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ICDExpert for Post-acute Care

ICDExpert for Post-acute Care
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Publisher: Optum360
Experts: Julie Orton Van
Sample Pages:  View PDF

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IN STOCK $199.95


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ICDExpert for Post-acute Care, with our hallmark features and content, is designed specifically to address the challenges faced by home health, hospice, skilled nursing, and rehabilitation services with using ICD-10-CM/PCS coding and reimbursement systems. This valuable online solution delivers every description, guideline, and instruction in Expert code books, but in a more convenient format and just as affordable. Updated monthly, ensuring code descriptions and clinical information are always current, and helping you comply with HIPAA. Use as a complement or replacement for your coding book. Read more

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Features and benefits

  • Optum360 Edge—Optum360 Library. Supplemental content has been added that address home health and hospice reimbursement and coverage issues including:
    • Overview of Home Health Prospective Payment System
    • Qualifications for Medicare Coverage of Home Health
    • Oasis Diagnosis Guidance
    • Case-mix Variables and Scores
    • Clinical Dimension Case-mix Groups
    • NRS Case-mix Adjustment Variables and Scores
    • Diagnosis Categories for NRS Case-mix Adjustments
    • Valid Diagnosis/Etiology Pairings
    • Hospice Criteria for Medicare Coverage of Non-cancer Hospice Care
    • Hospice Guidance and Quality Reporting Guidance
    • Optum360 FastFinder(TM) for Home Health
  • Optum360 Edge—Placeholder X alert.  This symbol,  (designed and used exclusively by Optum360) alerts the coder to a new ICD-10-CM convention — the use of a “placeholder X”.
  • Optum360 Edge—Detailed clinical descriptions and lay-descriptions. Access comprehensive clinical and lay information at the chapter, code block, category, subcategory, and code level. Includes proprietary Focus Points.
  • Optum360 Edge—Key Word. Green font is used to differentiate key words that appear in similar code descriptions in a given category.
  • Optum360 Edge—Color-coding and symbols specific to the home health PPS edits. Quickly identify coding and reimbursement issues specific to home health for improved coding accuracy and work efficiency. 
  • Optum360 EdgeColor-coding for hospice non-cancer diagnosis codes. Know at a glance which diagnosis codes qualify a non-cancer patient for hospice care.
  • Optum360 Edge—Exclusive Following references and Check additional character symbol in the indexes. The Following references help coders locate those alphanumeric codes that are out of sequence in the tabular
  • Optum360 Edge—Additional character required symbols. Know when an additional character is required for code specificity and validity to avoid invalid code submissions (provided in Index and Tabular Section).
  • Optum360 Edge—Highlighted coding instructional and informational notes. Recognize important code usage guidance for specific sections more easily with highlighted notes.
  • Optum360 Edge—"Unspecified” and “Other” code alerts. Find official coding guidance that suggests home health agencies avoid using diagnoses that are unspecified or vague.
  • Optum360 Edge—Anatomical illustrations.  Focus is on featuring anatomy and terminology included in the ICD-10-CM/PCS classification systems, in order to help you better understand procedures and anatomy so you can select the best possible codes.
  • Optum360 Edge—Official index. Navigate through the official index to the tabular section and external causes using our exclusive shade guides to easily identify subterm levels under main terms.
  • Optum360 EdgeHallmark design and features. Ease into the new classification system using intuitive visual alerts to highlight code groupings as well as the distinctions between code choices—plus, added features that make finding specific sections easier.
  • Optum360 Edge—ICD-9-CM / ICD-10-CM Mapping.  Includes ICD-9 v1 and v2 codes mapped to ICD-10-CM codes using the GEM (General Equivalency Mappings) and proprietary Optum360 MapSelects. Also includes Optum360 Tabular (ICD-10-CM book) Content and Optum360 mapping logic. Maps ICD-9-CM v3 procedure codes to ICD-10-PCS codes. 
  • Notations for diagnoses that group to clinical dimension. Expedite identification of diagnoses that group a patient to expanded clinical dimensions case mix groups to ensure appropriate reimbursement.
  • Non-Routine Supply (NRS) diagnosis alert. Every condition that may qualify to receive non-routine supply reimbursement adjustment is identified.
  • Manifestation code alert. Properly use codes that represent manifestations of underlying disease by knowing when two codes are required and by knowing alerts to sequencing rules.
  • Table of Drugs and Chemicals and Neoplasm Table Updated tables within ICD-10-CM with shaded columns and check additional character symbols.
  • HIPAA compliance. Comply with HIPAA transaction and code set requirements to avoid delayed or denied claims and costly fines for violations.
  • Anatomical illustrations. Large displays of anatomical illustrations on your screen help you better understand procedures and anatomy so you can select the best possible codes.

The price of ICDExpert for Post-acute Care does not include add-ons. Add-ons sold separately.

Click here
to view all the available add-on modules.

Available add-ons:

  • AHA Coding Clinic® for ICD Add-on (Item WA02 & WA02C)



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Content Experts

Julie Orton  Van - Julie Orton Van works at Optum360 as a product manager for coding and referential software. She has over 30 years’ experience in the health care industry, including medical coding and billing, physician office management, home health and hospice, Medicare cost-accounting, managed care, claims adjudication systems, business rules configuration to automate physician credentialing and network participation, contract and benefits administration from a payer perspective, reference and CLIA-waived laboratory interfaces, and clinical information systems including technical support and clinical content for a fully-integrated ambulatory electronic health record at the University of Utah Health Sciences Center. She possesses specific knowledge of federal and state regulations regarding eligibility and benefit requirements for HMO, PPO, Medicare Risk, Medicare Cost, Medicaid, indemnity, third-party administration, and COBRA.

She has consulted in practice management with an emphasis on revenue cycle management and establishing policies and procedures for purchasing, inventory, and Medicare cost accounting. She has served on several boards interested in health care, including the Utah Health Information Network (UHIN) committee for implementation of daily eligibility and enrollment electronic data interfaces (EDI). She has presented on topics relating to capitation, code based system configuration to support business rules, the electronic health record and data quality. Ms. Van recently worked with business analysts, software developers, quality assurance specialists, and customers to create a coding application specific to post-acute care. Ms. Van graduated cum laude from Westminster College with degrees in Business Administration and Economics and English. She is an active member of the American Academy of Professional Coders, is a Certified Professional Coder (CPC) and a Certified Professional Coder - Payer with a specialty credential in Evaluation and Management (CEMC).

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