AAPC Coder Complete
AAPC Coder Complete provides all the coding and reimbursement tools needed for inpatient coders, outpatient coders and CDI experts. Quickly view the OPPS fee schedules for freestanding ASCs and hospital based outpatient services in one place. For each CPT® code, you can identify the applicable modifiers, status indicators and payment indicators. For procedures that require devices, you can view if there is a credit adjustment policy for the device. Avoid bundling and determine proper modifier use by using the Medicare OPPS CCI checker for up to 25 codes at one time. The cross-reference tools allow you to forward and backward map CPT® to ICD-9-CM Volume 1 and 3, ICD-9-CM Volume 1 to ICD-10-CM and ICD-9-CM Volume 1 to the appropriate DRG options. Easily identity the DRG options, including CC and MCC, for each ICD-9-CM Volume 1 code.

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APC look up provides necessary detail on one page including long descriptor, payment and coverage info and more.

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CPT Assistant
CPT® Assistant is the official word from the AMA on proper CPT® code usage. AAPC Coder's Code Connect add-on allows you to search all CPT® Assistant articles from 1990 to present by CPT® code to narrow the options to only related articles for quick coding guidance.

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Coding Clinic
The HCPCS Coding Clinic delivers the official guidance published quarterly by the American Hospital Association (AHA) Central Office on correct HCPCS level II code usage. Each issue offers consistent and accurate advice for the proper use of HCPCS and includes information on HCPCS reporting for hospitals HCPCS Level 1 (CPT®) and Level II codes, the latest code assignments from emerging technologies, and real examples.

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DRG Codes

MS-DRGs are Easily Support Through AAPC Coder

Facilities billing inpatient care rely on Multiple Severity - Diagnostic Related Groups (MS-DRGs) to report episodes of care and receive reimbursement. Encompassing 20 body areas and gathered into around 500 groupings, MS-DRGs are determined based on the ICD-10-CM primary diagnosis codes assigned to the case. Complications and comorbidities (CC) add to the severity and reimbursement of the episodes of care.

Proper MS-DRG assignment requires a number the right tools based on ICD-10-CM and PCS codes and guidelines, current Inpatient Prospective Payment System (IPPS) data, up-to-date federal guidelines, and well-written software, all of which AAPC Coder provides. Here are some examples:

  • ICD-10-CM and ICD-10-PCS coding - Quickly find the ICD-10 code that best describes the patient's diagnosis or procedure with a look-up tool that includes the very latest from CMS. Intuitive and accurate, AAPC's electronic coding tools are designed for coders by coders.
  • Major Diagnostic Categories - AAPC Coder's MDC look-up tool helps you crosswalk the proper ICD-10 codes with the MDCs your patient represents. Outlier and CC status won't fool you as you use our intuitive tool.
  • DRG Grouper - Imagine calculating in a few moments what it would take a spreadsheet to accomplish. AAPC Coder's grouper allows you to enter one or more ICD-10 codes, along with some other required inputs, click a button, and get the resulting DRG and other important information (including the Relative Weight, Length of Stay, Procedure Type, Post Acute Indication and other items).
  • DRG Payment Calculator - You can calculate your reimbursement with our integrated DRG Payment Calculator, where you can input some additional information to see how much Medicare will pay for that episode of care. The payment calculator shows the different payment components (Federal Operating Payment, Operating Indirect Medical Education Add-on, Operating Disproportionate Share Hospital Add-on, other add-ons and adjustments etc.) as well as the Billed Outlier Threshold (if costs were unusually high - which can qualify for an additional outlier payment).
  • AAPC Coder's Additional Content - AAPC Coder keeps you up-to-date on regulatory changes by updating when needed. Find links, articles about, and the regulations that will help you be efficient and effective. Coding Clinic and other resources can be added on as you need them.
DRG Ranges and Sections