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