Lower: Hips & Below A1706 978-1-60151-170-6Coding Companion® for Orthopaedics—Upper: Spine & Above A1652 978-1-60151-165-2New Coding Companion® for Pediatrics A2246 978-1-60151-224-6Coding Companion® for Plastics/OMS/Dermatology A1669 978-1-60151-166-9Coding Companion® for Podiatry A1744 978-1-60151-174-4Coding Companion® for Primary Care A1683 978-1-60151-168-3Coding Companion® for Radiology A1676 978-1-60151-167-6Coding Companion® for Urology/Nephrology A1737 978-1-60151-173-7 Available: Now $199.95 each
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New for 2009
2009 Code PathwaysA great supplement to your Coding
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accurate coding of complex procedures.
Specialty-specific, these laminated flip
charts provide guidance and simplify
procedure code selection by mapping out
various options.
» Minimize claim denials with Medicare payer
and Pub. 100 references.
» Access specialty-specific ICD-9-CM,
HCPCS Level II and CPT® code sets.
» CCI edit updates delivered to your desktop
via e-mail.
2009 Coding and Payment GuidesThe 2009 Coding and Payment Guide is a one-stop
coding, billing and documentation resource for
submitting accurate claims.
SPT P H Y
Discount for APTA members
2009 Coding and Payment Guide for the Physical TherapistItem # SPT09 Available: Now
ISBN: 978-160151-182-9 $179.95
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2009 Coding and Payment Guide for Behavioral Health Services
Item # SYCH09 Available: Now ISBN: 978-160151-183-6 $179.95
CPT is a registered trademark of the American Medical Association.
SAP P H Y
2009 Coding and Payment Guide for Anesthesia Services
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2009 Coding and Payment Guide for Laboratory Services
Item # SLAB09 Available: Now ISBN: 978-160151-185-0 $179.95
Includes the information
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Title ISBN Item#
Code Pathways for Dermatology 978-1-60151-213-0 1715New Code Pathways for ENT/Pulmonology 978-1-60151-223-9 1721Code Pathways for General Surgery 978-1-60151-214-7 1714Code Pathways for OB/GYN 978-1-60151-209-3 1716Code Pathways for Ophthalmology 978-1-60151-210-9 1717Code Pathways for Orthopaedics–Lower Hips & Below 978-1-60151-212-3 1718Code Pathways for Orthopaedics–Upper Spine & Above 978-1-60151-211-6 1719Code Pathways Urology and Nephrology 978-1-60151-215-4 1720
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2009 Code Pathways
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» Numerical organization by CPT® code
allows for quick location of diagnosis and
procedure code information.
» Appendix offers a quick reference for
add-on and unlisted codes, along with
CPT® and HCPCS modifiers.
» Referencing clear explanations of CPT®,
ICD-9-CM, and HCPCS Level II codes
help reduce erroneous claim submissions.
» Icons help identify the most accurate use
of ICD-9-CM codes.
2009 Cross CodersBridge the gap between common codes with cross-coding resources that help improve
coding consistency and compliance with essential links from CPT® codes to the
appropriate ICD-9-CM and HCPCS Level II codes.
RCC SCC ACCP P P H YH YH Y
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2009 Anesthesia Cross Coder Item # 1921 Available: Now
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CPT is a registered trademark of the American Medical Association.
2009 Coding Guide for Dental ServicesCode common dental procedures more
efficiently with a comprehensive claims
processing, reimbursement, billing and
fee setting and documentation resource.
Includes definitions and guidelines for
current ICD-9-CM, CPT®, HCPCS Level II
and 2009-2010 CDT codes.
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2009 Coding Guide for Dental Services Item # 1896 Available: Now
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2009 Procedural Cross CoderSave time with an ideal tool for
efficiently coding both inpatient and
outpatient procedures. Crosswalks
from ICD-9-CM procedure to HCPCS
Level II and CPT® codes allow you to
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a single resource.
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2009 Procedural Cross Coder Item # 1922 Available: Now
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2009 Fast FindersMake coding faster and easier with
these double-sided, laminated sheets
each containing approximately 300
commonly reported codes for your
specialty.
» Alphabetically arranged for quick
location.
» Short, functional code descriptions.
2009 E/M Fast FinderAssign the evaluation and management codes that
are part of the 99000 series of the CPT® code set with
the E/M Fast Finder for 2009. It’s the durable, carry-
along reference that enables level, difficulty and other
determinations for each E/M code in the exam room,
lab or office—anywhere you go.
2009 E/M Fast FinderItem # 1254 Available: Now
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EMFF P H CEU
ICD-9-CM Fast Finder 2009
Ob/Gyn
Abortion631 Blighted ovum629.81 Habit abort w/o curr preg632 Missed
Spontaneous634.92 Complete634.91 Incomplete634.90 Unspecified
AIDS and STDsAIDS
V08 HIV, asymptomaticV65.44 HIV, counseling042 HIV, symptomatic078.11 Condyloma acuminatumV01.6 Exposure to STD078.19 Genital warts
Gonococcal infection098.10 Acute, upper GU tract098.11 Cystitis (acute)098.31 Cystitis (chronic)
Herpes054.10 Genital (simplex), NOS054.12 Vulva, ulceration054.11 Vulvovaginitis079.4 Human papilloma virus (HPV)
Syphilis092.0 Early, latent, serological
relapse after tx091.0 Genital chancre (primary)
Breast611.0 Abscess
Abnormal mammogram793.81 Microcalcification793.89 Other
Benign dysplasia610.1 Diffuse cystic mastopathy610.2 Fibroadenosis610.0 Solitary cyst611.6 Galactorrhea (not obstetrical)611.72 Lump/mass611.0 Mastitis611.71 Mastodynia611.79 Nipple inversion/discharge
ContraceptionCounseling/management
V25.03 Emerg contraceptive counselV25.02 Fitting, diaphragmV25.01 Prescription, oralV25.02 Prescription, vaginal agentsV26.4 Procreative, general
Follow-upV25.43 Implantable subdermalV25.42 IUDV25.41 Oral agent prescrip
InsertionV25.5 Implantable subdermal V25.1 IUDV25.2 Sterilization
Diabetes MellitusRequires fifth digit:0 type II or unspec type, not stated as
uncontrolled; assign for type IIregardless of insulin requirement;assign V58.67 for long-term insulin use
1 type I, not stated as uncontrolled 2 type II or unspec type, uncontrolled;
assign for type II regardless of insulinrequirement; assign V58.67 for long-term insulin use
3 type I, uncontrolled250.0_ w/o complication
Diseases of Ovary/FallopianTube/Pelvis/Peritoneum614.8 Oth spec inflam dz of pelvic
organs & tissues614.3 Parametritis/pelvic
cellulitis, acute614.4 Parametritis/pelvic
cellulitis, chronic614.9 PID
Salpingitis and oophoritis614.0 Acute614.1 Chronic614.2 Unspecified
Endometriosis617.2 Fallopian tube617.1 Ovary617.3 Pelvic peritoneum617.0 Uterus/cervix
Estrogen receptor statusV86.1 Negative [ER-]V86.0 Positive [ER+]
Exam/ScreeningOther exam
V26.21 Fertility testingV67.01 Follow-up pap smear after surgV76.11 Mammogram, high riskV72.41 Preg exam, negativeV72.42 Preg exam, positiveV72.40 Preg exam, unconfirmedV72.84 Preoperative, NOSV72.31 Routine gynecologicalV72.32 Smear to confirm recent
norm follow abnorm smear
ScreeningV73.88 Chlamydial disease, specifiedV26.31 Genet dz carrier status, femV26.32 Genet testing, otherV76.19 Neop, breast exam, otherV76.2 Neoplasm cervix, malignantV76.50 Neoplasm, intestineV76.46 Neoplasm, ovaryV76.47 Neoplasm, vaginaV77.0 Thyroid disordersV74.5 Venereal disease
General Signs/SymptomsAbdomen
789.04 Pain, left lower quadrant789.07 Pain, generalized789.03 Pain, right lower quadrant
Anemia280.0 Due to chronic blood loss285.9 Unspecified
Backache724.2 Lumbago V49.84 Bed confinement status626.7 Bleeding, postcoital780.6 Fever784.0 Headache455.6 Hemorrhoids, unspecified
Hypertension, nonpregnant401.1 Benign796.2 Elevated BP w/o HTN dx
Nausea787.02 Alone787.01 w/vomiting278.00 Obesity, unspecified629.89 Oth spec disor, fem gen org625.0 Painful intercourse
Pelvis swelling, mass or lump789.34 Left lower quadrant789.33 Right lower quadrant
Genital mutilation status629.21 Clitorectomy629.22 Clitorec w/excis of lab min629.23 Infibulation629.29 Other629.21 Type I629.22 Type II629.23 Type III
629.29 Type IV629.20 Unspecified
Infertility628.0 Anovulation628.8 Other specified origin628.2 Tubal origin628.9 Unspecified origin
Lab findings, abnormal795.81 Elevated CEA795.82 Elevated CA 125795.89 Other abn tumor markers
Menopause627.4 Artificial stateV49.81 Asymptom, age-rel status
Bleeding627.1 Postmenopausal627.0 Premenopausal627.2 Climacteric states V07.4 Hormone replace therapy256.31 Premature627.3 Vaginal atrophy
Menses626.0 Absence625.3 Dysmenorrhea626.2 Excessive/frequent626.4 Irregularity626.6 Metrorrhagia625.2 Mittelschmerz625.4 Premenst tension syn (PMS)626.1 Scantiness/infrequency626.8 Uterine hemorrhage
NeoplasmBenign
217 Breast221.0 Fallopian tube220 Ovary221.1 Vagina221.2 Vulva
Carcinoma in situ233.0 Breast233.1 Cervix uteri233.3 Genitalia, NOS233.2 Uterus, NOS
Malignant174.6 Breast, axillary tail174.8 Breast, contiguous/other174.4 Breast, upper, outer180.8 Cervix, other site180.9 Cervix uteri, NOS182.0 Corpus uteri, exc isthmus180.0 Endocervix180.1 Exocervix183.2 Fallopian tube182.1 Isthmus184.1 Labia majora184.2 Labia minora183.0 Ovary182.8 Uterine body, other spec184.0 Vagina184.4 Vulva, NOS
3745
Lactiferous ducts
Glandlobules
Pectoralismuscle
Fat
Cervix
Dysplasia is abnormal development of breast tissue; fibroadenosis is a degeneration of gland tissue marked by formation of fibrous nodules
Salpingitis is aninflammation of thefallopian tube whileoophoritis pertains
to the ovary; metritisis an inflammation
of the uterus
Broadligament
Uterus
NippleAreola
Areolarglands
Fallopian tubeUterus
Vaginalcanal
Ovary
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2009 2009 ICD-9-CM HCPCS2009 Fast Finder Description Item# Item#
Allergy and Immunology 2121 behavioral Health 2122 Cardiology 2123 Cardiovascular/Thoracic 2124 Chiropractic Medicine 2125 Dental/OMS 2126 Dermatology 2127 Drug Codes 1561Emergency Medicine 2128 Endocrinology 2129 ENT 2130 External Causes - E Codes 2131 Family Practice 2132 Gastroenterology 2133 General Surgery 2134 Hematology Oncology 2135 Home Health 1562Infectious Diseases 2136 Modifiers 1563Neurology/Neurosurgery 2137 OB/GYN 2138 Ophthalmology/Optometry 2139 Orthopaedics 2140 Orthotics 1564Pain Management 2141 Pediatrics 2142 Physical Medicine/Rehabilitation 2143 Physician Office Supplies 1565Physical Therapy 2144 Plastic and Reconstructive Surgery 2145 Podiatry 2146 Primary Care/Internal Medicine 2147 Prosthetics 1566Signs and Symptoms 2148 Urology/Nephrology 2149 V Codes 2153 Vision and Hearing 1567
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CPT is a registered trademark of the American Medical Association.
For use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See table of contents.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See table of contents.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See table of contents.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH Y
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Encoder ProEncoder Pro is the essential lookup tool for CPT®, ICD-9-CM and HCPCS codes.
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Encoder Pro Professional
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» Modifier crosswalk.
Encoder Pro Expert
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» Compliance Editor.
» Fee Calculator.
CPT is a registered trademark of the American Medical Association.
Code It Fast I-9Code It Fast I-9 is a desktop/network application that delivers fast, efficient ICD-9-CM
code lookup in a desktop application. This tool references all Volume 1 diagnosis.
» Use the fast search engine to quickly
look up clinically accurate diagnosis and
procedure codes by term.
» Reduce research time and improve coding
accuracy with handy color-coded edits and
network-shareable notes.
» Quickly reference code selection and its
appropriate diagnosis-related group, using
the DRG crosswalk.
» Quickly reference code selection and its
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2009 Coders’ Desk Reference for ProceduresMaster CPT® codes and details, plus
improve your accuracy for Medicare
code selection with the comprehensive
guide to procedural coding.
» Contains over 8,000 CPT® codes and more than 6,000 lay descriptions of CPT® procedures.
» Anatomical illustrations of body sites described in operative reports.
» Reduce research time and improve accuracy with modifier definitions,
narrative descriptions and rules.
2009 Coders’ Desk Reference for DiagnosesFor clinical, coding and documentation
guidance beyond the ICD-9-CM book,
turn to the Coders’ Desk Reference for
Diagnoses.
» Ingenix edge® Learn about the changes
for 2009 with complete information on
new codes and their impact on coding
practices.
» Select codes using detailed, clinical
explanations, coding tips and scenarios.
CPT is a registered trademark of the American Medical Association.
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Item # 1329 Available: NowISBN: 978-1-60151-200-0 $134.95
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Item # IDR09 Available: NowISBN: 978-1-60151-136-2 $134.95
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2009 Coders’ Desk Reference for ICD-9-CM Procedures
Item # 1602 Available: NowISBN: 978-1-60151-137-9 $134.95
2009 Coders’ Desk Reference for ICD-9-CM ProceduresThis reference guide describes all ICD-9-CM
procedures in full detail with complete coding
advice.
» Ingenix edge® Updated to include detailed clinical
information and coding tips with scenarios for all
the new ICD-9-CM procedure codes for 2009.
» Select the right ICD-9-CM code every time
using detailed descriptions, coding advice
and scenarios.
» ICD-9-CM procedural coding instruction. Helps
you understand the conventions and guidelines
of ICD-9-CM procedure coding.
For use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See table of contents.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See table of contents.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See table of contents.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH Y
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2009 Insurance Directory Data FileItem # 1582 Available: Now
ISBN: 978-1-60151-195-9 $499.95
2009 Insurance Directory Item # 1581 Available: Now
ISBN: 978-1-60151-194-2 $79.95
2009 Coders’ Desk Reference for HCPCS Level IIItem # 1514 Available: Now
ISBN: 978-1-60151-161-4 $134.95
2009 Coders’ Desk Reference for HCPCS level IISimplify the rules governing HCPCS codes.
» More than 3,000 alphanumerical
HCPCS Level II codes with lay
descriptions for more than 2,000 codes.
» Modifier definitions, diagnosis code
suggestions and usage rules help
you choose mofiferes and E/M codes
accepted by payers.
2009 Insurance DirectoryMost insurance companies have had a
change in their contact information over
the past year. Stay up-to-date with the
Insurance Directory, a complete, updated
resource of insurance company information.
» New Listing of payers capable
of receiving electronic billing and
attachments.
2009 Physicians’ Guide to Implementing the Medicare Quality Reporting InitiativeOwn the information and tools you need to help
capture the bonus payment for quality reporting
to Medicare.
» Gain in-depth understanding with detailed explanations and supporting information on all reporting guidelines and issues.
» Have all 175 quality reporting measures at your fingertips, including 62 new for 2009.
» Now includes two searchable CDs of quality measure codes, cross coding information and flow charts.
» Access code linkage information for ICD-9-CM, CPT® or CPT® Level II/HCPCS codes.
GIR HP
New-CD now contains code linkage information.
2009 Physicians’ Guide to Implementing the Medicare Quality Reporting Initiative
Item # 1645 Available: Mar 2009 ISBN: 978-1-60151-249-9 $229.95
For use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See table of contents.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See table of contents.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See table of contents.P CEUH Y
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2009 Coders’ DictionaryUnlike other medical dictionaries, the
Coders’ Dictionary lays the groundwork
for understanding medical terminology
from a coder’s perspective. Ingenix has
developed this dictionary with the specific
needs of medical coders, admitting clerks,
billers and adjudicators in mind.
.
» Updated to include more than 8,000
alphabetic entries and 250 illustrations
for terminology key to code selection.
» Clear, concise definitions for clinical,
coding, billing and reimbursement terms.
CPT is a registered trademark of the American Medical Association.
TCD P H
2009 Coders’ DictionaryItem # 1517 Available: Now
ISBN: 978-1-60151-199-7 $99.95
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2009 Auditing Tool KitItem # 1572 Available: Feb 2009ISBN: 978-1-60151-191-1 $199.95
New, convenient softbound format
2009 auditing Tool KitThis resource helps guide your
internal auditing processes
and improve billing and coding
accuracy—so you can comply with
Office of Inspector General (OIG)
standards and the annual work plan.
» Equip yourself with the latest auditing
forms to improve your audits and
processes.
» Quickly access the forms and
terms you are seeking with a
searchable CD with topics
organized in an A-to-Z format.
CPTC P H Y
2009 CPT® Changes: An Insider’s ViewItem # CI09 Available: Now
ISBN: 978-1-60359-059-4 $67.95
2009 CPT® Changes: an Insider’s ViewCPT® Changes: An Insider’s View outlines the
specific changes to the CPT® code set for 2009,
provides the official rationale behind the changes
and explains the impact on reporting and
reimbursement for medical services. It includes
all new, revised and deleted codes.
» Organized by CPT® code section and code
number to easily find codes.
» Illustrations demonstrate how to use new
codes.
» Clinical examples describe how services
included in new CPT® codes are performed.
» Coding and billing tips focus on rules for billing.
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The HIPAA Tool Kit thoroughly explains
HIPAA requirements, and helps you
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» Security implementation guidance
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» Customizable training presentations in
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Denial Management Tool KitThe Denial Management Took Kit helps
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2009 DRG ExpertImprove reimbursement management with
DRG Expert, a comprehensive resource
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validation. DRG Expert is organized by
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» Ingenix edge® Updated CMS rates for current
relative weight, geometric length of
stay and average length of stay for each
MS-DRG under both the IPPS and LTCH
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» Ingenix edge® Current MS-DRG structure.
Diagnosis and procedure codes that
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» Ingenix edge® Ingenix hallmark color coding.
Easily identify CC and MCC restrictions,
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» Ingenix edge® Valuable resources are at your
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2009 DRG Desk ReferenceAccess crucial information to accurately
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» Updated with over 400 pages of vital
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» Documentation Specificity Tables help
differentiate between non-specific and
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» Targeted DRG documentation and
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» New information on RAC program to
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» Tutorials demonstrate how to audit
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» Includes list with expanded Hospital
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» DRG decision trees outline the logic
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Uniform Billing EditorAccess detailed information about
Medicare and UB-04 billing rules, as
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» Quickly link HCPCS and CPT® codes
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» Crosswalk from UB-04 to UB-92
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» Find topics via field locators, revenue
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» Identify data inconsistencies,
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CPT is a registered trademark of the American Medical Association.
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Outpatient Billing ExpertThis reference tool is a one-source guide
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Outpatient Billing Expert also provides
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» Keep all billing accurate with the most
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» Includes comprehensive coverage of
both ASC and APC payment systems.
» Contains information used daily by
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» eBook exclusive! APC and ASC
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» Stay current with regulatory changes
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Outpatient Billing Expert eBook
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2007 Hospital Professional Billing EditorConquer the coding, billing and reimbursement issues
associated with billing professional services provided
by hospital-based physicians. Understanding the
differences in billing requirements for the professional
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2009 Facility Guide for Interventional RadiologyInterventional radiology and cardiology coding can baffle even the most experienced
coders. Developed to simplify coding for imaging-assisted surgical services, this facility-
based resource provides current CPT® and Medicare reporting guidelines along with
specific direction for coding complex interventional procedures.
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CPT is a registered trademark of the American Medical Association.
» Ingenix edge® Guidelines and tips for accurate billing of professional charges in the following
areas: ER physicians, EKG readings, pathologists, medical nutrition consulting, diabetic
self-management staff, CRNAs and hospitalists.
» Ingenix edge® Find out how to enroll the professional as a part of the hospital professional
group.
» Ingenix edge® Access source documentation and coding tips for both facility and
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» Reference billing instructions for completing the CMS-1500 and its electronic
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» Save time with ICD-9-CM, CPT® and HCPCS Level
II information specific to interventional radiology
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» Access the most current information, codes,
reimbursement guidance and tips for interventional
procedures.
» Optimize revenue for your facility with detailed
data on often-overlooked codes while capturing all
allowable charges.
» Stay up-to-date with CCI edits delivered quarterly
via e-mail.
For use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See table of contents.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See table of contents.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See table of contents.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See page 45.P CEUH Y
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OPPS ManagerOPPS Manager will give you a better
understanding of OPPS requirements and
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Clear up confusion about OPPS-related regulations.
HAPCM
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Hospital Chargemaster GuideUpdate and maintain an accurate charge description
master (CDM). Organized by ancillary service
department, this manual provides detailed guidelines
for achieving optimal reimbursement and department-
specific information for efficient auditing.
» Guidelines on how to review the CDM for coding, billing, reimbursement and
clinical accuracy.
» CPT®/HCPCS Level II and revenue code crosswalks for each clinical department.
» Determine how each code will be reimbursed under APCs and other payment
methodologies.
» Identifies department-specific CCI and OCE edits and fraud alerts to help maintain
compliance.
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CPT is a registered trademark of the American Medical Association.
» Clear, concise descriptions of OPPS-related regulations and legislation in a single source, updated twice per year.
» Operational analyses and implementation strategies for better management, auditing and consulting.
» Direct links to original CMS transmittals, Federal Register and legislative acts.
» 400+ searchable CMS regulatory documents catalogued in alphabetical order.
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For use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See table of contents.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See table of contents.P CEUH YFor use by Physicians & Clinics For use in Hospitals & Facilities For use by Payers Earn CEUs. See table of contents.P CEUH Y
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Ingenix learning: Coding and Reimbursement EducationProvides a full-featured
online curriculum that teaches
core coding practices and
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» Ingenix edge® Get prompt responses to content queries with access to our staff experts.
» Courses qualify for up to 5 CEUs from Academy of Professional Coders (AAPC) and AHIMA.
» Reduce overall training costs by eliminating travel expenses and reducing costs associated with instructor time and salary.
» Customized curriculum to meet your individual practice needs.
Course Skill Physician Hospital Payer *Price per Available Level Item# Item# Item# single user
New Implementing ICD-10 Professional Z960 Z960 Z960 64.95 OnlineNew Understanding and Using ICD-10-CM Professional Z961 Z961 Z961 64.95 OnlineNew Understanding and Using ICD-10-PCS: The Structure and Conventions Professional Z962 Z962 Z962 64.95 OnlineNew Introduction to Skilled Nursing Facilities Novice Z300 Z300 Z300 64.95 OnlineNew billing for Skilled Nursing Services Professional Z301 Z301 Z301 64.95 OnlineNew Coding for Skilled Nursing Services Professional Z302 Z302 Z302 64.95 OnlineThe Essentials—EncoderPro.com Training Novice Z625 99.00 OnlineImplementing Severity-based DRGs Professional Z746 64.95 OnlineImplementing the Medicare Physician Quality Reporting Initiative Professional Z632 64.95 OnlineA Practical Guide to Auditing Physician Services Master Z618 Z724 Z819 64.95 OnlineCoding from the Operative Report Master Z624 Z734 Z828 64.95 OnlineManaging and Preventing Denials Master Z617 Z723 Z818 64.95 OnlineEvaluation & Management Coding: The Use of CPT® E/M Codes Professional Z604 Z715 Z809 64.95 OnlineUnderstanding and Using Modifiers Professional Z612 Z722 Z816 64.95 OnlineUnderstanding Insurance Novice Z600 Z710 Z803 64.95 OnlineDiagnosis Coding: The Use of ICD-9-CM Codes Novice Z601 Z711 Z800 64.95 OnlineProcedure Coding: The Use of CPT® Codes Novice Z602 Z712 Z801 64.95 OnlineFoundations of Medical Terminology Novice Z603 Z713 Z802 64.95 OnlineIntroduction to Medical Claims Fraud Detection (Part 1) Novice Z834 64.95 OnlineIntroduction to Medical Claims Fraud Detection (Part 2) Novice Z830 64.95 OnlineIntroduction to Medical Claims Fraud Detection (Part 3) Novice Z831 64.95 OnlineIntroduction to Medical Claims Fraud Detection (Part 4) Novice Z832 64.95 OnlineA Management Perspective on Anti-Fraud (Part 5) Novice Z833 64.95 OnlineSupplies & Services Coding: The Use of HCPCS Level II Codes Novice Z605 Z714 Z807 64.95 OnlineIntroduction to Medical Coding Basics Novice Z627 Z737 Z829 64.95 OnlineIntroduction to Present on Admission Reporting Professional Z749 64.95 Online
CPT is a registered trademark of the American Medical Association.
*Multi-user pricing available
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2009 Customized Fee analyzerWhy rely on national averages? The Customized Fee
Analyzer provides a report tailored for your specific
geographic area, and the CPT® codes most frequently
used in your specialty.
» Benchmark your fees with a nationally recognized
database of nearly one billion real-life charge records.
» Support your fee development and contract negotiations
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CFA P CEU
The Customized Fee Analyzer is available for these specialties in all areas of the country.
Allergy/ImmunologyCardiologyChiropractic ServicesCardiovascular SurgeryDental*DermatologyFamily PracticeGastroenterologyGeneral PracticeGeneral SurgeryHand SurgeryHematologyInternal Medicinelaboratory
NeonatologyNephrologyNeurologyNeurosurgeryOb/GYNOncologyOphthalmology/OptometryOral and Maxillofacial Surgery*Orthopedic SurgeryOtolaryngologyPain ManagementPathologyPediatric Medicine
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* Dental, OMS and Anesthesia/Pain Management reports are sold as separate Fee Analyzers.
2009 Customized Fee AnalyzerOne Specialty Item# 1684 $299.95
Two Specialties Item# 1685 $399.95
All CPT® Codes Item# 1686 $449.95 Available: Now
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CPT is a registered trademark of the American Medical Association.
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Feeanalyzer.com FeeAnalyzer.com is the online subscription
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RBRVS PlusModel new conversion factors, see what
providers in other geographical areas are
receiving as Medicare reimbursement,
and determine your fees.
» Simplify your GPCI-adjusted calculations with
Medicare localities and pinpointed counties
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» Model fees, build spreadsheets and populate
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Ingenix Data FilesKeeping your coding, billing, fees and
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Medicare Desk Reference for HospitalsGet answers to vital questions about the Medicare program and its impact on your facility.
This all-in-one reference provides access to information that will improve management of
coverage, billing and payment policies for Medicare services.
» Quickly locate answers to billing and compliance questions along with information
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Medicare Desk Reference for Hospitals
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Medicare Desk Reference for Hospitals eBook
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Medicare Desk Reference for Physicians
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Answers to all of your Medicare billing and payment questions.
Medicare Desk Reference for PhysiciansThe Medicare Desk Reference for
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If you’ve been buying an AMA ICD-9-CM book, you’ve been buying Ingenix content.
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In fact, our ICD-9-CM Physician Volumes 1 & 2 content and expertise have been so reliable that the AMA has been purchasing it from us for the past 16 years and publishing it under their book cover. But that will change this year. For 2010, the only way to guarantee you receive the same content you’ve grown to rely on is to purchase the Ingenix product.
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Use source code 121739 to ensure your discount.