2021 Auditors’ Desk Reference

Optum360 | 2021 | Nichole VanHorn

List Price

Item #: AUDR21
ISBN: 9781622547081
Available: NOW

This unique manual shows what the medical record must contain for correct coding and billing of specific medical and diagnostic services and procedures. It provides coders and anyone concerned about coding with an auditor’s perspective on the clinical detail, regulatory instructions, and coding protocol needed for code assignment. Avoid the devastating effects of outside audits and reviews with this detailed coding tool.

Optum360 Edge—Get online access to customizable audit worksheets. Protect your revenue critical services and procedures.
Expanded office and other outpatient E/M services (99201-99215) section. Keep up to date on the new reporting guidelines.
• Conduct skilled internal audits. Ensure proper reimbursement.
• Differentiate between similar procedures. Compare and contrast seemingly similar, but different, procedures.
• Completely updated for 2021 code set and regulatory changes.
Increase Revenue. Learn the appropriate way to report telehealth services.
• Provides coders with an auditor’s perspective. Know the clinical detail, regulatory instructions, and coding best practices needed for code assignment.
Know what information needs to be in the medical record and on the claim form to capture appropriate reimbursement.
• Know the key terms that need to be mentioned in the medical record to support code assignment.
• See the medical conditions that are indicated for diagnostic, therapeutic and surgical purposes.

• Gain valuable code intelligence. Confirm correct code assignment.
• Train your staff. This resource is thorough and can easily be used to train staff assign codes appropriately.
Correct Modifier Assignment. It contains modifier decision-making trees that assist with assigning correct modifiers. Supports Best Practices. 


Nichole VanHorn, CPC, CCS-P

Ms. VanHorn has more than 20 years of experience in the health care profession. Her areas of expertise include CPT® and ICD-10-CM coding in multiple specialties, auditing, and education. Most recently she served as Clinical Auditor for a multi-specialty group. Ms. VanHorn was responsible for the oversight of the physician coding and education section of the Corporate Compliance Program. She has been an active member of her local American Academy of Professional Coders (AAPC) chapter for several years and has also served as an officer.

CPT is a registered trademark of the American Medical Association.