ICDExpert for Post-acute Care


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Item #: 9076
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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 using ICD-10-CM 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.

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  • 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 FastFinderTM for Home Health
  • Optum360 EdgeColor-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.
  • 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”.
  • 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.
  • Key Word. Green font is used to differentiate key words that appear in similar code descriptions in a given category.
  • 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
  • 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).
  • Highlighted coding instructional and informational notes. Recognize important code usage guidance for specific sections more easily with highlighted notes.
  • "Unspecified” and “Other” code alerts. Find official coding guidance that suggests home health agencies avoid using diagnoses that are unspecified or vague.
  • Anatomical illustrations.  Focus is on featuring anatomy and terminology included in the ICD-10-CM classification systems, in order to help you better understand procedures and anatomy so you can select the best possible codes.
  • 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.
  • Hallmark 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.
  • 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. 
  • 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.