Get ready for the changes ahead.

Transcription

Get ready for the changes ahead.
Medical Coding, Billing & Reimbursement
Spring/Summer 2010 Catalog
Electronic Products
Pages 2-11
New Look for ICD-9-CM
Pages 12-16
CPT®, HCPCS & DRG
Pages 18-22
ICD-10 &Training
Pages 42-43
New Products
Page 45
Get ready for the
changes ahead.
NEW
Solutions for 2011 code changes,
ICD-10 preparation, and electronic coding.
>> Introducing 2011 editions—save 15%
>> Up to 45% off 2010 resources
>> Budget-friendly book and eSolution packages
Order Online
Save an
additional 5% on
2011 editions
How would you
like to reduce your
denial rate by 50%?
Learn how one eSolutions
client did just that in less
than 3 months.*
The future is now
Make the switch to eSolutions
2010 is the year to transition to eSolutions. As the health care system shifts to
using sophisticated technology, Ingenix continues to keep pace with industry evolutions by offering
essential coding resources online. Switching to eSolutions is quick and easy with almost instant
benefits, including:
»D
ecreased A/R days and improved cash flow.
» Reduced denials.
» Improved reimbursement.
» Simplified ICD-10 transition.
*Turn to page 5 for the full story.
Sign up for a FREE product demo today!
demo
Choose from a select group of Ingenix online resources appearing within the eSolutions section.
Upon signing up, you will be contacted by an Ingenix e-Solutions Specialist for a custom product
demonstration. Visit www.shopingenix.com/demo3 to sign up.
1 800
(464 3649), option 1
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Table of Contents
P For use by Physicians & Clinics
P
H For use in Hospitals & Facilities
A For use by Postacute Services
H A Y B E S T P A C K A G E D E A L S
3 •• • Print and Electronic Solutions
44•••• Create Your Own Package
P
H A Y 2 •• •
4 •
5 •• •
6 •
6 • 7 •• 8 •
8 • 8 • 9 •• •
9 •
10••••
11 •• •
P
H A Y 12 • •
14 • •
16 ••
16 •••
17 •••
17 •••
17 •••
18•• •
20•• •
22 • •
P
P
ESSENTIAL CODING
ICD-9-CM Code Books for Physicians
ICD-9-CM Code Books for Hospitals
ICD-9-CM Expert for Home Health Services
ICD-9-CM Expert for Skilled Nursing Facilities, Inpatient
Rehabilitation Facilities, and Hospices
OASIS Editor
MDS Editor
Coding, Reporting, and Documentation Guidance for
Postacute Facilities (CD)
CPT® Coding Books
HCPCS Level II Code Books
DRG Resources
H A Y 23••••
24•• •
24•• •
25•• •
26•• •
26•• •
27•• •
27•
eSOLUTIONS
IngenixExpert.com
EncoderPro.com
Referential Add-ons
EncoderPro.com for Payers
Encoder Pro Desktop
Caretracker
RevenueCyclePro.com
FacilityCoder.com Expert
ASCExpert.com
DrugReimbursement.com
ChargemasterExpert.com
Real-time eContent
Ingenix Data Files
DESK R E F E R E N C E
MedicalReferenceEngine.com
Coders’ Desk References
E/M Fast Finder
Comprehensive ICD-9-CM Table of Drugs and Chemicals
Insurance Directory
CPT® Changes: An Insider’s View
Coders’ Dictionary
Physician’s Compliance Guide
H A Y SPECIALTY R E F E R E N C E
28•• •
30•• •
30• 31•• •
Coding Companion ® Specialty Guides
Coding and Payment Guides
Coding and Payment Guide for Dental Services
Cross Coders
Products contained in this catalog are made in the USA.
CPT is a registered trademark of the American Medical Association.
P
Y For use by Payers
Available for download online
H A Y SPECIALTY R E F E R E N C E
( cont. )
32•• • Fast Finder ® Sheets
33•• • Coders’ Desk References for Specialties
33•• • Billing Companion for OB/GYN
P
H A Y 34• •
34• •
35• 36• 36• •
36•
P
H A Y 37•• •
37 • •
38 • •
38 • •
39• 39•• •
P
P
•
•
•
C O D I N G , B I L L I N G , A N D P AY M E N T
Complete Guide for Interventional Radiology
Hospital Compliance Desk Reference
Uniform Billing Editor
Outpatient Billing Expert
HIPAA Tool Kit
Auditing and Denial Management Tool Kit
H A Y 40• 40••
40••
41 ••
PRICING AND COST
The Essential RBRVS
RBRVS Plus
Customized Fee Analyzer
National Fee Analyzer
Relative Values for Physicians
HCPCS Fee Analyzer
MEDICARE REFERENCE
Medicare Correct Coding Guide
Complete Guide to Medicare Coverage Issues
Physicians’ Guide to Medicare Quality Reporting
Medicare Desk References
H A Y TRAINING
42•••• Coder Education Book Series
42•••• Ingenix Essentials Conference
43•••• ICD-10 Prepared
P
H A Y N E W P R O D U C T S
10••••
23••••
37 • •
45•• •
45•• •
Real-time eContent
MedicalReferenceEngine.com
Hospital Compliance Desk Reference
2010 ICD-10-CM Mappings
2010 Clinical Documentation Guide for the
Musculoskeletal System
45•• • 2010 Evaluation and Management Coding Advisor
.com
eSolutions
2
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Going Electronic—First Steps
Ease into the transition.
Maybe you’d prefer to start going electronic
with just one code set. Our IngenixExpert.com
products provide electronic code reference for
the code set of your choice. You and your staff
can learn how easy it is to perform electronic
code look-ups, gain confidence, and submit
cleaner claims.
IngenixExpert.com lets you start with one code set at a time.
Ingenix Expert.com
instructions. Avoid thumbing
Gain direct access to every code,
through multiple code books
description, guideline, and instruction
searching for information.
found in your Expert code book. It’s
easy with IngenixExpert.com. Its
1-on-1 demo
See inside cover
for details
»Always current code descriptions
and clinical information. Code more
powerful search engine helps you
confidently knowing that you are
maximize coding confidence and
XEIMD/XEIHP/XEHBK/XECPT
accessing up-to-date extensive
submit cleaner claims. Plus, it’s
appendixes, commonly miscoded
always up-to-date with the latest
HIPAA-compliant information. Use it
alongside your coding book—or as a
standalone solution.
Current Procedural Coding Expert.com
Item # 1400 Available: Online
$74.95 Single-user. Multi-user pricing available.
procedures, Medicare requirements,
and glossaries with a simple click of
ICD-9-CM Expert.com for Hospitals
Item # 1403 Available: Online
$89.95 Single-user. Multi-user pricing available.
the mouse.
»Anatomical illustrations. Large
»Faster, easier searches. Locate the
displays of anatomical illustrations
code you need with a term search,
on your screen help you better
or scroll through the index to access
understand procedures and
sections from the code book.
anatomy so you can select the
ICD-9-CM Expert.com for Physicians
Item # 1402 Available: Online
$79.95 Single-user. Multi-user pricing available.
HCPCS Expert.com
Item # 1401 Available: Online
$69.95 Single-user. Multi-user pricing available.
best possible codes.
»Immediate guidance from user-
Call for Multi-user pricing.
friendly AMA, Ingenix, and Medicare
color-coded edits, guidelines, and
P H Y
*See opposite page for savings on EncoderPro.com, Expert.com, and coding book packages.
CPT is a registered trademark of the American Medical Association.
P
For use by Physicians & Clinics
H
For use in Hospitals & Facilities
A
For use by Postacute Services
Y
For use by Payers
Available for download online
1 800
(464 3649), option 1
Mention your source code for discounts
3
Save
40% on
packages
Take the first step with book and eSolution packages that let you keep your
books while you learn how to become a whiz with your electronic products.
2011 Future of Coding Spiral Package
› 2011 ICD-9-CM Expert for Physicians
› 2011 Current Procedural Coding Expert
› 2011 HCPCS Level II Expert
› EncoderPro.com Standard
2011 Future of Coding Spiral Package
Item # P1689 Available: Now
Regular Price: $599.80 Package Price: $359.88
Turn page to learn more
2011 Future of Coding Compact Package
› 2011 ICD-9-CM Standard for Physicians
› 2011 Current Procedural Coding Expert
› 2011 HCPCS Level II Expert
› EncoderPro.com Standard
2011 Future of Coding Compact Package
Item # P1688 Available: Now
Regular Price: $551.80 Package Price: $331.08
Turn page to learn more
2011 ICD-9-CM
Physician Expert Package
Item # P1690
Available: Now
Regular Price: $175.90
Package Price: $107.94
2011 ICD-9-CM Physician Expert Package
› 2011 ICD-9-CM Expert for Physicians
› ICD-9-CM Expert.com
2011 Current
Procedural Coding
Expert Package
Item # P1691
Available: Now
Regular Price: $174.90
Package Price: $104.94
2011 Current Procedural Coding
Expert Package
› 2011 Current Procedural Coding Expert
› Current Procedural Coding Expert.com
2011 HCPCS Expert
Coding Package
Item # P1692
Available: Now
Regular Price: $169.90
Package Price: $101.94
2011 HCPCS Expert Coding Package
› 2011 HCPCS Level II Expert
› HCPCS Expert.com
Medallion customers and Partner Accounts are not eligible for the above package offers.
P
For use by Physicians & Clinics
H
For use in Hospitals & Facilities
A
For use by Postacute Services
Y
For use by Payers
Available for download online
eSolutions
Ingenix makes the transition cost effective with
budget-friendly code book and eSolution packages.
.com
eSolutions
4
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Electronic coding processes:
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The industry is switching to electronic coding and billing solutions. Make sure you stay ahead of the curve
with EncoderPro.com, our premier online coding and billing tool that provides:
» Increased accuracy, fewer denials, and timely reimbursement
» Easier transition to ICD-10 and improved regulatory compliance
» Expert content from 37 code books and data files updated in real time
Access the content of more than 37 Ingenix
code books in one EncoderPro.com subscription.
XCIFC/ XEPRO/XEPRC
P
Assess your needs
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EncoderPro.com
Item # 1137
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Professional
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CodeLogicTM Search Engine – Search across all three code sets simultaneously
•
•
•
Color Code Edits
•
•
•
Coders’ Desk Reference Lay Descriptions
•
•
•
Deleted Code Crosswalk
•
•
•
Automatic Monthly Updates
•
•
•
Local Coverage Determinations (LCDs) and Medicare’s Pub. 100 Access
•
•
Modifier Crosswalk
•
•
Medicare CCI Edits
•
•
Cross-coder relationships from 12 coding and billing specialty reference books
•
•
features
Enhanced Compliance Editor – Check your work by running selected codes through an edit check prior to
submittal to a clearinghouse/vendor/payer. Includes an 18-month historical content database.
•
Fee Calculator – Calculate the adjusted Medicare reimbursement rate for your area.
•
Complete LCD/NCD Policy View – Reference all of the local and national coverage guidelines in addition
to the code edits for Part B policies issued by your carrier.
•
Claims scrubbing and repair available
•
NEW
•
ICD-10 Mapping Tool – Crosswalk from ICD-9-CM codes to the appropriate ICD-10 code
quickly and easily.
Our newest feature for EncoderPro.com Expert, it will help you:
» Quickly link ICD-9 codes to the new ICD-10 codes
» Learn the code set as you code
» Access reimbursement mapping information
» Receive the payment you deserve
*Indian Stream Health Center realized a 1,000% return on their EncoderPro.com investment in the first month of use.
P
For use by Physicians & Clinics
H
For use in Hospitals & Facilities
A
For use by Postacute Services
Y
For use by Payers
Available for download online
1 800
(464 3649), option 1
Mention your source code for discounts
5
Claims Batch Editor and the Repair Toolkit for EncoderPro.com Expert create a
complete, end-to-end physician revenue cycle workflow solution for your office.
Claims Batch Editor
Claims Batch Editor Repair Toolkit
This powerful, yet easy-to-use, scrubber for physician claims
Boost your scrubbing capabilities with the Repair Toolkit tools to
automatically checks for errors prior to submission, so you
streamline the workflow to review coding issues and repair these
submit clean claims the first time.
issues — prior to submittal to a payer.
Claims Batch Editor Repair Toolkit
Item # WA18 Available: Online
$250.00 per physician, per year
Claims Batch Editor
Item # WA16 Available: Online
$500.00 per physician, per year
Supplement your online subscriptions with valuable, referential add-ons.
Add-on prices are per user, per year unless otherwise specified.
CPT ® Assistant Add-on
Item # WA01 $250.00
FeeAnalyzer.com Professional Add-on
Item # WA14 $1,250.00
Patient Encounter Plus Add-on
Item # WA15 $279.99
Stedman’s Medical Dictionary Add-on
Item # WA04 $125.00
Ingenix Coders’ Dictionary Add-on
Item # WA05 $75.00
CEU Add-on
Item # WA17 $250.00 per 10 CEUs
AHA Coding Clinic for ICD-9-CM Add-on
Item # WA02 $250.00
DrugReimbursement.com Add-on
Item # WA08 $499.95
Historical Application Content Add-On
Item # WA11 $149.00
For more details on add-ons, please visit ShopIngenix.com and type in the key word “add-on.”
Customer Spotlight
Sun Radiology Reduces Claims Denial Rates by 50 Percent with EncoderPro.com Expert
“Encoder Pro and Claims Batch Editor have helped improve our productivity, reduced denial rates, and given us a significant
financial benefit … In the long run, that means that we’ll be able to provide better services to our patients.”
—Sharon Hicks, Sun Radiology Billing Supervisor
Encoder Pro and Claims Batch Editor have helped Sun Radiology accelerate its
revenue cycle, increase revenues and maximize resources at a significant value:
ƒƒ Reduced A/R days by 14 days
ƒƒ Reduced denial rate by 50 percent
ƒƒ Achieved a return on investment of 812 percent
ƒƒ Significantly reduced clearinghouse fees
Call 800 INGENIX (464 3649), option 1, to learn how you can reduce your denial rates.
Or visit shopingenix.com/transition.
P
For use by Physicians & Clinics
H
For use in Hospitals & Facilities
A
For use by Postacute Services
Y
For use by Payers
Available for download online
eSolutions
Increase Revenue and Reduce Denial
Rates & A/R Days
.com
eSolutions
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EncoderPro.com for Payers
EncoderPro.com for Payers is designed specifically for payer
1-on-1 demo
organizations to search for CPT® procedures, HCPCS supplies and
See inside cover
for details
services, and ICD-9-CM diagnosis and procedures codes based on
descriptions on the provider and hospital claim forms.
»Includes Coders’ Desk Reference lay descriptions.
»Color code edits. Determine charges allowed by Medicare for
capitation, fee-for-service, outpatient and inpatient hospital
services, and provider payments.
Y
xepay/xepap
EncoderPro.com for Payers
Item # 1145 Available: Online
$999.95 Single-user.
Call for Multi-user pricing.
»Medicare secondary payer coordination of benefits. Access the
entire MSP Manual and understand assigning responsibility for first
and second payer.
Encoder Pro Desktop
Code lookup is fast and simple with Encoder Pro, the coder’s essential CPT®, ICD9-CM, and HCPCS code reference software, that lets you simultaneously search
thousands of codes using up to four terms.
»Compliance editor. Check for coding
EPRC
»
IngenixEdge ®
Powerful CodeLogic™
accuracy and review your code
search engine technology. Keyword
selections for CCI unbundle edits,
search across all code sets
ICD-9-CM specificity, age, medical
simultaneously using up to four terms,
necessity, and gender.
acronyms, abbreviations, or even
»Fee calculator. Helps you calculate
the Medicare reimbursement rate for
your area.
»
IngenixEdge ®
Access local coverage
determinations (LCDs) and Medicare’s
Pub. 100. Check procedures for
Medicare coverage instructions and
medical necessity edits.
coding confidence.
Lay descriptions for
»Crosswalking. Links procedure codes
procedures and HCPCS. Access
to corresponding diagnosis and supply
Coders’ Desk Reference descriptions
codes immediately and guides you to
for thousands of procedures and
the correct modifiers.
services to better understand CPT®
»Color code edits. Reduce research
and HCPCS differences.
»
Web-based version
available—see page 4.
IngenixEdge ®
Encoder Pro Desktop
Item # 3460 Available: Now
$999.95 Single-user.
Call for Multi-user pricing.
coverage information regularly for
misspelled terms.
»
P
IngenixEdge ®
time and improve coding accuracy
Automatic quarterly updates.
with at-a-glance sex and age edits,
Delivers code changes before
Medicare coverage, and bundled
implementation and updates Medicare
procedures.
CPT is a registered trademark of the American Medical Association.
P
For use by Physicians & Clinics
H
For use in Hospitals & Facilities
A
For use by Postacute Services
Y
For use by Payers
Available for download online
1 800
(464 3649), option 1
Mention your source code for discounts
7
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For use by Physicians & Clinics
H
For use in Hospitals & Facilities
A
For use by Postacute Services
Y
For use by Payers
Available for download online
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eSolutions
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Optimize your
facility’s revenue cycle
with eSolutions.
RevenueCyclePro.com
H
Improve revenue cycle performance indicators
RevenueCyclePro.com is a comprehensive, online, problem-solving tool that compiles references and data that hospitals
depend on to increase efficiency across the entire revenue cycle.
» NEW ICD-10 Mapping Tool.
» Get quick access to data and medical code sets you
need to capture outpatient and inpatient reimbursement.
» Answer questions about coding, billing, coverage, and
reimbursement.
» Resolve edits, problems, and issues related to the
codes and other data reported on the claim to minimize
noncompliance exposure.
RevenueCyclePro.com
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FacilityCoder.com Expert
H
FacilityCoder.com Expert delivers HIM coders the most
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code books.
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Item # 1152 Price: $899.95 Single-user.
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ASCExpert.com
H
Achieve accurate reimbursement under the new Medicare ASC payment system
ASCExpert.com, designed specifically for ASCs,
provides a complete set of resources and tools for ASC
office managers, coding and billing specialists, and ASC
Administrators and allows you to:
» Search across all ICD-9-CM, CPT ® codes and HCPCS
Level II codes.
» Access a listing of CPT ® and HCPCS Level II codes that an
ASC can and cannot use and codes identified as unlisted,
inpatient-only, and packaged and nonreportable.
» View code details, lay descriptions, color icons, edits, and
modifiers.
P
For use by Physicians & Clinics
H
For use in Hospitals & Facilities
A
» List medical necessity and compliance edits with
ABN generation.
» Identify CCI claim edits.
» View a quarterly snapshot of Historical data dating back to
CY 2008.
» Identify CPT ® code and HCPCS Level II codes linked with
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» HCPCS & CPT ® codes assigned to 16 new payment
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Item # 1373 Price: $1,099.95
For use by Postacute Services
Y
For use by Payers
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9
eSolutions
1-on-1 demo
See inside cover
for details
P H Y
drc
New
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Item # 1022 Available: Now
$499.95 Single-user.
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CME
H
ChargemasterExpert.com
Item # 1782 Available: Now
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DrugReimbursement.com
DrugReimbursement.com is an online drug coding and
reimbursement reference tool and database that provides
up-to-date Medicare coding, billing, and reimbursement
ChargemasterExpert.com
information for FDA-approved drug codes.
ChargemasterExpert.com is a robust, user-friendly online
application that helps your hospital maintain a complete,
»Provides complete listing of HCPCS Level II and CPT®
up-to-date chargemaster for Medicare billing and compliance.
codes with full descriptions linked to NDC codes for billing
drugs, biologicals, and vaccines under Medicare Part B
»Review your charge description master (CDM) automatically.
(hospital and physician).
»Implement code changes by the effective date.
»Save research time. Provides complete, up-to-date
»Maintain chargemaster accuracy at a detail level.
crosswalk of approved national drug codes (NDCs) to
»Improve revenue capture by ensuring accurate and
CMS-billable drug codes under Part B and current AWP
and Medicare Part B payment rates.
competitive pricing, identifying missing procedures, and
»Simplify drug searches. Flexible search capabilities allow
identifying cross-coding opportunities.
you to quickly search for drugs by CPT® code, HCPCS
Use the multi-hospital features to:
Level II code, NDC, drug name (brand or generic), ICD-9-CM
»Create a corporate standard chargemaster.
code, and by manufacturer.
»View and evaluate multiple chargemasters simultaneously.
»Improve billing and chargemaster accuracy. Detailed drug
data identifies packaging and billable units, related NDCs,
product packaging, strength, ingredients, therapeutic class,
»Pinpoint and easily convert and map line items that are not
in compliance with the corporate standard.
and other details. Special icons alert you to new, revised, or
deleted codes and quality issues.
CPT is a registered trademark of the American Medical Association.
P
For use by Physicians & Clinics
H
For use in Hospitals & Facilities
A
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Y
For use by Payers
Available for download online
.com
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Empower your business
Your Software
Application
Your systems
might include…
» Data
(e.g. medical codes)
» Practice management
eSolutions
Data Services
WEb services Call
» Billing software
» Features (e.g. medical
code searching)
» EMR/EHR
» Medical documentation
» Or any other kind
of system requiring
Ingenix data, features
or functionality
Returned Data
» Functionality
(e.g. claim
compliance review)
Integrate Ingenix data, features,
and functionality into your
existing workflow.
Real-Time eContent
Available: Now
Call for pricing.
Real-Time eContent
Improve your revenue and workflow with real-time access to proprietary data, Ingenix expertise in code searching and code
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You don’t need to build and maintain complex health care management tools or spend time managing, maintaining, or updating
data. We do it all for you. We have been publishing some of the most trusted coding resources, coding search engines, and
compliance review editing tools in the industry since 1984. Ingenix Real-Time eContent provides access to the raw health care
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compliance editing to improve both the quality of data and
operational processes.
Available data, features, and functionality:
» Powerful code searching capabilities through Ingenix
» Medicare correct coding initiative (CCI) edits
CodeLogic™ search engine
» Cross-coder relationships
» The content of 37 printed coding resources and proprietary
data compiled into an online service
Pub. 100 access
» Compliance edits from a leading coding and referential
» Comprehensive support and virtual storage
look-up tool
P
For use by Physicians & Clinics
» Local coverage determinations (LCDs) and Medicare’s
» Customizable services
H
For use in Hospitals & Facilities
A
For use by Postacute Services
Y
For use by Payers
Available for download online
1 800
(464 3649), option 1
Mention your source code for discounts
11
with Ingenix data.
Data Services
The success of your practice depends heavily on your practice
management system. However, your system is only as good
as the data that goes into it. Keeping it up-to-date with accurate
coding, billing, and fee data is essential to profitability. Trust
Ingenix to provide you with the most reliable, precise code and
fee data. Ingenix data files supply you with rigorously reviewed
data, valuable proprietary information, and frequent updates to
maximize your system’s capabilities.
»Get the content you need. Code sets, relative values,
»Stay current with subscriptions (available for most products).
Medicare fee schedules, Medicare carrier-based fees,
Frequent updates keep your systems up-to-date as important
commercial fee benchmarks, and much more.
changes are made.
»Depend on Ingenix clinicians. Our staff is dedicated to
»Find the descriptions you need. Code set data files contain all
reviewing and maintaining data so that you can be confident
current codes and full descriptions, as well as clinically
that it’s accurate and reliable.
abbreviated (not truncated) short and medium descriptions.
Download your data updates via the Online Data Access System. As soon as updates are available, you will be
alerted via email and will have access to download your updated files immediately.
Title
Item No. Code Set Data
ICD-9-CM Vol. 1 and Vol. 3 (subscription)
Price
Title
Item No. Price
4826
4824
4831
4833
4834
4835
4836
4838
$4,999.95
$899.95
$899.95
$899.95
$899.95
$899.95
$899.95
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Reference Data
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Physician Sample.fm Page 1 Wednesday, March 24, 2010 3:48 PM
Tabular List
Endocrine, Nutritional and Metabolic Diseases, and Immunity
3. Endocrine, Nutritional and Metabolic Diseases,
and ImmunityPhysician
Disorders(240-279)
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Hypothalamus
Wednesday, March 24, 2010
Pituitary3:48 PM
(Hypophysis)
gland
Thyroid gland
2
NOTE
240–244.9
The Endocrine System
endocrine and metabolic disturbances specific to the fetus
and newborn (775.0-775.9)
All neoplasms, whether functionally active or not, are classified
in Chapter 2. Codes in Chapter 3 (i.e., 242.8, 246.0, 251-253,
255-259) may be used to identify such functional activity
associated with any neoplasm, or by ectopic endocrine tissue.
Pineal gland
Parathyoid
glands
Thymus gland
Tabular List
Endocrine, Nutritional and Metabolic Diseases, and Immu
Disorders of Thyroid Gland (240-246)
Adrenal
(Suprarenal)
glands
Pancreas
3. Endocrine, Nutritional and Metabolic Diseases,
Ovaries
b 240 Simple and unspecified goiter
DEF: An enlarged thyroid gland often caused by an inadequate dietary intake
of iodine.
and Immunity Disorders(240-279)
240.0 Goiter, specified as simple
Any condition classifiable to 240.9, specified as simple
Testes
2
240.9 Goiter, unspecified
Enlargement of thyroid
NOTE
Goiter or struma:
NOS
diffuse colloid
endemic
hyperplastic
nontoxic (diffuse)
parenchymatous
sporadic
2 congenital (dyshormonogenic) goiter (246.1)
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b 242
diagnosis codes.
IngenixEdge ®
Coding Tables. Reduce time
0 without mention of thyrotoxic crisis or storm
1 with mention of thyrotoxic crisis or storm241
b
§
§
additional research and steps (includes
c 242.0 Toxic diffuse goiter
[0-1]
c 242.1 Toxic uninodular goiter
[0-1]
claim submission.
»E-mail alerts for
special reports.
Thyroid nodule
Uninodular goiter
toxic or with hyperthyroidism
[0-1]
IngenixEdge®
Additional Digit
Required Symbols
Secondary thyroid hyperplasia
Unspecified Code
AHA:commonly
J-A, ‘85, 9
DEF: Enlarged thyroid,
due to decreased thyroid
Other Specified Code
Adenomatous goiter
E03.9 Hypothyroidism unspecified
Nodular goiter (nontoxic) NOS
Struma nodosa (simplex)
Manifestation Code
wx Revised Text
b 242 Thyrotoxicosis with or without goiter
Sample page from 2011 ICD-9-CM Expert
for Physicians, Volumes 1 & 2
§
l New Code
s Revised Code Title
Volume 1 – 1
neonatal thyrotoxicosis (775.3)
c 242.0 Toxic diffuse goiter
Basedow's disease
Exophthalmic or toxic goiter NOS
Graves' disease
Primary thyroid hyperplasia
DEF: Diffuse thyroid enlargement accompanied by hyperthyroidism,
bulging eyes, and dermopathy.
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§ c Y242.1
Toxic
goiter
For use by Postacute Services
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byuninodular
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[0-1]
Thyroid nodule
§
c 242.3 Toxic nodu
[0-1]
Adenom
Nodular
Struma n
Any cond
hyp
§
c 242.4 Thyrotoxic
§
c 242.8 Thyrotoxic
[0-1]
[0-1]
Overprod
Thyrotox
factitia
Use addi
243 Congenital hypo
Congenital thyro
Cretinism (athyr
Use additional c
2 conge
DEF: Underproduc
I-10
DEF: A condition caused by excess quantities of thyroid hormones being
introduced into the tissues
The following fifth-digit subclassification is for use with categories 242:
0 without mention of thyrotoxic crisis or storm
1 with mention of thyrotoxic crisis or storm
[0-1]
Ovaries
E05.90 Thy
I-10
Unspecified
hypothyroidism
DEF: Symptomatic hyperthyroidism with multiple nodules on the production with
244.9multiple
nodules;
no clinical hypothyroidism.
enlarged thyroid gland. Abrupt onset of symptoms; including
Hypothyroidism
primary or NOS
extreme nervousness, insomnia, weight loss, tremors,241.9
and psychosis
Myxedema
Unspecified nontoxic
nodular goiter
or coma.
AHA: 3Q, ‘99, 19; 4Q, ‘96, 29
b
c Additional Digit Required
2011 ICD-9-CM
Thymus gland
IngenixEdge® § c 242.9 Thyrotoxic
[0-1] cause
ICD-10
Hyperthy
Spotlight
Thyrotox
acidto
[PAS]
DEF: Enlarged thyroid, P-aminosalicylic
commonly due
decreased thyroid
Phenylbutazone
production, with single
nodule; no clinical hypothyroidism.
Resorcinol
2
Includes
our ICD-10
Spotlight and
Coding Tips
features!
I-10
Multinodular goiter
(nontoxic)
Secondary
hypothyroidism NEC
c 242.2 Toxic multinodular goiter
»Valid three-digit code list. See at a
glance whether a code is valid for
Basedow's disease
Exophthalmic or toxic goiter NOS
Graves' disease
Primary thyroid hyperplasia
E89.0 Postprocedural hypothyroidism
DEF: Symptomatic hyperthyroidism with a single nodule on the
E04.1 Nontoxic singleIatrogenic
thyroidhypothyroidism
nodule
NOS
enlarged thyroid gland. Abrupt onset of symptoms; including
Use additional E code to identify drug
extreme nervousness, insomnia, weight loss, tremors,241.1
and psychosis
Nontoxic multinodular
goiter
or coma.
244.8 Other specified acquired hypothyroidism
§
I-10
Nontoxic nodular goiter
244.1 Other postablative hypothyroidism
Hypothyroidism
2 adenoma of thyroid
(226) following therapy, such as irradiation
244.2 Iodine
hypothyroidism
cystadenoma
ofHypothyroidism
thyroid
(226)
resulting from administration or ingestion of
iodide
241.0 Nontoxic uninodular goiter
Use additional E code to identify drug
DEF: Diffuse thyroid enlargement accompanied by hyperthyroidism,Thyroid nodule
Other iatrogenic hypothyroidism
bulging eyes, and dermopathy.
Uninodular 244.3
goiter Hypothyroidism
(nontoxic) resulting from:
exclusive table covering Personal/
Family history code assignment).
[0-1] cause
240.0 Goiter, specified asHyperthyroidism
simple
NOS
Thyrotoxicosis
Any condition classifiable
to NOS
240.9, specified as simple
E05.90 Thyrotoxicosis uns w/o thyrotoxic crisis or storm
Goiter,
unspecified
243 Congenital hypothyroidism
I-10
thyroid insufficiency
Enlargement Congenital
of thyroid
241.1 Nontoxic multinodular goiter
Cretinism (athyrotic) (endemic)
Multinodular goiter (nontoxic)
Goiter or struma:
Use additional code to identify associated mental retardation
DEF: Enlarged thyroid, commonly due to decreased thyroid
NOS
2 congenital (dyshormonogenic) goiter (246.1)
production with multiple nodules; no clinical hypothyroidism.
DEF: Underproduction of thyroid hormone present from birth.
diffuse colloid
241.9 Unspecified nontoxic nodular goiter
Adenomatous goiter
b 244 Acquired hypothyroidism
endemic
Nodular goiter (nontoxic) NOS
1 athyroidism (acquired)
hyperplastic
Struma nodosa (simplex)
(acquired)
nontoxic (diffuse) hypothyroidism
myxedema (adult) (juvenile)
Thyrotoxicosis with or without goiter
thyroid (gland) insufficiency (acquired)
parenchymatous
2 neonatal thyrotoxicosis (775.3)
sporadic 244.0 Postsurgical hypothyroidism
DEF: A condition caused by excess quantities of thyroid hormones being
introduced into the tissues
DEF: Underproduction of thyroid hormone due to surgical removal of
goiter (246.1)
all or (dyshormonogenic)
part of the thyroid gland.
The following fifth-digit subclassification is for use with categories 242: 2 congenital
spent on code selection for complex
diagnoses that typically require
Overproduction of thyroid-stimulating hormone [TSH]
Th
Hypothalamus
Pituitary
(Hypophysis)
gland
Thyroid gland
240–244.9
ICD-9-CM Code Changes:
and coding tips for all new 2011
[0-1]
DEF: An enlarged thyroid gland
caused
an inadequate
dietary intake
Use often
additional
E codeby
to identify
cause, if drug-induced
of iodine.
§ c 242.9 Thyrotoxicosis without mention of goiter or other
DEF: Enlarged thyroid, commonly due to decreased thyroid
production, with single nodule; no clinical hypothyroidism.
240.9
E04.1 Nontoxic single thyroid nodule
An Insider’s View. Find chapter- by-
»
[0-1]
Thyrotoxicosis:
b 240 Simple and unspecified goiter
factitia from ingestion of excessive thyroid material
adenoma of thyroid (226)
cystadenoma of thyroid (226)
241.0 Nontoxic uninodular goiter
Thyroid nodule
Uninodular goiter (nontoxic)
when you buy directly from Ingenix.
»
endocrine andToxic
metabolic
disturbances specific to the fetus
nodular goiter, unspecified
§ c 242.3
and
newborn
(775.0-775.9)
[0-1]
Adenomatous
goiter
Nodular
goiter
toxic
or with
All neoplasms, whether
functionally
active
orhyperthyroidism
not, are classified
Struma nodosa
in Chapter 2. CodesAny
in Chapter
3 (i.e., 242.8, 246.0, 251-253,
condition classifiable to 241.9 specified as toxic or with
255-259) may be used to
identify such functional activity
hyperthyroidism
associated
neoplasm,
orectopic
by ectopic
tissue.
§ cwith
242.4any
Thyrotoxicosis
from
thyroid endocrine
nodule
Thyrotoxicosis
of other
specified origin
c 242.8
Disorders§ of
Thyroid
Gland
(240-246)
b 241 Nontoxic nodular goiter
Endocrine, Nutritional and Metabolic Diseases, and Immunity
2011 ICD-9-CM Expert for Physicians,
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b 244 Acquired hypoth
1
athyr
hypo
myxe
thyro
244.0 Postsurgic
DEF: Unde
all or part
E89.0 Post
244.1 Other post
Hypothy
244.2 Iodine hyp
Hypothy
iod
Use addi
244.3 Other iatro
Hypothy
P-amin
Pheny
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HCPCS DRUGS ADMINISTERED OTHER THAN ORAL METHOD
J0704 Injection, betamethasone sodium phosphate, per 4
mg
q
N @
J0706 Injection, caffeine citrate, 5 mg
Use this code for Cafcit.
J1060
K @
J0881 Injection, darbepoetin alfa, 1 mcg (non-ESRD use) n
Use this code for Aranesp.
A @
J0882 Injection, darbepoetin alfa, 1 mcg (for ESRD on
dialysis)
Use this code for Aranesp.
MED: 100-2,15,50
MED: 100-2,6,10; 100-4,4,240
q
AHA: 2Q,'02,8
N @
J0710 Injection, cephapirin sodium, up to 1 g
N @
MED: 100-2,6,10; 100-4,4,240
q
MED: 100-2,15,50
K @
J0713 Injection, ceftazidime, per 500 mg
Use this code for Ceptax, Fortaz, Tazicef
q
Essential Coding
J0715 Injection, ceftizoxime sodium, per 500 mg
Use this code for Cefizox.
q
A @
MED: 100-2,15,50
N @
J0720 Injection, chloramphenicol sodium succinate, up to 1
g
q
Use this code for Chlormycetin.
MED: 100-2,15,50
N @
J0725 Injection, chorionic gonadotropin, per 1,000 USP
units
N @
J0895 Injection, deferoxamine mesylate, 500 mg
q
Take your coding
Use this code for Desferal.
J0900 Injection, testosterone enanthate and estradiol valerate,
up to 1 cc
q
P H Y
J0740 Injection, cidofovir,
mg Level II Professional
2011375
HCPCS
Use this code for Vistide. (Softbound)
MED: 100-2,15,50
Item # HB11 Available: Dec 2010
ISBN:
978-1-60151-415-8
$72.95
N @ J0743 Injection, cilastatin
sodium;
imipenem, per
250
mg
Use this
HCPCS Level
II code for Primaxin I.M., Primaxin I.V.
electronic – see page 4
for more information
MED: 100-2,15,50
N @
K @
Over 37 Ingenix code
J0894 Injection, decitabine, 1books
mg
for the price ofn5,
Use this code for Dacogen.
including HCPCS Level II
n
MED: 100-2,15,50
2011
MED: 100-2,6,10; 100-4,4,240
,
K @
N @
J0735 Injection, clonidine HCl, 1 mg
hp Iopidine
Use this code for Clorpres, Duraclon,
J0886 Injection, epoetin alfa, 1000 units (for ESRD on
dialysis)
Use this code for Epogen/Procrit.
q
MED: 100-2,15,50
K @
n
MED: 100-2,6,10; 100-2,15,50; 100-4,4,240
MED: 100-2,15,50
N @
e
J0885 Injection, epoetin alfa, (for non-ESRD use), 1000
units
Use this code for Epogen/Procrit.
,
MED: 100-2,15,50
J0945 Injection, brompheniramine maleate, per 10 mg
MED: 100-2,15,50
n
Drugs Administered Other Than Oral Method
N @
.com
q
2010Injection,
Edition estradiol valerate, up to 40 mg
N @ J0970
q
Item # HB10 Use
Available:
Now
this code
for Clinagen LA, Clinagen, LA-10, Clinagen
LA-20, Clinagen
LA-40, Delestrogen
ISBN: 978-1-60151-288-8
$72.95 $40.12
MED: 100-2,15,50
q
J1000 Injection, depo-estradiol cypionate, up to 5 mg
q
MED: 100-2,15,50
Use this code for depGynogen, Depogen, Estradiol
Over 200 changes went into effect for 2010—be prepared to effectively manage
more HCPCS coding and reimbursement
Cypionate
N @ J0744 Injection, ciprofloxacin for intravenous infusion, 200
changes come 2011mg
in physician, hospital outpatient, and ASC
settings.
You’ll
get
the
complete 2011 code set with information
MED:
100-2,15,50
q
Use this code for Cipro.
N
@
J1020
Injection,
q
from every HCPCS source—CMS, OPPS addendum B, and the physician fee schedule.methylprednisolone acetate, 20 mg
Use this code for Depo-Medrol.
N @ J0745 Injection, codeine phosphate, per 30 mg
q
N @
q
MED: 100-2,15,50
Medicare quality reporting bonus payments.
N @
J0770 Injection, colistimethate sodium, up to 150 mg
q
Use this
code for Coly-Mycin
M.2011 HCPCS,
» Comprehensive code
updates.
Access all
N
@ J1030 icons.
Injection, methylprednisolone acetate, 40 mg
» DMEPOS
Use this code for DepoMedalone40, Depo-Medrol,
Sano-Drol
»
AHA Coding Clinic for HCPCS references. Receive added
MED: 100-2,15,50; 100-4,4,240
with
articles
on difficult-to-code
II
N support
@ J1040
Injection,
methylprednisolone
acetate,HCPCS
80 mg Level
q
MED: 100-2,15,50
MPFS, and OPPS files and deleted codes for HCPCS Level II.
J0780 Injection, prochlorperazine, up to 10 mg
Use this code for Compazine, Cotranzine, Compa-Z,
» OPPS status indicators
and ASC payment indicators.
Ultrazine-10.
N @
K @
J0795 Injection, corticorelin ovine triflutate, 1 mcg
Use this code for Acthrel.
J0800 Injection, corticotropin, up to 40 units
Use this code for H.P. Acthar gel
K @
J0835 Injection, cosyntropin, per 0.25 mg Payment
Indicators
Use this code for Cortrosyn.
K @
J0850 Injection, cytomegalovirus immune globulin
intravenous (human), per vial
Use this code for Cytogam.
MED: 100-2,15,50
MED: 100-2,15,50; 100-4,4,240
N @
J1051 Injection, medroxyprogesterone acetate, 50 mg
Use this code for Depo-Provera.
E
J1055 Injection, medroxyprogesterone acetate for
contraceptive use, 150 mg
Use this code for Depo-Provera.
;
J1056 Injection, medroxyprogesterone acetate/estradiol
cypionate, 5 mg/25 mg
Use this code for Lunelle monthly contraceptive.
;
n
n
ASC
E
n
N @
n
J1060 Injection, testosterone cypionate and estradiol
cypionate, up to 1 ml
q
Use this code for Depo-Testadiol, Duo-Span, Duo-Span
II.
Special
Coverage
Instruction
MED: 100-2,15,50; 100-4,4,240
K @
2009 HCPCS
P
MED: 100-2,15,50
J0878 Injection, daptomycin, 1 mg
Use this code for Cubicin.
Special Coverage Instructions
Noncovered by Medicare
g-w ASC Payment Indicators
For use by Physicians & Clinics
H
;q
MED: 100-2,15,50
MED: 100-2,15,50
OPPS
Status
Indicators
80, Depo-Medrol, Duro Cort, Methylcotolone,
Pri-Methylate, Sano-Drol
» Plus, color-coded
bars and icons with user-friendly icons.
MED: 100-2,15,50
K @
Use this code for Cortimed, DepMedalone, DepoMedalone
codes or sections.
q
MED: 100-2,15,50
» In-depth illustrations.
q
n
Carrier Discretion
@ Quantity Alert
l New Code
MED: Pub 100/NCD References 7 DMEPOS Paid
For use in Hospitals & Facilities
A
J0704 — J1060
MED: 100-2,15,50; 100-4,4,240
MED: 100-2,15,50
» PQRINicons.
@ J0760
Injection,
colchicine,
per 1with
mg potential for
Recognize
HCPCS
codes
For use by Postacute Services
m Recycled/Reinstated
, SNF Excluded
Y
For use by Payers
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s Revised Code
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National Average Payment Tables.
»
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Deleted Codes Crosswalk Appendix.
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» Table of Drugs.
2011 HCPCS Level II Expert Updateable
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» All changes, additions, and deletions in the HCPCS Level II
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» Appendixes for the National Average Payment Tables, MUEs,
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2011 DRG Expert eBook
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requirements for key medical conditions—on the spot.
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Desk Reference
Comprehensive medical reference
information at your fingertips
MedicalReferenceEngine.com—coming soon
Trying to find the information you need to code correctly and
understand complicated regulatory information is cumbersome and
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Search these
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Reduce research time and enhance productivity
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Ingenix MedicalReferenceEngine.com will be here late 2010
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MLN Matters
Proposed and Final Rules
CMS Pub 100
RAC Audit
Code of Federal Regulations
Open Door Forum Call
Archives and Transcripts
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PQRI
ICD-10
Available for download online
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CDRH
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2011 Coders’ Desk Reference
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2011 Coders’ Desk Reference
for HCPCS Level II
Identify the minute differences between, and components
Our one-of-a-kind, comprehensive resource on the 2011
of, similar CPT codes and answer questions with this
HCPCS code set helps you reduce coding errors, check
comprehensive resource for all 2011 CPT® codes.
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®
and distinguish between HCPCS codes.
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Chart of new, revised, and deleted codes
with crosswalk. See all code changes at a glance and know
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»Over 3,000 HCPCS Level II codes and 2,000
lay descriptions.
»Comprehensive CPT® code listing with more than 8,000
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»Modifier definitions, diagnosis code suggestions, and
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®
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»Anatomical illustrations of body sites described in
» Coding and billing instructions to reduce research time.
operative reports.
»Surgical terms chapter defines the components
» Additional chapters for documentation, durable medical
of surgical procedures.
equipment (DME), fraud and abuse, compliance, and HIPAA.
»Procedure crosswalk links eponyms to codes.
Access E/M
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See our NEW E/M Coding Advisor–page 45
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Quickly assign the evaluation and management (E/M) codes
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Now Available
Specialty Coders’ Desk
References (see pg. 33)
Ophthalmology
Cardiology
Pediatrics
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for Diagnoses
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2011 Coders’ Desk Reference
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2011 Coders’ Desk Reference
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When the code book and coding guidelines do not have
This reference guide describes all ICD-9-CM
the answer to your specific coding question, the Ingenix
procedures in full detail with complete coding advice.
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Detailed clinical descriptions. Access
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Numerical organization by ICD-9-CM code.
»Chapter-by-chapter 2011 new code summary and highlights
Numerical organization by code. This resource is
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code book.
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»Chapter-by-chapter 2010 new code summary and
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»Easily assign the proper code for procedures identified by
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eponyms and common names.
»Syndrome chapter.
»Relevant terminology and detailed illustrations.
2011 Comprehensive ICD-9-CM Table of Drugs and Chemicals
How often do you look up a drug or chemical in your ICD-9-CM code book, and it’s not in the Table of Drugs
and Chemicals, or research the therapeutic class or generic equivalent of drug in order to correctly assign
Includes over
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and chemicals
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»The Official Table of Drugs and
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Chemicals, plus thousands of
with dependence risk or that are
instruction pertaining to
additional brand name drug
regulated under the Controlled
poisoning, adverse effects, and
entries.
Substance Act (CSA).
toxic effects.
»Therapeutic Class for each drug. »ICD-9-CM AHFS Therapeutic
»Brand names crosswalked to
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Classification fills in the gaps
pharmaceuticals approved by
when researching drugs that are
the FDA.
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2011 Coding Companion ® Specialty Guides
Title
Coding Companion® for Cardiology/Cardiothoracic Surgery/Vascular Surgery
Coding Companion® for Emergency Medicine
Coding Companion® for ENT/Allergy/Pulmonology
Coding Companion® for General Surgery/Gastroenterology
Coding Companion® for Neurosurgery/Neurology
Coding Companion® for OB/GYN
Coding Companion® for Oncology/Hematology
Coding Companion® for Ophthalmology
Coding Companion® for Orthopaedics—Lower: Hips & Below
Coding Companion® for Orthopaedics—Upper: Spine & Above
Coding Companion® for Pediatrics
Coding Companion® for Plastics/OMS/Dermatology
Coding Companion® for Podiatry
Coding Companion® for Primary Care
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Trust the first specialty resource to feature an illustration for
every CPT® code for 16 specialties.
27327 Excision, tumor, soft tissue of thigh or knee
area, subcutaneous; less than 3 cm
27328 Excision, tumor, soft tissue of thigh or knee
area, subfascial (eg, intramuscular); less
than 5 cm
27337 Excision, tumor, soft tissue of thigh or knee
area, subcutaneous; 3 cm or greater
27339 Excision, tumor, soft tissue of thigh or knee
area, subfascial (eg, intramuscular); 5 cm
or greater
Coding Tips
Terms To Know
Codes 27337 and 27339 are new for 2010.
They are resequenced codes and will not
display in numeric order. Codes 27327 and
27328 have been revised for 2010 in the
official CPT description. An excisional biopsy
is not reported separately when a therapeutic
excision is performed during the same surgical
session. Local anesthesia is included in this
service. However, this procedure may be
performed under general anesthesia,
depending on the age and/or condition of the
patient.
graft. Tissue implant from another part of the
body or another person.
Specialty Reference
27327-27328
[27337, 27339]
lymphangioma. Benign, malformed lymph
channels.
soft tissue. Nonepithelial tissues outside of
the skeleton that includes subcutaneous
adipose tissue, fibrous tissue, fascia, muscles,
blood and lymph vessels, and peripheral
nervous system tissue.
CCI Version 15.3
01250, 01320, 10060, 10140, 10160, 20610,
27306-27307, 27306-27310v, 29445,
83.31 Excision of lesion of tendon sheath
29870-29871, 29871, 29874, 29876-29883,
83.32 Excision of lesion of muscle
Detailed
29885-29887, 36000, 36400-36410,
illustrations
36420-36430, 36440, 36600, 36640, 37202,
83.39 Excision of lesion of other soft tissue
for each code
43752, 51701-51703, 62310-62319,
or code set
83.49 Other excision of soft tissue
64400-64435, 64445-64450, 64470, 64475,
86.3 Other local excision or destruction of
64479, 64483, 64505-64530, 69990,
lesion or tissue of skin and
93000-93010, 93040-93042, 93318, 94002,
Detailed
subcutaneous tissue
illustrations
94200, 94250, 94680-94690, 94770,
95812-95816, 95819, 95822, 95829, 95955,
86.4 Radical excision of skin lesion
96360, 96365, 96372, 96374-96376,
99148-99149, 99150
Anesthesia
Also not with 27327: 11011-11012v,
27327 00400
12001-12007, 12020-12037, 13120-13121,
27328 01320
27323-27325, 27340-27345, 38500, J2001
27337 00400
Also not with 27328: 11012v, 11401, 11404,
27339 01320
12001-12007, 12020-12037, 13120-13121,
20680, 27325, 27327, 27340-27345, 27372,
ICD-9-CM Diagnostic
64712
171.3 Malignant neoplasm of connective
Note: These CCI edits are used for Medicare.
and other soft tissue of lower limb,
Other payers may reimburse on codes listed
CCI and CCI and Medicare
including hip
Easy-toabove.
Medicare
edits
understand
at your
172.7 Malignant melanoma of edits
skin of
lower
at your fingertips
explanations
Easy-tofingertips
Medicare Edits
limb, including hip
understand of codes
Fac Non-Fac
Explanation
173.7 Other malignant neoplasm of skin of
explanations
RVU
RVU
FUD Assist
codes
The physician removes a tumor of
from
the soft
lower limb, including hip
8.46 11.82
90
27327
N/A
tissue of the thigh or knee area that is located
195.5 Malignant neoplasm of lower limb
16.2
16.2
90
27328
N/A
in the subcutaneous tissue in 27327 and
198.89 Secondary malignant neoplasm of
d
27337 and in the deep soft tissue, below the
11.32 11.32
90
27337
other specified sites
d
fascial plane, or within the muscle in 27328
20.39 20.39
90
27339
2010
Companions
and Coding
27339. With
the proper anesthesia
209.34 Merkel cell carcinoma of the lower
Medicare References: 100-2,15,260;
administered, the physician makes an incision
Title
Item No.
ISBN 100-4,14,10
100-4,12,30;
100-4,12,90.3;
limb
® the mass and dissects to
in theCompanion
skin overlying
Coding
for Cardiology/Cardiothoracic209.75
Surgery/Vascular
Surgery
978-1-60151-317-5
Secondary Merkel
cell carcinoma A3175
the tumor. The extent
of the tumor is
Coding
Companion® for Emergency
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A3137
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214.1 Lipoma of other skin and
identified and a dissection
is undertaken all
®
Coding
Companion
ENT/Allergy/Pulmonology
A3106
978-1-60151-310-6
subcutaneous tissue
the way
around thefor
tumor.
A portion of
®
Coding
Companion
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A3113
978-1-60151-311-3
neighboring
soft tissue
may alsoSurgery/Gastroenterology
be removed
214.8 Lipoma of other specified sites
® removal of all tumor tissue.
to ensure
adequate
Coding
Companion
for Neurosurgery/Neurology 215.3 Other benign neoplasm of connective
A3212
978-1-60151-321-2
A drain
may be inserted
and the incision is
®
Coding
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and other soft tissue of lower limb,A3229
repaired with layers of sutures, staples, or
Coding Companion® for Oncology/Hematology
A3199
978-1-60151-319-9
including hip
Steri-strips. Report 27327 for excision of a
®
Coding
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A3182
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228.1 Lymphangioma, any site
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resected area is
®
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less than
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27337
for excision of a
238.1
Neoplasm of uncertain behavior ofA3205
®
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Coding
Companion
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Orthopaedics—Upper:
978-1-60151-324-3
connective and other soft tissue A3243
Report
27328 for®excision
of a subfascial or
Coding
Companion
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239.2 Neoplasms of unspecified nature ofA3120
intramuscular tumor
whose resected area is
®
bone, soft tissue, and skin
Coding
Companion
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A3236
978-1-60151-323-6
less than
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27339
for excision of a
®
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782.2 Localized superficial swelling, mass,A3151
subfascial
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tumor that is 5 cm
or lump
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Coding Companion® for Primary Care
A3144
978-1-60151-314-4
ICD-9-CM Procedural
A3168
A3250
Available:
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2011 Coding and Payment Guide for Dental Services
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»Numerical organization by CPT® code allows for quick
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»Links ICD-9-CM procedure codes with corresponding CPT®
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»Includes all procedural HCPCS codes required by CMS for
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2011 Fast Finder Description
2011
2010
2011
ICD-9-CM ICD-9-CM HCPCS
Item#
Item#
Item#
Allergy and Immunology 18001
16214
Behavioral Health
18002
16215
Cardiology
18003
16216
Cardiovascular/Thoracic Surgery
18004
16217
Chemotherapy Drugs
7160
1769
7154
1762
7153
1763
7155
1764
7156
1765
7157
1766
7158
1767
Vision and Hearing
7159
1768
Available: Dec 2010 Now
Chiropractic Medicine
18005
16218
Dental/OMS
18006
16219
Dermatology
18007
16220
Drug Codes
Emergency Medicine
18008
16221
2011 Fast Finder ® Sheets
Endocrinology
18009 16222
Fast Finder sheets include approximately 300 of the
ENT 18010
16223
most commonly reported codes and descriptions for
External Causes E Codes
18011
16224
each specialty. These double-sided, laminated quick
Family Practice
18012 16225
reference sheets help you increase the speed and
Gastroenterology
18013 16226
General Surgery
18014 16227
Hematology/Oncology
18015 16228
Home Health
18016
16229
Infectious Diseases
18017 16230
®
efficiency of coding.
»Arranged alphabetically by main terms so you
can quickly locate codes by common diagnosis or
procedural categories.
»Contains 200–300 codes with shortened descriptions
based on actual frequencies for each specialty.
»More than 30 common specialties code sets
are available.
»Code sets cover appropriate anatomy underlying
diseases and manifestations specific for each specialty.
»Updated annually by experts who follow the regulatory
and code set changes.
»Convenient and affordable enough to order multiple
copies of a single specialty or multiple resources for
Modifiers
Neurology/Neurosurgery
18018 16231
OB/GYN
18019 16232
Ophthalmology/Optometry 18020 16233
Orthopaedics
18021 16234
Orthotics
Pain Management
18022 16235
Pediatrics
18023 16236
Physical Medicine/Rehabilitation
18024 16237
Physician Office Supplies
Physical Therapy 18025 16238
Plastic and Reconstructive Surgery
18026 16239
Podiatry 18027 16240
Primary Care/ Internal Medicine
18028 16241
Prosthetics
multi-specialty practices or hospitals, without breaking
Signs and Symptoms
18029 16242
the budget.
Skilled Nursing Facilities
18030
16243
Urolology/Nephrology
18031
16244
V Codes
18032 16245
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Understand the why behind diagnostic codes
2011 Coders’ Desk References for Specialties
In order to accurately code for specialty services, you need to understand the clinical background of diseases, medical
procedures, and anatomy. To help you boost coding accuracy and save time, we’ve compiled this vital information into one,
comprehensive specialty-specific resource. No matter what your skill level, this book will provide the foundation for correct
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»Get easy-to-understand descriptions of common specialty
»Understand how anatomy symptoms and complicating
conditions are represented by diagnosis codes to provide
diagnoses, including those that are typically denied and
vital education for staff in preparation of the ICD-10 transition.
included in RAC and OIG audits.
»Recognize what to look for in clinical documentation so you
»Ensure that you are appropriately representing the level
can fine tune physician queries and improve communication
of severity and reporting medical necessity to support
between physicians and coding and billing staff.
accurate reimbursement.
»Know the key commonalities between codes in similar
»Identify the general symptoms associated with diseases so
classifications to ensure accurate, precise coding and billing.
2011 Billing Companion
for OB/GYN
Item # BOGY11
Available: Dec 2010
ISBN: 978-1-60151-447-9
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BOGY
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that you know what should and should not be coded.
An essential billing resource for OB/GYN practices.
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Topics are located based on procedure codes, coverage issues,
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You won’t have to second-guess yourself again; this
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needs to be indicated on the CMS-1500 claim form for coverage.
H For use&inClinics
A For use
Y For use
CEU
HP &
P For
Y For
For use by Physicians
& use
Clinics
Hospitals
Facilities
by Postacute
Services
by Earn
Payers
Available
for download online
by Physicians
For
use in Hospitals
& Facilities
use by Payers
CEUs. See
page 45.
Specialty Reference
PEDR
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Unlike competing products, The Essential RBRVS products
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provide a complete scale of relative values from the
RBRVS calculations with the click of a mouse. Model new
Medicare Physician Fee Schedule as well as gap values for
the codes not valued by Medicare, including HCPCS Level II.
»Easily identify values for different code sets. Organized by
CPT® and HCPCS codes.
conversion factors, see what providers in other geographical
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your fees using RBRVS.
»Quarterly updates that include Medicare’s most recent
»Evaluate and analyze the costs associated with a service,
providing a more complete picture of your reimbursement
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changes and updated gap values.
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Simplify your GPCI-adjusted calculations.
»Ingenix gap codes. Includes relative values for those
total RVUs.
services not valued for Medicare—same data used by many
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commercial claims help in fee development. Medicare’s
»Includes RBRVS relative value units for nearly all CPT®
modifier and payment indicator tables are included.
»E-mail alerts and Web updates included to keep you informed
on the most current CMS changes and updated gap codes.
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»Print or export fees or ranges of fees. Model fees, build
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Ingenix Data Vault.
CPT is a registered trademark of the American Medical Association.
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2011 Customized Fee Analyzer
Competitive fee schedules are key to financial success. Even a few incorrectly set
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low charges could cost you thousands of dollars each year. The Customized Fee
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»Benchmark your fees with a nationally recognized database of nearly one billion
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actual charge data for the codes most commonly used in your specialty.
The Customized Fee Analyzer is available for these specialties in all
areas of the country.
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Urology
* Dental and OMS reports are sold as Dental Fee Analyzers.
Visit www.shopingenix.com/feeanalyzers to see our full
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CPT is a registered trademark of the American Medical Association.
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For use by Payers
Available for download online
Pricing & Cost
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Pricing & Cost
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2011 HCPCS Fee Analyzer Data File
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2011 Relative Values
for Physicians
2011 HCPCS Fee Analyzer
National Fee Analyzer provides practices
with charge data for fee schedule
Relative Values for Physicians is
customized report that includes
evaluation and competitive analysis for
a complete relative value system
percentiles of national charge data
contracting purposes. This comprehensive
established by surveys of physicians in
as well as locality-specific Medicare
tool can help you estimate competitive
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allowables for HCPCS codes. Revise
fees and reimbursement for all areas of
you can establish, defend, and negotiate
your current fee schedule, negotiate a
the country.
fees for medical and surgical procedures
contract, or conduct competitive analysis
with the same relative values used by
for a specific geographic location.
»Nearly 1 billion transactions updated
HCPCS Fee Analyzer provides a
many insurance companies.
fully for 2011 help ensure that you
have an accurate and comprehensive
picture of charges nationwide.
»National 50 th and 75th percentile
charge data.
»Negotiate contracts more effectively
with charge information by CPT® code.
»Perform competitive analyses with
»This tool is free from government
confidence and make more accurate
budgetary influence. The relative
adjustments of charges. Four
value scale is based on physician
reference points of charge data
survey data.
(25th, 50 th, 75th, 85th percentiles).
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actual clinical work performed.
compiled from more than 350 million
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CPT is a registered trademark of the American Medical Association.
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For use by Payers
Available for download online
.com
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25% off
New
H Y
DHRC
2011 Complete Guide
for Interventional Radiology
Item # FIR11 Available: Dec 2010
ISBN: 978-1-60151-380-9 $199.95
2011 Hospital Compliance
Desk Reference
Item # DRHC11 Available: Sep 2010
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2010 Edition
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2011 Complete Guide for
Interventional Radiology
2011 Hospital Compliance Desk Reference
This new resource addresses the full spectrum of
Developed to simplify coding for imaging-assisted
audits stemming from recovery audit contractors (RACs),
surgical services, this guide provides current CPT
Medicare administrative contractors (MACs), Medicaid
®
and Medicare reporting guidelines along with specific
independent contractors (MICs), and the Zone program
direction for coding complex interventional procedures.
integrity contractors (ZIPCS). This is a must-have
reference for every hospital, payer, and consultant.
»
NEW
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»Understand the types of reviews, target strategies,
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»
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targeted and top-audited DRGs.
Save time by reviewing only the
»Get insights to where the RACs are most likely to find
ICD-9-CM, CPT,® and HCPCS Level II codes related
to interventional procedures.
erroneous claims—and the resulting overpayments
from Medicare.
»Make the most appropriate code selection for
»Present-on-admission tutorial with source
interventional procedures with the most up-to-date
information, codes, reimbursement guidance, and tips.
documentation table.
»Optimize revenue with detailed data on often-
»Stay abreast of regulatory changes posted on our
overlooked codes while capturing all charges possible
and allowable.
customers-only Web site.
»Complete CC and MCC list. Know how
»Anatomical diagrams distinguish among common
codes considered MCCs and CCs will affect
interventional radiology and cardiology procedures
DRG assignment—helping to legitimately
with illustrations.
improve reimbursement.
»Medicare CCI edits delivered quarterly via email.
»Case examples.
CPT is a registered trademark of the American Medical Association.
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Y
For use by Payers
Available for download online
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Coding, Billing, & Payment
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Uniform Billing Editor eBook
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Access detailed, accurate, and timely information about
This reference tool is a one-source guide for both hospital
Medicare and UB-04 billing rules and 837i requirements
outpatient departments (HOPD) and free-standing
that will have to be met in the future.
ambulatory surgical centers (ASC) billing outpatient claims.
»Easily locate topics based on field locators, revenue
» NEW Now includes OPPS Manager CD-ROM. Provides
codes, or coding structures. This easy-to-use format is
narrative explanations for OPPS regulatory requirements,
fully indexed and tabbed with icons for quick reference.
direct links to the original CMS source documents, and
operational strategy for management, auditing, and
»Quickly link HCPCS and CPT® codes to applicable
consulting. Now you can access the entire history, original
revenue codes and prevent the most common reasons
for rejections—mismatched revenue codes and CPT® or
source documents, and the intent of OPPS in a single place.
»Comprehensive coverage of both ASC and APC payment
HCPCS codes.
systems will help your facility establish the right payment
»Provides links to 837i, 4010 and 5010 data elements
and audit reimbursement processes.
and any applicable billing rules—facilitating easier
»Keep all billing current and accurate with the most recent
transition to the 837i.
code sets and information from CMS and other industry
»Coding and billing tips with quick access to official
sources.
sources to help you submit claims to Medicare
»Resolve billing and denial issues and establish payment
accurately the first time.
and audit reimbursement processes in your HOPD or
»Identify data inconsistencies, potential rejections, and
your ASC facility.
denials through OCE and MCE edits.
»Includes fees, formulas, and tables to determine
Download your eBook content immediately via the
appropriate APC or ASC reimbursement.
Ingenix Data Vault.
»Non-OPPS payment fee schedule provides the name of
the fee schedule that applies to non-OPPS payments.
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Manage the constant changes to billing and reimbursement rules.
CPT is a registered trademark of the American Medical Association.
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HIPAA Tool Kit
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HIPAA Tool Kit
2011 Auditing and Denial Management Tool Kit
Perform ongoing HIPAA compliance assessments or create a
Understand your denials, better manage your claims process,
new compliance program.
and audit claims and administrative procedures to identify any
underlying problems that can lead to denials. From appropriate
»Time-saving A-to-Z reference. Quickly locate key terms and
management, appeals, and auditing—you’ll submit the right
find answers written in plain English.
»
NEW
data collection and claims submission to payer inquiries, denial
Web updates page. Carries summaries of latest rules
and official guidance, such as the new Breach Notification
information up front, and you’ll know exactly how to correct
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rules.
»
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Understand how to efficiently resolve denied
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»Policy and procedure development guidance templates.
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Quickly respond to payer inquiries, understand and
address the various types of remittance advice codes utilized
by payers. Detailed explanations of the top denials codes are
Over 200+ templates for privacy, security, transaction
provided with examples and action alerts.
policies, and forms that can be customized to expedite the
development of policies.
»Identify the root cause of denials and take action to prevent
delayed or denied payment or at risk behavior. Understand the
»Customizable assessment and implementation templates.
processes necessary to audit and review existing claim and
Systematically assess current operations for HIPAA readiness,
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and easily translate the findings into action plans.
cycle pitfalls.
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»Understand how to efficiently resolve denied claims.
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»Includes searchable CD—Easy access to printable templates to
help improve your appeal and resubmission processes. Simply
search the contents of the manual for key topics.
P
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Coding, Billing, & Payment
HTKT
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Medicare Correct Coding Guide
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Complete Guide to
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Medicare guidelines and improve management of denials. View
Just like the manual, the Medicare Correct Coding Guide
the extensive changes Medicare has made to its coverage
eBook contains Medicare Physician Fee Schedule (MPFS)
manual and process for communicating coverage issues.
RVUs, correct coding policies, payment restrictions, and
»Icons highlight status of National Coverage Determination
CCI edits that can be retrieved faster with greater ease.
(NCD) policies.
Now includes medically unlikely edits (MUEs).
»
Exclusive
»Fully indexed and organized with crosswalks between the
Instantly know why a code combination will not be
paid separately with Ingenix edit icons for each CCI edit.
» Exclusive Easily calculate payments based on your locality.
Includes Medicare Reimbursement Pro fee calculator.
Internet-only Manuals (IOMs) and print manuals.
»Coverage alert newsletter. View a synopsis of the changes
at a glance.
Download your eBook content immediately via the
»Stay current with quarterly MPFS and CCI changes.
Ingenix Data Vault.
Stay current with CMS changes.
2011 Physicians’ Guide to Medicare Quality Reporting
The Physicians’ Guide to Medicare Quality Reporting provides the information and
tools you need to accurately report quality measures to Medicare. Take advantage of
Ingenix-exclusive information with the first print product designed to simplify quality
reporting and help you capture the bonus payment.
»Searchable CD hosts tools, templates,
»Access detailed data and code sets for
GIR
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2011 Physicians’ Guide to
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Item # 4906 Available: Apr 2011
ISBN: 978-1-60151-398-4 $229.95
For use by Physicians & Clinics
and data collection worksheets to simplify
revised measures.
quality reporting.
»Includes quality measure codes, cross
2010 Edition
Item # 1669 Available: Now
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all quality measures, including new and
»Get expert guidance for getting started,
coding information, and flow charts used
plus strategies for simplifying the
to track the care provided to patients,
reporting process.
based on published Clinical Guidelines.
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BCP
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Medicare Desk Reference
for Hospitals eBook
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for Hospitals
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Improve management of Medicare coverage,
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Simplify your day-to-day operations with answers the most
The Medicare Desk Reference for Physicians is a
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so that you can make the best decisions for your facility.
valuable time researching through multiple resources.
»Access the most up-to-date information concerning
» Ingenix Edge File accurate Medicare Part B claims based on
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the most current requirements the first time. Minimize the
»A-to-Z desk reference format allows you to quickly locate
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potential exposure to fraud and abuse allegations.
»Get fast answers to Medicare coverage and policy
questions and information about the rules affecting
issues by topic—improving efficiency in coding and
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documentation.
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»Topics are organized in an A-to-Z format making crucial
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topics easy to find.
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»Alert icons. Know at a glance which topics have specific
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documentation.
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BCG
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Coder Education
Designed to help you understand and improve your coding skills, our training series equips you and your staff with the
Training
knowledge to stay compliant amidst unpredictable changes in coding sets and rules.
IEASY
ILHPB11
ILICD11
Medical Billing Basics
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Item # ICL111 Available: Dec 2010
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ILCPT11
Comprehensive Instruction for
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Hospital Based Physicians: Physician, Facility, and Payer Markets
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Comprehensive Instruction in the
Use of Diagnosis Codes
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Comprehensive Instruction in the
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ICD-10 Training
AAPC and INGENIX
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ICD-10 Prepared
Ingenix has the resources to help you
prepare for your transition to ICD-10.
The Department of Health and Human Services issued a Final Rule setting the
implementation date for ICD-10-CM and ICD-10-PCS as October 1, 2013. For more
information on the final rule and the resources available from Ingenix to help guide you
Ingenix ICD-9 books,
EncoderPro.com Expert
and RevenueCyclePro.com
include ICD-10
transition tools!
EncoderPro.com, pg. 4
RevenueCyclePro.com, pg. 8
ICD-9 Code Books, pg. 12
through the transition, visit the NEW Coder’s Corner section on www.icd10prepared.com.
NEW
2010 Drafts
ICD-10 Draft Code Set Resources
Our new 2010 Draft editions contain the complete, official code sets and are redesigned to better facilitate training
and application of the new ICD-10 classifications systems.
» NEW IngenixEdge
®
» The most current, complete, and official code sets and
Hallmark color coding and symbols.
Ease into the new classification system with the
guidelines. Learn, train, and prepare by using the
familiar look and feel of an Ingenix ICD-9-CM code
complete code set to understand the classification
book; intuitive symbols and visual alerts highlight
system as a whole rather than through a narrow focus.
code groupings, as well as the distinctions between
code choices.
» E-book option. The complete code book on CD
provides increased portability and easy reference from
your computer.
ITenCD
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ITen
ICD-10-CM: The Complete
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Item # ITEN10 Available: Now
ISBN: 978-1-60151-400-4 $99.95
ITPC
ICD-10-CM: The Complete Official
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ICD-10-PCS: The Complete
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ISBN: 978-1-60151-402-8 $99.95
H Y
ICD-10-PCS: The Complete Official
Draft Code Set (CD)
Item # 1781 Available: Now
ISBN: 978-1-60151-403-5 $119.95
NEW ICD-10-CM Mappings book—see page 45 for details.
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Y
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44
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2011 Specialty Reference
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2010 ICD-10-CM Mappings
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2010 Evaluation and Management
Coding Advisor
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2010 Evaluation and
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when it comes to the transition to
2010 Clinical
Documentation Guide for
the Musculoskeletal System
ICD-10. The higher degree of specificity
Determine if the codes submitted
is notoriously difficult, mainly because
in the ICD-10-CM code set is going to
for payment are supported by
coders have trouble accurately selecting
require more documentation and more
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a code from among a range of seemingly
Preparation is the name of the game
Evaluation and management (E/M) coding
coding precision. The task of preparing
for this monumental change may seem
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»Describes what providers must
providers make more mistakes with E/M
overwhelming. This book was created to
document in the medical record
coding than coding for any other item or
simplify matters and get your office or
for services performed upon the
service. This new resource offers detailed
facility ready for future documentation
musculoskeletal system.
and advanced guidance on selecting the
and coding needs.
appropriate E/M codes.
»Helps providers improve a long
»Links ICD-9-CM codes to all valid ICD10-CM alternatives.
»Convenient look-up tool for verifying
coding practices using the new
standing claims problem—poor
documentation in the medical record.
»Review of the E/M rules and protocols.
»E/M template examples for EMRs
»Explains the difference between
with guidelines for using templates to
similar procedures.
avoid over-coding.
code system.
NEW
»Essential for documentation
improvement in preparation for ICD-10.
Medicare is no longer accepting “Consultation
»Must-have resource to update or
validate super bills, forms, reports, and
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2
010 Consultation Codes
Fast Finder® Sheet
2010 Consultation Codes
Item #1998 Available: May 2010
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Codes”. Use this quick reference for guidance
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Introducing
2011
Editions
O u r C o m m i t m e n t to Acc u r ac y Ingenix is committed to producing accurate and reliable materials. To report
corrections please visit www.shopingenix.com/accuracy or email [email protected]. You can also reach Customer
Service by calling (800) INGENIX (464-3649), option 1.
See what’s new and improved at Ingenix.
2011 ICD-9-CM book
enhancements
Based on customer
feedback, we’ve added a
new modified font, more
vibrant colors, and other
feature enhancements to
help improve readability
and daily coding process.
New electronic book options
Electronic solutions
Now you can access the content
of your favorite code books online.
Download Ingenix eBooks and code
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Pg 12
Pgs 11 and 23
ICD-10 preparation
Pg 4
New products
Check out our improved 2010 Draft
ICD-10 books, now designed like an
ICD-9 code book. Plus, ICD-10 mapping
tools are now available with the
ICD-10-CM Mappings guide,
EncoderPro.com Expert, and
RevenueCyclePro.com.
Pg 43
We’ve expanded our
solutions; see the
latest additions
to the Ingenix
family.
10th Annual Ingenix
Essentials Conference
Score a perfect 10 at our
annual coding and billing
conference in Las Vegas,
November 29–
December 1.
Pg 42
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