The official CPT® guidelines at your fingertips Providers want accurate reimbursement. Payers want efficient claims processing. Since the CPT® code set is a dynamic, ever-changing standard, an outdated codebook does not suffice. Correct reporting and billing of medical procedures and services begins with CPT® 2021 Professional Edition. Only the AMA, with the help of physicians and other experts in the health care community, creates and maintains the CPT code set. No other publisher can claim that. No other codebook can provide the official guidelines to code medical services and procedures properly.The CPT® 2021 Professional Edition Codebook covers hundreds of code, guideline and text changes. It features the following enhancements: More full-color procedural illustrations Notes pages at the end of every code set section and subsection CPT® Changes, CPT® Assistant, and Clinical Examples in Radiology citations — provides cross-referenced information in popular AMA resources that can enhance your understanding of the CPT code set A comprehensive index — aids you in locating codes related to a specific procedure, service, anatomic site, condition, synonym, eponym or abbreviation to allow for a clearer, quicker search Full-color anatomical and procedural illustrations — help improve coding accuracy and understanding of the anatomy and procedures being discussed Coding tips throughout each section — improve your understanding of the nuances of the code set Enhanced codebook table of contents — allows users to perform a quick search of the codebook’s entire content without being in a specific section Section-specific table of contents — provides users with a tool to navigate more effectively through each section’s codes Summary of additions, deletions and revisions — provides a quick reference to 2021 changes without having to refer to previous editions Multiple appendices — offer quick reference to additional information and resources that cover such topics as modifiers, clinical examples, add-on codes, multianalyte assays, vascular families and telemedicine services Comprehensive E/M code selection tables — aid physicians and coders in assigning the most appropriate evaluation and management codes Adhesive section tabs — allow you to flag those sections and pages most relevant to your work

This print and digital coding package includes one spiralbound copy of CPT® 2020 Professional Edition, single-user access of the eBook version of the codebook and free access to all premium content available in the CPT® QuickRef app (accessible by mobile device only). Premium app content includes the following: Coding and Billing Pack 2020 Use your mobile device to access all CPT codes, AMA and CMS '95 and '97 guidelines, modifiers, procedural illustrations, clinical examples and links to relevant CPT® Assistant articles.CPT QuickRef app The fully loaded CPT QuickRef app combines the best of AMA’s CPT content with billing tools to help improve the accuracy and efficiency of the work you perform. Features of the CPT QuickRef app with premium content include: The latest information — Receive updates from the cloud when new RVUs and proprietary laboratory analysis (PLA) codes are released or when technical corrections are made to 2020 CPT codes Two editions of the CPT code set — Easily navigate between 2019 and 2020 code sets to ensure the codes in use during a patient visit are recognized at the time of the year-end code transition Favorites — Select the codes you use most and save them to your favorites list Facility and non-facility RVUs — Use federal data on facility and non-facility work and practice expense values GPCIs — Set your region’s geographic practice cost index to calculate accurate Medicare payments for each procedure Global days — Reference the number of global days CMS assigns to a given procedure Illustrations — Better understand complex procedures with AMA-created illustrations Clear references to CPT Assistant articles — View article titles instead of date and page number references found in other resources CPT Assistant Archive 1990 — 2019 Access the full content of all CPT Assistant issues (1990–2019) using your mobile device. View images of the CPT QuickRef app.

The DRG Expert has been a trusted and comprehensive reference to the DRG classification system for more than 25 years. Organized by major diagnostic category (MDC), the convenient and innovative book layout follows the logical MS-DRG decision process. This is a must-have reference for those who need to verify DRG information and accurately assign MS-DRGs concurrently or retrospectively based on ICD-10-CM methodology, which goes into effect October 1, 2020. Key Features and Benefits • Optum360 Edge — Visual indicators notify you of special alerts. Easily identify CC and MCC restrictions, special payment status, transfer DRG status, surgical/medical partitioning, and other requirements. • Optum360 Edge — Medicare CMS rate structure. Updated to provide current relative weight (RW), geometric mean length-of-stay (GMLOS), and arithmetic mean length-of-stay (AMLOS) for each MS-DRG under IPPS. • Optum360 Edge — MS-DRG structure. Every diagnosis and procedure code that defines each DRG is listed. • Optum360 Edge — LTC-DRG crosswalk and current rate structure. Know what the RW and length-of-stay data are for each MS-DRG under the LTCH prospective payment system. • Optum360 Edge — MDC diagnosis list. Complete list of mutually exclusive diagnoses defining each MDC. • Optum360 Edge — Transfer DRG symbol. Indicates a DRG selected as a qualified discharge that may be paid at the per diem rate. • Optum360 Edge — Average national payment. Listed for every MS-DRG as a quick benchmark comparison. • Easily locate the correct DRG. Use the numeric or alphabetic index to quickly identify a DRG based on its diagnosis or procedure code. • Surgical hierarchy table. Quickly find the DRG hierarchy for multiple procedure cases to help you assign the code that reflects the greatest resource utilization. • Alphabetic and numeric indexes. Search for DRGs by the numeric codes or by code titles for fast look-up. • Icons indicate which CC subclass the DRG belongs to based on the presence or absence of CCs or major CCs (MCCs). • Complete list of diagnoses considered CCs and MCCs. • List of those principal diagnoses that are their own CC and their own MCC. • Full titles for each MS-DRG. Selection of the correct DRG begins with knowing its accurate and complete description.

HCPCS 2021 Level II Professional Edition provides your practice a quick and accurate coding reference. Along with the most current HCPCS codes and regulations included in the codebook, you'll have everything needed for accurate medical billing and maximum reimbursement. View 2020 Sample Pages Uses Organized for quick and accurate coding, HCPCS Level II 2021 Professional Edition codebook includes the most current Healthcare Common Procedure Coding System codes and regulations, which are essential references needed for accurate medical billing and maximum permissable reimbursement. This professional edition includes such features as Netter's Anatomy illustrations, dental codes and ASC (Ambulatory Surgical Center) payment and status indicators. Features Full-color Netter’s Anatomy illustrations — clarify complex anatomic information and how it affects coding. At-a-glance code listings and distinctive symbols — identify all new, revised, reinstated and deleted codes for 2021. The American Hospital Association Coding Clinic® for HCPCS citations — provides sources for information about specific codes and their usage. Convenient spiral binding — provides easy access in practice settings. Quantity feature — highlights units of service allowable per patient, per day, as listed in the Medically Unlikely Edits (MUEs) for enhanced accuracy on claims. Drug code annotations — identify brand-name drugs as well as drugs that appear on the National Drug Class (NDC) directory and other Food and Drug Administration (FDA) approved drugs. Color-coded — Table of Drugs makes it easier to find specific drug information. Durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) indicators — clearly identify supplies to report to durable medical third-party payers. Ambulatory Surgery Center (ASC) payment and status indicators — show which codes are payable in the Hospital Outpatient Prospective Payment System. American Dental Association (ADA) Current Dental Terminology code sets — offer access to all dental codes in one place. Jurisdiction symbols — show the appropriate contractor to be billed for suppliers submitting claims to Medicare contractors, Part B carriers and Medicare administrative contractors for DMEPOS services. Special coverage information — provides alerts when codes have specific coverage instructions, are not valid or covered by Medicare or may be paid at the carrier’s discretion. Age/Sex edits — identify codes for use only with patients of a specific age or sex.

This 2021 edition is guaranteed to arrive with the official 2020 guidelines bound in the codebook. Preferred choice for those taking certification exams. View 2020 Sample Pages Uses ICD-10-CM 2021: The Complete Official Codebook provides the entire updated code set for diagnostic coding, organized to make the challenge of accurate coding easier. This codebook is the cornerstone for establishing medical necessity, determining coverage and ensuring appropriate reimbursement. Each of the 21 chapters in the Tabular List of Diseases and Injuries is organized to provide quick and simple navigation to facilitate accurate coding. The book also contains supplementary appendixes including a coding tutorial, pharmacology listings, a list of valid three-character codes and additional information on Z-codes for long-term drug use and Z-codes that can only be used as a principal diagnosis. Features Full list of code changes — provides the complete list of new, revised, and deleted codes QPP symbol in the tabular section — identifies diagnosis codes associated with Quality Payment Program (QPP) measures under MARCA The addition of more than 100 coding tips — gives insight into coding for physician and outpatient settings The addition of more than 300 new definitions in the tabular listing — highlights key components of the disease process or injury Intuitive features and format — include full-color illustrations and visual alerts, including color-coding and symbols that identify coding notes and instructions, additional character requirements, codes associated with CMS hierarchical condition categories (HCC), Medicare Code Edits (MCEs), manifestation codes, other specified codes, and unspecified codes Placeholder X — alerts the coder to an important ICD-10-CM convention — the use of a “placeholder X” for three-, four- and five-character codes requiring a seventh character extension Coding guideline explanations and examples — provide additional insight into the guidelines at the beginning of each chapter in the tabular section Muscle/tendon translation table — helps determine muscle/tendon action (flexor, extensor, other), which is a component of codes for acquired conditions and injuries affecting the muscles and tendons Appendices — supplement with information on proper coding practices, risk adjustment coding, pharmacology, and Z codes

The 2021 ICD-10-CM Expert for Hospitals with Guidelines, with our hallmark features and format, makes facing the challenge of accurate diagnosis coding easier for acute care and longterm care hospitals (LTCH). This code book contains the complete ICD-10-CM code set, MCEs, and ICD-10 MS-DRG edits with symbols identifying codes for comorbidities/complications (CC) and major comorbidities/complications (MCC). Also identified are hospital acquired conditions (HAC) and CMS hierarchical condition categories (HCC). Delivery might be delayed beyond the October 1, 2020 effective date. Delivery is dependent on when the updated Official Guidelines for Coding and Reporting for 2021 are released from CMS. Key Features and Benefits • Optum360 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, HCCs, QPP, and unspecified codes. • Coding tips. Coding tips are reviewed and updated and assist in appropriate code selection. • Clinical definitions. Clinical definitions help provide an understanding of complex ICD-10-CM diagnostic terms. • List of code changes and conversion table. A list of all 2021 new, revised, and deleted codes to identify at a glance code changes, 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 • Guidelines with coding examples. Official Guidelines for Coding and Reporting including chapterspecific coding examples. • Detailed color anatomy illustration appendix. Many illustrations at the code level identifying specific code-related anatomy. • Downloadable files. CMS updates received after this ICD-10-CM Expert goes to print, including MCCs, CC Excludes PDx collection, and POA exempt codes. • Supplementary appendixes. Additional information provided for POA coding and reporting tutorial; code lists for CC, MCC, and other valuable appendixes.

The 2021 ICD-10-CM Expert for Physicians with Guidelines, with our hallmark features and format, makes facing the challenge of accurate diagnosis coding easier. Developed specifically to meet the needs of physicians, the Optum360 codebook contains the complete ICD-10-CM code set, which is the cornerstone for establishing medical necessity, determining coverage, and ensuring appropriate reimbursement. Symbols in the tabular section identify codes associated with CMS quality payment program (QPP) measures and CMS hierarchical condition categories (HCC) used in risk adjustment (RA) coding. Supplementary appendixes available only in the expert edition include: pharmacology listings, Z codes for long-term use of drugs and associated drug names, and Z codes used only as primary diagnosis. Delivery might be delayed beyond the September 1, 2020 effective date. Delivery is dependent on when the updated Official Guidelines for Coding and Reporting for 2021 are released from CMS. Key Features and Benefits • Optum360 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, HCCs, QPP, and unspecified codes. • Updated coding tips. Coding tips are reviewed and updated, and assist in appropriate code selection. • Clinical definitions. Clinical definitions have been added for a better understanding of complex ICD10-CM diagnostic terms. • List of code changes and conversion table. A list of all 2021 new, revised, and deleted codes to identify at a glance code changes for your specialty. 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. • Guidelines with coding examples. Official Guidelines for Coding and Reporting including chapterspecific coding examples. • Helpful illustrations. Detailed color anatomy illustration appendix. Plus many illustrations at the code level identifying specific code-related anatomy.

The ICD-10-CM Professional for Hospitals, with 2021 Guidelines, with our hallmark features and format, makes facing the challenge of accurate diagnosis coding easier for acute care and long-term care hospitals (LTCH). This code book contains the complete ICD-10-CM code set, MCEs, and ICD-10 MS-DRG edits with symbols identifying codes for comorbidities/complications (CC) and major comorbidities/complications (MCC). Also identified are hospital acquired conditions (HAC) and CMS hierarchical condition categories (HCC). Delivery might be delayed beyond the October 1, 2020 effective date. Delivery is dependent on when the updated Official Guidelines for Coding and Reporting for 2021 are released from CMS. Key Features and Benefits • Optum360 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, HCCs, QPP, and unspecified codes. • Updated — Coding tips. Coding tips are reviewed and updated and assist in appropriate code selection. • Clinical definitions. Clinical definitions have been added for a better understanding of complex ICD10-CM diagnostic terms. • List of code changes and conversion table. A list of all 2021 new, revised, and deleted codes to identify at a glance code changes for your specialty. 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.

The 2021 ICD-10-CM Professional for Physicians with Guidelines, with our hallmark features and format, makes facing the challenge of accurate diagnosis coding easier. Developed specifically to meet the needs of physicians, the Optum360 codebook contains the complete ICD-10-CM code set, which is the cornerstone for establishing medical necessity, determining coverage, and ensuring appropriate reimbursement. Symbols in the tabular section identify codes associated with CMS quality payment program (QPP) measures and CMS hierarchical condition categories (HCC) used in risk adjustment (RA) coding. Delivery might be delayed beyond the October 1, 2020 effective date. Delivery is dependent on when the updated Official Guidelines for Coding and Reporting for 2021 are released from CMS. Key Features and Benefits • Optum360 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, HCCs, QPP, and unspecified codes. • Updated coding tips. Coding tips are reviewed and updated, and assist in appropriate code selection. • Clinical definitions. Clinical definitions have been added for a better understanding of complex ICD10-CM diagnostic terms. • List of code changes and conversion table. A list of all 2021 new, revised, and deleted codes to identify at a glance code changes for your specialty. 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. • Guidelines with coding examples. Official Guidelines for Coding and Reporting including chapterspecific coding examples. • Helpful illustrations. Detailed color anatomy illustration appendix. Plus many illustrations at the code level identifying specific code-related anatomy.

ICD-10-PCS 2021: The Complete Official Codebook helps coders use the PCS portion of the ICD-10 code set. The code set is laid out in easy-to-understanding tables sorted by type of procedure. View 2020 Sample Pages Uses ICD-10-PCS 2021: The Complete Official Codebook contains the complete ICD-10-PCS code set and supplementary appendixes required for reporting inpatient procedures. This illustrated codebook presents the code set in 17 sections of tables arranged by general procedure type. Tables within the extensive Medical and Surgical section are additionally sectioned out by body system, indicated by color-coded page borders. ICD-10-PCS contains classifications for procedures, devices and technologies. Features Summary of changes — indicates how additions and deletions affect each section of ICD-10-PCS Complete 2021 ICD-10-PCS code set — The code set is organized in 17 sections. Each section contains a code table by which a code can be built through character selections that reflect the procedure performed. A character meanings table and citations to American Hospital Association’s Coding Clinic start each section. Official coding guidelines — instruct on appropriate use of the code set and its sections Full-color illustrations — provide a visual explanation of anatomy and procedural approach Approach illustrations show the access location, method, and instrumentation that determine the approach Body parts with indicators to applicable code characters (provided immediately after the character meaning tables in the Medical/Surgical sections) Visual alerts — identify male/female procedures and new/revised character values Detailed information on structure and conventions of ICD-10-PCS — explains the unique structure and the specific definitions and functions of each character while providing sample exercises (and answers) to practice your skills Color-coding and symbols for the Medicare Code Edits — for the most comprehensive coverage of ICD10 MS-DRG MCEs for procedures, including: Non-covered procedures Limited coverage procedures Combination only procedures Non-operating room procedures affecting MS-DRG assignment Non-operating room procedures NOT affecting MS-DRG assignment Hospital acquired condition (HAC)-related procedures Procedure combination tables — identify ICD-10-PCS code combination requirements needed to satisfy certain MS-DRG requirements Valuable resources to enhance productivity — include: Root operation definition table for medical/surgical section Root operation for medical/surgical section grouped by objective Operation/Type definition tables for other ICD-10-PCS sections Body part definitions and body part key for accurate identification of correct body part character Device key and device aggregation tables Approach definitions Substance key

The ICD-10-PCS Expert is our spiral bound version of ICD-10-PCS with snap tabs to allow faster referencing of procedural terms in the index and sections in the tabular. It contains the complete ICD-10-PCS code set and all of the supplementary appendixes required for reporting of inpatient procedures. In addition, you will find the familiar Optum360 coding and reimbursement alerts you have come to rely upon, including the Medicare Code Edits (MCE) and ICD-10 MS-DRG edits. Intuitively organized into 17 sections of code tables with supplementary definitions tables and device and body part keys, the Optum360 ICD-10-PCS codebook sets the standard for coding accuracy, which is the cornerstone of healthcare analytics and revenue cycle management. Key Features and Benefits • Optum360 Edge — Color-coding and symbols for Medicare Code Edits. Includes our hallmark color-coding and symbols identifying ICD-10 MS-DRG MCEs for non-covered procedures, limited coverage procedures, combination only procedures, non-operating room procedures affecting MSDRG assignment, non-operating room procedures NOT affecting MS-DRG assignment, and hospital acquired condition (HAC) related procedures. • Approach illustrations. The approach illustrations show components that determine the approach, including access location, method, and instrumentation. • Body part definitions included in root operation tables. All terms listed in the body part definition appendix are included in the root operation tables for the Medical/Surgical section eliminating the need to reference the appendixes when selecting the correct body part value. • Illustrations. Illustrations of body parts with body part values accompany the Character Meaning tables in the Medical/Surgical section.

The 26th edition of the AAP cornerstone coding publication has been completely updated to include all pediatric changes in CPT® and ICD-10-CM codes for 2021—complete with expert guidance on their application. The book's many pediatric clinical vignettes, examples, and tips provide the added guidance needed to ensure coding accuracy and payment.

The 26th edition of the AAP cornerstone coding publication has been completely updated to include all pediatric changes in CPT® and ICD-10-CM codes for 2021—complete with expert guidance on their application. The book's many pediatric clinical vignettes, examples, and tips provide the added guidance needed to ensure coding accuracy and payment.

This convenient card includes the most commonly reported 2021 CPT and ICD-10-CM codes. It can be used as a template to design an office superbill or as is. It is laminated for extra durability.

This convenient card includes the most commonly reported 2021 CPT and ICD-10-CM codes. It can be used as a template to design an office superbill or as is. It is laminated for extra durability.

The Coder's Handbook includes over 1,100 pages packed with information designed to save you time, help you code faster and more accurately, improve your reimbursement and reduce your audit liability.