EncoderPro.com for Payers-Standard provides access to comprehensive code validation software online for fast search capability. Designed specifically for payer organizations users can search for CPT® procedures, HCPCS supplies and services, and ICD-9-CM diagnosis and procedures codes based on descriptions on the provider and hospital claim forms, and better understand procedural and diagnosis codes using the Coders’ Desk Reference lay descriptions. Also, with EncoderPro.com for Payers-Standard users can correctly identify the services in question for outpatient and inpatient hospital services, invasive procedures, CT, MRI and PET scans.
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.
- Modifier Crosswalk. Choose from a comprehensive array of modifiers for each procedure based on millions of claim scenarios to ensure correct modifier use when billing payers.
- 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.
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