EncoderPro.com Expert

• Expert Exclusive—Enhanced claim review (with Optum ClaimsManager rules). Check your work by running your selected codes through an automated edit review to ensure proper unbundling, correct modifiers, complete diagnoses, and more prior to submittal to a clearinghouse/vendor/payer. Includes access to a 24-month historical content database for use during claim adjudication. Over 130 coding rules are reviewed. 
• Expert Exclusive—Fee calculator. Calculate the adjusted Medicare reimbursement rate for your area. 
• ICD-10-CM and PCS. Includes mapping content from ICD-9-CM volumes 1 and 3 codes to ICD10-CM and PCS codes (as well as backward mapping) using the GEM (General Equivalency Mappings) and Optum MapSelect clinical mapping content. Also includes ICD-10-CM and PCS searching and Optum tabular (ICD10-CM and PCS books) content.

Plus all of the valuable features of EncoderPro.com Professional: 

• Optum Edge—Powerful CodeLogic™ search engine technology. Keyword search across all code sets (including ICD-10-CM and PCS) simultaneously using up to four terms, acronyms, abbreviations, or even misspelled words. 
• Optum 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. 
• Optum 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 (LCDs) and Medicare’s Internet Only Manuals access. Check procedures for Medicare coverage instructions and medical necessity edits across all CMS MACs. Understand which ICD-10-CM/procedure combinations 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. Includes code set cross coding (ICD to CPT ®, CPT ® to ICD, etc.), 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 and 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.

• AHA Coding Clinic^® for HCPCS Add-on (Item WA03 & WA03C)
• AHA Coding Clinic^® for ICD Add-on (Item WA02 & WA02C)
• The AMA CPT^® Content Module Add-on (Item WA34)
• Total CPT^® Add-on (Item WA37)
• The ASA CROSSWALK^® Add-on (Item WA24)
• Claim Appeal and Denial Support Add-on (Item WA32)
• Claims Batch Editor Add-on (Item WA16)
• Clinical Documentation Improvement Add-on (WA35)
• Coders' Dictionary Add-on (Item WA05)
• Dental Codes Add-on (Item WA23)
• Dr. Z’s Medical Coding Series: Interventional Radiology Add-on (Items WA30 & WA31)
• DrugReimbursement.com Add-on (Item WA08)
• EncoderPro.com Plus Add-on (Item WA45)
• Historical Application Content Add-on (Item WA11)
• Optum Specialty Articles Add-on (WA22)

CPT is a registered trademark of the American Medical Association.