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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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ICD-9 Codes

INTERNATIONAL CLASSIFICATION OF DISEASES, 9TH REVISION, CLINICAL MODIFICATION ICD-9-CM VOLUMES 1 & 2 (DIAGNOSES) is the code set used by Non-HIPAA covered entries (Workers’ Compensation and auto insurance companies) that were not required to convert to ICD-10. Auditors who are reviewing claims prior to 2015 and HCC Medicare Advantage Risk Adjustment coders still need access to this extensive code set. AAPC Coder makes this simple and easy to accomplish. ICD-9-CM Volumes 1 and 2 represent the diagnosis/reason a procedure is done.

The format for ICD-9 diagnoses codes is a decimal placed after the first three characters and two possible add-on characters following: xxx.xx. ICD-9 PCS were used to report procedures for inpatient hospital services from Volume 3, which represent procedures that were done at inpatient hospital facilities. AAPC Coder give you ready access to these legacy codes making your audit work faster and more accurate.

September 09, 2019

In a world of uncertainty, one thing medical coders can count on is ICD-10-CM yearly updates. It's already that time of year again when the Centers for Disease Control and Prevention (CDC) releases... [ Read More ]

September 01, 2019

Timing is everything when defining and capturing the 7th character in an ICD-10-CM code. ICD-10-CM brought about new concepts for diagnosis coding, with some being straightforward and others being ... [ Read More ]

August 20, 2019

Know what to watch when coding bug bites, poison ivy, and heatstroke! Get ICD-10 pointers. Somehow it is mid-August already, and talk about 2020 code updates is buzzing. But summer 2019 isn't done ... [ Read More ]

August 12, 2019

Look at diagnosis history changes and Medicare's national and local coverage determinations for greater insight into denied claims. Coverage determinations for hyperbaric oxygen therapy (HBOT) for ... [ Read More ]

August 06, 2019

Alert coders of Excludes1 conflicts to help you catch problems in problem lists and avoid costly denials and rework. By Rebecca Caux-Harry, CPC In April's Healthcare Business Monthly (pages 56-57),... [ Read More ]

Having an issue getting paid by Medicare for cpt 37253 when billing over 5 units, this is an add on code and cannot use a modifier. billing 37252 with 37253
going through... [ Read More ]
Is anyone having an issue with getting IMRT code 77431 (Radiation therapy management with complete course of therapy consisting of 1 or 2 fractions only) paid by insurance? We ... [ Read More ]
In the A/P the provider puts:

E11.21-T2DM w/diabetic nephropathy
E11.42-T2DM w/ diabetic polyneuropathy
morning FBS 160-200
Plan: increase Levemir... [ Read More ]
I'm wondering if anyone out there is billing for post-operative scopes, which modifiers they are using, and if the charges are being paid? We have questions about CPT 31231 and... [ Read More ]
Hi, I recently became certified. BC Community (Illiniois Medicaid) is denying multiple DOS for CPT 11055 for included in allowance/similar procedure paid. Does this CPT have a ... [ Read More ]
The official rule is No Modifiers on Unlisted codes. Which makes sense as far as pricing modifiers like -22 or -52. But what about -26 for unlisted radiology or lab procedures? ... [ Read More ]
Do any insurers cover the routine checking of peak flows and spirometry in asthma patients q3months?
... [ Read More ]
I am billing for Critical Access Hospitals and we see incredibly too many rejections that state the following:
A7:... [ Read More ]
I am working on some Medicare Dermatology claims. It was billed with 11302 and 11302-59. Is there a better way to code this to get reimbursement? Medicare is denying the first 1... [ Read More ]
For the 24 hour holter monitor we bill in the physician's office 93224. We put on the holter and interp. Should the DOS be when the physician reads the data or the day the holt... [ Read More ]