2025 HCPCS Level II Professional (Softbound)
Optum | 2025 |
Accurately report supplies and services for physician, hospital outpatient, and ASC settings with the 2025 HCPCS Level II Professional. Use this comprehensive reference for the HCPCS code set that focuses on management of reimbursement. This user-friendly book guides any coder confidently through current modifiers, code changes, additions, and deletions with information as dictated by the Centers for Medicare and Medicaid Services (CMS).
- New - Expanded Modifier appendix. Includes HCPCS Level II modifiers and descriptions and easy-to-understand guidance and coding tips for some of the more difficult modifiers, assisting in appropriate usage and reimbursement.
- New - Helpful illustrations. Detailed color anatomy illustration chapter. Plus, many illustrations at the code level identifying specific code-related supplies and services.
- Table of Drugs. Locate both generic and brand-name drugs and their corresponding codes based on the amount and route of administration.
- Code level documentation tips. When appropriate, guidance is provided to assist correct coding.
- APC status indicators and ASC designation symbols. Determine which codes are payable under OPPS and which codes enable billing using ASC groupings, as well as how to accurately use each to help ensure appropriate billing and reimbursement.
- Comprehensive Drug Information. The C and J code sections include a listing of a common drug(s) to be used for that code. Also, as needed, a coding tip and/or drug notation is provided.
- DMEPOS icon. Distinguish codes paid under the DMEPOS fee schedule to improve efficiency when coding for supplies that should be submitted under the system to durable medical payers.
- In-depth illustrations. Enhance your coding process and accuracy for supplies and services with detailed visual references.
- AHA Coding Clinic® for HCPCS references. Receive additional support with articles on difficult-to-code HCPCS Level II codes or sections.
- Color-coded bars and icons. Spot important information to help reduce inaccurate and denied claims with informative flags signaling Internet Only Manual (IOM) references, age and gender edits, quantity alerts, new/deleted/revised code changes, and government coverage and rules for each code.
- User-friendly appendixes. Navigate additional information easily with structured references and excerpts, including a comprehensive drug table, acronyms/abbreviations, and modifiers.
Elizabeth Leibold, RHIT
Ms. Leibold has more than 25 years of experience in the healthcare profession. She has served in a variety of roles, ranging from patient registration to billing and collections and has an extensive background in both physician and hospital outpatient coding and compliance. She has worked for large healthcare systems and health information management service companies and has wide-ranging experience in facility and professional component coding, along with CPT expertise in interventional procedures, infusion services, emergency department, observation, and ambulatory surgery coding. Her areas of expertise include chart-to-claim coding audits and providing staff education to both tenured and new coding staff. She is an active member of the American Health Information Management Association (AHIMA), Middle Tennessee Health Information Management Association (MTHIMA), and West Tennessee Health Information Management Association (WTHIMA).
Jaqueline Petersen, MHA, RHIA, CHDA, CPC
Ms. Petersen is a subject matter expert (SME) with Optum360. She has served as Senior Clinical Product Research Analyst with Optum360 developing business requirements for edits to support correct coding and reimbursement for claims processing applications. Her experience includes development of data-driven and system rules for both professional and facility claims and in-depth analysis of claims data inclusive of ICD-10-CM, CPT®, HCPCS and modifiers. Her background also includes consulting work for Optum, serving as a SME, and providing coding and reimbursement education to internal and external clients. Ms. Petersen is a member of the American Academy of Professional Coders (AAPC) and the American Health Information Management Association (AHIMA).
CPT is a registered trademark of the American Medical Association.
CPT is a registered trademark of the American Medical Association.
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