Key Features and Benefits

·       New — Extended Understanding Modifiers Appendix. Provides easy-to-understand guidance for some of the more difficult modifiers, assisting in appropriate usage and reimbursement.

·       Optum Edge — Code-specific definitions, rules, and references. Reference comprehensive information compiled from the Centers for Medicare and Medicaid Services (CMS), the AMA, Optum, and other sources to assist with accurate coding and speed reimbursement.

·       Evaluation and Management (E/M) Services Guidelines. AMA CPT^® section guidelines for the Evaluation and Management (E/M) Services Guidelines are provided in their entirety.

·       Extended Evaluation and Management Appendix. Easy-to-use grids and extended guidelines to facilitate E/M code selection.   

·       Icons/color bars. Familiar icons or color bars used for new, revised, add-on, resequenced, telemedicine, and for correct modifier usage. Also identify which new or revised CPT^® codes are valid, but not in the current CPT^® book.

·       Extensive user-friendly index. Find codes in a flash with our accurate and expansive alphabetic index with terms listed in a variety of ways.

·       New, Revised, and Deleted codes appendix. Easily identify changes to CPT^® code descriptions, including code changes made mid-year by the AMA, but not found in the AMA’s CPT^® code book.

·       CPT^® Assistant references. Identifies that an article or discussion of a CPT^® code exists in the AMA’s CPT^® Assistant newsletter. Use the citation to locate the correct volume.

·       Medicare coverage rules with icons and IOM references at the code level. Understand which CMS policies apply to CPT^® codes prior to claim submission. Some of these icons include CCI and Provider MUE edits, ASC payment and OPPS status indicators, and IOM references.

·       Facility and non-facility RVUs and global/follow-up days. Evaluate your fees and understand the impact on standard post procedure coverage.