2025 ICD-10-CM Expert for Physicians with Guidelines (eBook)
Optum | 2025 |
The 2025 ICD-10-CM Expert for Physicians, with our hallmark features and format, makes facing the challenge of accurate diagnosis coding easier. Developed specifically to meet the needs of physicians, the Optum codebook contains the complete ICD-10-CM code set, which is the cornerstone for establishing medical necessity, determining coverage, and ensuring appropriate reimbursement. Also included are the 2025 ICD-10-CM Official Guidelines for Coding and Reporting, with chapter-specific guidelines and examples in the tabular section. The familiar Optum symbols identify codes associated with CMS quality payment program (QPP) measures and CMS hierarchical condition categories (HCC) used in risk adjustment (RA) coding and more.
- Optum Edge — Intuitive features and format. Visual alerts, including color-coding and symbols that identify coding notes and instructions, additional character requirements, placeholder X, Medicare Code Edits (MCE), manifestation codes, QPP, HCCs, unspecified codes, and more.
- Optum Edge — ICONS for April updates. Easily distinguish between April and October new and revised codes with green icons for April and black for October changes.
- Optum Edge — Expanded Table of Drugs and Chemicals. Expanded to include updated drugs and codes listed with associated intent with icon to easily identify the added drugs.
- Optum Edge — ICONS identifying RxHCCs and ESRD HCCs. Quickly identify the RxHCC and ESRD/PACE ICD-10-CM codes used in risk adjustment coding by Medicare Advantage Plans.
- Optum Edge — ICONS identifying HHS-HCCs. Easily identify the Department of Health and Human Services HHS-HCCs used by commercial insurance companies.
- Guidelines with coding examples. Official Guidelines for Coding and Reporting including chapter-specific coding examples.
- Product Updates. April and other ICD-10-CM changes and updates will be made available on the Optum Product Update page on Optumcoding.com for our valued ICD-10-CM customers.
- Coding tips and clinical definitions. Coding tips assist in appropriate code selection, while clinical definitions provide a better understanding of complex ICD-10-CM diagnostic terms.
- List of code changes and conversion table. A list of all 2025 new, revised, and deleted codes. Plus, an ICD-10-CM conversion table from the new and changed codes to the code previously used.
- Updated index with shaded guides. The updated Index to Diseases and Injuries includes vertical shaded guides that show the indent levels for subentries under main terms.
- Helpful illustrations. Detailed color anatomy illustration appendix. Plus, many illustrations at the code level identifying specific code-related anatomy.
Jacqueline Petersen, MHA, RHIA, CHDA, CPC
Ms. Petersen is a Registered Health Information Administrator with 30 years of experience in the healthcare profession. She has served as Senior Clinical Product Research Analyst with Optum 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, 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).
Laura Anderson, RN, BSN, CCDS
Ms. Anderson is a Registered Nurse and CDI Specialist/Educator with more than 20 years of experience in the healthcare profession. She obtained her BSN at the University of Minnesota and spent most of her bedside nursing career on Medical-Surgical care units. Her clinical documentation experience began in 2007, covering CDI specialist training, education development, and physician engagement. She has served as a CDI Team Lead and consultant, working with senior leadership to incorporate CDI work into documentation compliance and quality metrics. Ms. Anderson also has a BS degree in Biology (Winthrop University), with research experience in liver cancer and radiation-induced leukemia. She has presented at the state and national levels for the Association of Clinical Documentation Integrity Specialists (ACDIS) and has served as a co-lead for the Minnesota state chapter.
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