The ICD-10-CM Expert for Physicians with Optum360's hallmark features and format makes facing the challenge of accurate diagnosis coding easier. Developed specifically to meet the needs of physicians, the Optum360 code book contains the complete ICD-10-CM code set which is the cornerstone for establishing medical necessity, determining coverage, and ensuring appropriate reimbursement.

Now with a new symbol in the tabular for codes associated with CMS quality payment program (QPP) measures and a symbol to identify codes associated with CMS hierarchical condition categories (HCC) used in risk adjustment (RA) coding. Supplementary appendixes available only in the expert edition include: pharmacology listings, Z codes for long-term use of drugs and associated drug names; and Z codes used only as primary diagnosis.

New features in Professional and Expert editions of 2020 ICD-10-CM for Physicians:

• Complete list of new revised and deleted codes
• Conversion table identifying new codes to the 2018 ed. code
• Coding Tips specific physician and outpatient settings
• Introducing a new symbol in the tabular to identify diagnosis codes associated with QPP measures
• More definitions added for diagnostic terms

Key features and benefits of this ICD10 code book:

• New — Optum360 Edge — QPP measures. Introducing a new symbol in the tabular to identify diagnosis codes associated with QPP measures.
• New — Optum360 Edge — Coding Tips. Specific coding tips for physician and outpatient settings.
• New — Optum360 Edge — More Definitions. More diagnostic terms are defined.
• New — Optum360 Edge — Complete list of code changes. All 2020 new, revised, and deleted codes listed in the front of the book.
• Optum360 Edge — Two delivery options. Delivery option 1 – guaranteed delivery before October 1, 2018. Updated 2020 guidelines will be provided in a guideline booklet that will be shipped separately. Delivery option 2 – guidelines bound in the book. Books may arrive after October 1, but are guaranteed to contain the complete updated 2020 code set along with updated 2020 guidelines.
• Optum360 Edge — Intuitive features and format. Includes all of the Optum360 visual alerts, including color-coding and symbols that identify coding notes and instructions, additional character requirements, placeholder X, Medicare Code Edits (MCE), manifestation codes, HCCs, and unspecified codes.

What is the difference between the Expert and Professional editions?

• Expert Edition: Spiral bound and appendixes which include: POA coding and reporting tutorial; pharmacology listings of common drugs with therapeutic classes and indications; and code lists for CC, MCC and PDx CC/MCC.
• Expert Edition: Downloadable files for CC Excludes PDx collection, POA exempt codes.
• The Professional edition does not include the above features.