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Accurately report supplies and services for physician, hospital outpatient, and ASC settings with the Optum360 HCPCS Level II Expert. Use this comprehensive reference for the HCPCS code set that focuses on management of reimbursement. This user-friendly book will guide any coder confidently through current modifiers, code changes, additions and deletions with information as dictated by the Centers for Medicare and Medicaid Services (CMS).
- Optum360 Edge—Access to Medically Unlikely Edits (MUE). Improve accuracy of claims by ensuring compliance with the CMS program through easy access to codes and their associated MUE units.
- Color-coded bars and icons. Spot important information to help reduce inaccurate and denied claims with informative flags signaling Pub. 100 references, age and gender edits, quantity alerts, new/deleted/revised code changes and government coverage and rules for each code.
- Optum360 Edge—Expanded index and glossary of terms. Ease code look-up with additional ways to locate codes and increase your understanding of HCPCS codes to improve coding accuracy.
- Optum360 Edge—Special appendixes. Get additional information with appendixes for the listing of PQRS codes and a deleted codes crosswalk.
- Most complete HCPCS code set available. Find information on codes from sources that generates HCPCS codes, including CMS, OPPS addendum B, and the Medicare fee schedule.
- Table of Drugs. Locate both generic and brand-name drugs and their corresponding codes based on the amount and route of administration.
- PQRS icons. Recognize potential for Medicare quality reporting bonus payments with icons denoting which HCPCS codes fall under the Physician Quality Reporting System.
- APC status indicators and ASC designation symbols. Determine which codes are payable under OPPS, which codes enable billing using ASC groupings and how to accurately use each to help ensure appropriate billing and reimbursement.
- DMEPOS icon. Distinguish codes paid under the DMEPOS fee schedule to improve efficiency when coding for supplies that should be submitted under the system to durable medical payers.
- AHA Coding Clinic for HCPCS references. Receive added support with articles on difficult-to-code HCPCS Level II codes or sections.