Ryan Devey I Optum360 Physician eSolutions Product Manager
Web-Based Medical Coding Content:
A Wealth of Content by Code Whether it’s CMS, the AMA, AHA, ASA, or a number of any other coding organizations, finding
coding content has never been easier.
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Presentation disclaimer
All of the information provided is believed to be accurate and reliable; however, Optum360® assumes no responsibility for any errors. Optum360 is providing this information for educational purposes only and not as a replacement for professional judgment and experience; therefore any use of this information is at your sole risk and Optum360 neither assumes nor is responsible for its use.
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Web-Based Medical Coding Content: A Wealth of Content by Code
Today’s world of the technology:
• Rotary dial phones instead of our iPhones or Androids (Show of hands)
• Encyclopedias/libraries vs. Internet (today’s library)
• Handwritten letters/documents vs. email
• Computers in our jobs (Can you imagine a life without them? Anyone?)
Let us show you how web-based coding information products and replace VOLUMES of
print content, and how it can provide this content in the same way as a book/newsletter,
only with more current information and much more efficient look-up capabilities. The
majority of users of these web-based products often wonder how they did their job before
using these products…you will too!
In this presentation we will discuss…
• Why web-based medical coding information applications?
• A massive library of coding content: A focus on clinical documentation and exclusive
AMA CPT® content.
• Why Optum360? Simply…the Optum360 proprietary content and exclusive content
delivery permissions.
CPT © 2015 American Medical Association. All Rights Reserved
Why web-based medical coding information applications?
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Benefits of web-based medical coding information applications
• Improve overall production
• Increase coding and billing accuracy
• Potentially decreased denials Efficient code selection through fast and simple lookup
Search across all four code sets in real-time for efficient claim preparation and
fewer rejections
Practices billing Medicare part B and private payers can reference procedure, service/supply and diagnosis codes and coverage information much faster
Automatic monthly updates
Volumes of historical content without additional “physical” space
A massive library of coding content: A focus on clinical documentation and exclusive AMA CPT® content
CPT © 2015 American Medical Association. All Rights Reserved
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 7
Web-based medical coding information applications
Optum360 offers real-time coding tools
designed specifically for users to quickly and
accurately access and assign codes.
Search, research, validate and print…
• CPT®
• HCPCS
• ICD-9-CM v1, v2, v3
• ICD-10-CM and PCS
CPT © 2015 American Medical Association. All Rights Reserved
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Content overview: And this is just the beginning…
Features include, but not limited to…
• CodeLogic™ Search Engine
• Color Code Edits (Over 30 icon alerts per
code type)
• Lay descriptions / Annotations
• Deleted Code Crosswalk
• Real-time updates
• User notes and favorite lists
• Print Code Summary
• All code book resources (indexes, tables,
appendixes, notes, guidelines)
• ICD-9-CM V1, V3, HCPCS and Anesthesia
Crosswalks
• Medicare’s Pub 100
• Modifier Crosswalk
• Future Codes
• PQRS per code
• CMS HCC information
• Medicare CCI (Correct Coding Initiative) Edits
• MPFS Fee Calculator (with reductions)
• LCD/NCD Policy Lookup Tools
• A Complete Claims Review Tool (Compliance
Editor – Powered by Optum Claims Manager)
• Merck Manual Content (NEW!)
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Add-on capabilities
• AHA Coding Clinic for ICD-9-CM
Includes Article Index with code or keyword search functionality
• AHA Coding Clinic for HCPCS
Includes Article Index with code or keyword search functionality
• Dr. Z’s Medical Coding Series: Interventional Radiology Coding Reference
Access to the go-to manual that simplifies the complexity inherent with interventional radiology coding. Includes details for appropriate coding and charging of both vascular and non-vascular procedures, laid out by type and anatomical site, as well as thorough instructions about the included components, based on the appropriate CPT® or HCPCS code.
• The AMA CPT® Content Module
All CPT® Assistant, CPT Changes, and AMA Knowledge Base content back to 1990. Unrestricted. Any article, any newsletter/publication in its entirety.
• Optum360 DrugReimbursement.com
(EncoderPro.com for Payers only) – Optum360
crosswalks from J codes to NDC, AWP and HCPCS to
NDC
• Optum FeeAnalyzer.com
• ASA and Dental Code Crosswalks
• The I10 Map Manager
• Coder’s Essential 3-Pack
All code related data from DecisionHealth’s Pink Sheets,
Answer Books, and Part B News content.
• Optum360 and Stedman’s Medical Dictionary
Complete Medical Dictionary as provided by Stedman’s
and Optum360.
• The Clinical Documentation Improvement Add-on
Complete CDI content by code or keyword from 4
different CDI sources.
CPT © 2015 American Medical Association. All Rights Reserved
Why Optum360? Simply…the Optum360 proprietary content and
exclusive content delivery permissions.
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 11
The AMA CPT® Content Module
• The American Medical Association (AMA) Content Module Add-on includes 3
different publications IN THEIR ENTIRETY:
The CPT® Assistant Newsletter: Every article from every monthly edition for multiple
years.
The CPT® Changes: An Insider’s View. Every publication from 2006 to 2015.
The AMA Knowledge Base: Access to thousands of answers to questions asked by AMA
members and customers regarding CPT® codes and their use.
• AMA/Optum360 EXCLUSIVE: Users have the ability to access any publication in
its entirety. Users no longer are limited to just articles associated with codes.
Users can now search by month, year, etc., and see full newsletters, with all articles
available in each publication.
• AMA/Optum360 EXCLUSIVE: Users can gain unique insight into a CPT® code by
accessing questions asked by coders who use these CPT® codes. If you have a
question about the use of a CPT® code, chances are, others had that same
question, asked, and the AMA provided an answer.
CPT © 2015 American Medical Association. All Rights Reserved
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The AMA CPT® Content Module (continued)
• Search by newsletter month/year, keyword, code, etc.: Whether you are using Optum360 proprietary CodeLogic to find a code, or using our unique search functionality to find information specific to the AMA’s content for a particular CPT® code, you will be able to easily access the AMA content for any code, across all three AMA publications all at once, within many locations in EncoderPro.com.
• Access years of newsletters, publications, and questions. There are literally hundreds of volumes of content, all easily searchable by code/keyword, and we add to the library each month with the latest newsletters and question/answers from the AMA. Users of this add-on always have access to the most current AMA information, and to volumes of historical AMA content. No other online solution provides access to this valuable AMA content like Optum360.
CPT © 2015 American Medical Association. All Rights Reserved
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 13
The AMA CPT® Content Module
CPT © 2015 American Medical Association. All Rights Reserved
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 14
The AMA CPT® Content Module
CPT © 2015 American Medical Association. All Rights Reserved
Confidential property of Optum. Do not distribute or reproduce without express permission from Optum. 15
The Clinical Documentation Improvement Add-on
• The Clinical Documentation Improvement (CDI) Add-on includes 4 different sources for CDI improvement content:
– Optum360: The ICD-10-CM Clinical Documentation Improvement Desk Reference
– Optum360: The Guide to Clinical Validation Documentation and Coding Reference
– Optum360: Physician Consulting ICD-10-CM CDI Improvement Training Content
– Optum360: Clinical Documentation Guidelines for Facilities
• Identify and clarify…any confusing, incomplete, conflicting or missing information in the physician-documentation portion of the health recorded that is related to diagnoses or procedures.
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The Clinical Documentation Improvement Add-on (continued)
• Search clinical terms, codes, keywords, print and/or email…documentation that can be necessary for any clinician, coder or any other health care individual needing information for accurate code identification and a more robust and accurate depiction of patient severity.
• Foster and enhance...communication between members of the CDI team, coders and medical staff.
• Provide ICD-10-CM education…to medical staff members on the increased granularity inherent in ICD-10-CM and how it necessitates more detailed documentation in the medical record, as well as educating coding staff members clinical knowledge as it relates to the specificity in ICD-10.
• Provide continuity of care…for the patient, between members of the health care team that rely on documentation in the health record for determining ongoing treatment decisions.
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The Clinical Documentation Improvement Add-on
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The Clinical Documentation Improvement Add-on
Contact information
Ryan Devey, Physician eSolutions Product Manager
1-480-822-1004
