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provides online access to a powerful search application for all CPT®
, HCPCS Level II, ICD-10-CM/PCS , and ICD-9-CM code sets, as well as Optum360 and Medicare coding guidelines to ensure coding accuracy, improve billing performance, and reduce rejected claims. Complimentary monthly updates let you code confidently throughout the year. Plus, a compliance editor powered by the Optum360 Claims Manager
helps you review your code selections, and a fee calculator computes the Medicare reimbursement rate for your region to see how provides online access to a powerful search application for all CPT, HCPCS Level II, ICD-9-CM, and ICD-10-CM/PCS code sets, as well as Optum360 and Medicare coding guidelines to ensure coding accuracy, improve billing performance, and reduce rejected claims. Complimentary monthly updates let you code confidently throughout the year. Plus, a compliance editor powered by the Optum360 helps you review your code selections, and a fee calculator computes the Medicare reimbursement rate for your region. Read more
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Features and benefits
Plus all of the valuable features of EncoderPro.com Professional:
- Optum360 Edge—Powerful CodeLogic™ search engine technology. Keyword search across all code sets (including ICD-10-CM/-PCS) simultaneously using up to four terms, acronyms, abbreviations, or even misspelled words.
- Optum360 Edge—Lay descriptions for procedures and HCPCS. Access comprehensive Coders’ Desk Reference descriptions for thousands of procedures and services to enhance your understanding of CPT® and HCPCS code differences.
- Optum360 Edge—Automatic monthly updates. Real-time application service delivers code changes before implementation and updates Medicare coverage information regularly for coding confidence.
- Local coverage determinations (LCD) and Medicare’s Pub. 100 access. Check procedures for Medicare coverage instructions and medical necessity edits across all CMS MACs. Understand which ICD-9-CM (and ICD-10-CM) procedures define medical necessity and what the documentation guidelines are for successful claim submission. Gain insight into procedures and services that carry little or discretionary coverage and how to report them.
- 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.
- Cross-coder relationships. Provides valuable content from 12 coding and billing specialty reference books in one powerful solution. Cross-reference procedures to radiology, path/lab, medicine codes, and more.
- Medicare CCI edits. Understand coding relationships for bundled and mutually exclusive procedures and check your code combinations through a full year of CCI.
- Color-coded edits. Reduce research time and improve coding accuracy with at-a-glance sex or age edits, Medicare coverage, and bundled procedures.
- User notes. Easily identify codes or code groups requiring more personal or company information.
- Notepad. Store your most frequently used codes for easy access and export your codes to Windows programs.
Great value. Includes the content from more than 30 code and reference books in one powerful solution.
The price of EncoderPro.com Expert
does not include add-ons. Add-ons sold separately.
Click here to view all the available add-on modules
- AHA Coding Clinic for HCPCS Add-on (Item WA03)
- AHA Coding Clinic for ICD Add-on (Item WA02)
- Claims Batch Editor Add-on (Item WA16)
- Repair Toolkit for Claims Batch Editor Add-on (Item WA18)
- Coders’ Dictionary Add-on (Item WA05)
- Coder’s Essential 3-Pack (Item WA22)
- CPT® Assistant Add-on (Item WA01)
- CPT® Changes Add-on (Item WA27)
- CPT® Assistant/Changes (unrestricted) Add-on (Item WA37)
- The AMA Content Module Add-on (Item WA34)
- The CDI Add-on (Item WA35)
- Dental Codes Add-on (Item WA23)
- ASA Crosswalk® (Item WA24)
- DrugReimbursement.com Add-on (Item WA08)
- Historical Application Content Add-on (Item WA11)
- Stedman’s Dictionary Add-on (Item WA04)
- I-10 Map Manager (Item WA26)
CPT is a registered trademark of the American Medical Association.
Ryan Devey - Product Manager, EncoderPro.com
Employed at Optum360 for 10 years
Ryan graduated from the University of Utah in healthcare
administration and has worked for multiple commercial payer
organizations in several different roles. Additionally, Ryan
worked as a practice administrator for a physician clinic, where
he implemented an EMR system and a fully electronic coding
and code review process. For the past 10 years, Ryan has
designed and managed medical coding data management
systems, workers compensation rebilling systems and medical
coding/fee schedule software.
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