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ICD-9-CM Expert for Home Health Services, Nursing Facilities, and Hospices
Code with more precision and efficiency to reduce claim delays and denials using the ICD-9-CM Expert for Home Health Services, Nursing Facilities and Hospices, Volumes 1, 2 & 3.
This book has critical coding and reimbursement edit alerts designed specifically for these facilities — on the same page as the code you want. Do it right … in less time.
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EXCLUSIVE — 10 steps to correct coding. Step-by-step instruction to improve coding accuracy and use of ICD-9-CM conventions more effectively.
EXCLUSIVE — Email alerts for special reports. Alerts sent by email inform you when crucial information is posted on our website so that you can stay current with the latest regulatory and ICD-9-CM code changes.
EXCLUSIVE — Valid three-digit code list. Know at a glance whether a three-digit code is valid for submitting a claim — improving coding accuracy and reducing denied claims due to use of invalid codes.
EXCLUSIVE — Pharmacological listings. Link drug treatment with disease processes to identify complications and comorbidities that may affect DRG assignment — reducing the potential for “undercoding” and improving revenue.
EXCLUSIVE — Dx/MDC/DRG list. Perform quick audits by knowing which diagnosis codes and MDCs group to a specific DRG group (excluding when a secondary diagnosis affects a DRG) — helping to improve overall reimbursement and reduce the potential for fines.
EXCLUSIVE — Complete list of all CC codes. Quickly identify complications and comorbidities that affect DRG assignment — helping improve the accuracy of DRG selection and enhance reimbursement.
EXCLUSIVE — Color coding system. Improve coding accuracy and efficiency with intuitive symbols and color coding that alert you to crucial coding and reimbursement issues.
EXCLUSIVE — DRG alert symbol. Know if you’re assigning a DRG targeted by the OIG as having potential for “upcoding” — reducing the risk for audits and potential fines.
EXCLUSIVE — Additional digit symbol in both the tabular and the disease and procedure indexes. Color-coded symbols alert the coder when the code is invalid without a fourth or fifth digit.
EXCLUSIVE — CC principal diagnosis exclusions listed right with the CC code. Know at a glance if the CC code you are assigning will affect DRG assignment based upon the established principal diagnosis (PDx) for the case.
Major complication alert. Optimize reimbursement by knowing which diagnoses are considered major complications and will change the DRG assignment from DRG 122 to 121 for acute myocardial infarction cases.
Complex diagnosis alert. Ensure appropriate reimbursement by knowing which diagnoses may change the DRG assignment from DRG 125 to 124 for cardiac catheterization cases.
HIV major related diagnosis code alert. Know when a diagnosis entered as a secondary diagnosis with HIV will group the case to the higher-paying DRG 489, helping to improve reimbursement.
Medicare as secondary payer alert. See at a glance when Medicare should be considered a secondary payer.
CC condition symbol. Quickly identify complications and comorbidities that affect DRG assignment — helping improve the accuracy of DRG selection and enhancing reimbursement.
Current official code set with instructional notes and conventions, and complete official coding guidelines. Be in compliance with HIPAA transaction and code set requirements to avoid delayed or denied claims and costly fines for violating HIPAA requirements.
IPPS compliance symbols. Quickly identify all major Medicare Code Edits (MCE) used to audit claims submitted under the inpatient prospective payment system (IPPS) for diagnosis — unacceptable PDx, nonspecific PDx, questionable admission PDx, age, sex, CC, MSP and manifestation codes.
Procedure Medicare Code Edit alerts. Improve claim accuracy by being alerted to ALL the major Medicare edits pertaining to procedures; valid OR procedures, noncovered, limited coverage, non-operating room procedures affecting DRG assignment, valid OR procedures, nonspecific OR procedures, bilateral edits and sex edits.
AHA’s Coding Clinic for ICD-9-CM references. AHA's Coding Clinic provides the official coding advice that every coder in every health care setting must follow for ICD-9-CM.
Definitions and illustrations. Verify correct code selection using clinically oriented definitions and illustrations that give the user an in-depth understanding of anatomy and disease processes.
Manifestation code alert. Clearly identify and properly use codes that represent manifestations of underlying disease, and be alerted when two codes are required, improving coding accuracy and reducing denied claims.
Age and sex edits. Know which codes have restrictions on their use based on age or sex of the patient — reducing claims delays and denials.
New and revised code symbols and dated pages. Quickly identify new code information and the date of the most recent change so you can perform accurate retrospective claim audits.
Dictionary-style headers, QuickFlip™ color tabs, legends and keys on each page. Save time and improve coding efficiency by locating a specific section more quickly.
Summary of new code changes for 2006. Eliminate the guesswork and reduce denied claims
Earn CEUs from AAPC. Earn up to 5 CEUs awarded by the American Academy of Professional Coders (AAPC).
For Home Health Agencies
EXCLUSIVE — Excerpts from the home health prospective payment system final rule. Better forecast revenue by understanding the prospective payment system and how it will affect overall reimbursement of home health services.
EXCLUSIVE — Notation identifying diagnoses that group to the clinical dimension. Quickly identify primary and secondary diagnoses that group a patient to clinical dimensions, helping to ensure appropriate reimbursement
Medicare Home Health Manual section 204. Quickly locate coverage information for home health services.
For the Skilled Nursing Facility
EXCLUSIVE — Color coding for RUG-III classification system. Know the ICD-9-CM diagnosis and procedure codes that may qualify a SNF patient for assignment to a particular clinical category under the new reimbursement system for accurate claim submission.
Code of Federal Regulations 42CFR Parts; Resource Utilization Groups (RUG-III). Understand patient classification groups of the new SNF prospective payment system (PPS) to improve reporting and appropriate reimbursement.
Official coding guidelines specifically for skilled nursing facilities. Coding guidance that will ensure compliance.
For Hospice Services
EXCLUSIVE — Color coding for hospice non-cancer diagnosis codes. At a glance, know which diagnosis codes may qualify a non-cancer patient for hospice care before submitting a claim, and reduce delays and denials.
Guidelines addressing the Medicare hospice coverage of non-cancer hospice care. Reduce delays and denials by knowing what criteria need to be met for a non-cancer patient to be eligible for hospice care before submitting a claim.