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Stock #: 09-10170
ISBN : N/A

The new EncoderPro.com for Payers-Professional allows users to find CPT® procedure, HCPCS supplies and services, and ICD-9-CM diagnosis and procedure codes based on descriptions found on the provider’s CMS 1500 and hospital outpatient/inpatient UB-04 claim forms.

Now, with EncoderPro.com for Payers-Professional you can reference and better understand these codes using Coders' Desk Reference lay descriptions, correctly identify the medical necessity rules for prior authorization across physician clinic, ASC and hospital inpatient/outpatient setting, and run claims through one-up audits based on date of service and historical periods. EncoderPro.com for Payers-Professional was developed to assist payer organizations identify medical services and procedures furnished by physicians and other health care professionals. Get faster close-out of claims while improving operational efficiency and costs with the new EncoderPro.com for Payers-Professional.

Features & Benefits:

• Ingenix CodeLogicTM search engine. Find and validate CPT®, HCPCS, and ICD-9-CM codes using lay terms, acronyms, abbreviations and even the misspelled words found on outpatient and inpatient UB-04's and providers CMS 1500 claim forms.
• Featured Coders' Desk Reference lay descriptions. Clearly understand CPT®, HCPCS, and ICD-9-CM codes using Coders' Desk Reference lay descriptions—a one stop resource, providing lay descriptions for surgical, laboratory/pathology, radiology and medicine codes, eliminating the need for multiple resources and increasing productivity.
• Color code edits. Determine charges allowed by Medicare for capitation, fee-for-service, outpatient and inpatient hospital services and provider payments. Know cost and reimbursement amounts by understanding whether a code carries an age or sex edit, is covered by Medicare or contains bundled.
• Medicare secondary payer "coordination of benefits". Access the entire MSP Manual and understand assigning responsibility for first and second payer.
• CPT® is a registered trademark of the American Medical Association.