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.

Key Features and Benefits

• Optum Edge — Get online access to customizable audit worksheets. Protect your revenuecritical services and procedures.

• Conduct skilled internal audits. Ensure proper reimbursement.

• Differentiate between similar procedures. Compare and contrast seemingly similar, but different, procedures.

• Completely updated for 2023 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 how to assign codes appropriately.

• Correct modifier assignment. Modifier decision-making trees assist with assigning correct modifiers.

• Supports Best Practices.

The ICD-10-CM Fast Finders utilize our Optum Xpress Coding Matrix with ICD-10-CM codes presented by specialty and updated with the 2023 valid ICD-10-CM codes, in an easy-to-use table format that maximizes the number of codes contained in the fast finder and also simplifies code selection. These convenient and reliable coding tools provide complete and valid code selections at your fingertips. 

Use this coding tool to determine the most specific ICD-10-CM codes for your specialty – codes that accurately identify the patient condition and level of severity as well as support medical necessity.

• Optum Edge — Optum Xpress Coding Matrix (designed and used exclusively by Optum). Our easy-to-use, streamlined tables present valid code options for each condition.
• Optum Edge — Compact 6” x 9” accordion format. More codes, less space in our compact accordion format which provides 8–10 pages of specialty specific codes.
• Optum Edge — Alphabetically organized tables. Body systems and main diagnostic terms are organized alphabetically in tables that contain a comprehensive list of valid out to the 4th, 5th, 6th or 7th characters. 
• Complete and comprehensive coverage by specialty. The Fast Finders provide commonly used ICD-10-CM codes for each specialty as well a comprehensive list of valid codes within diagnostic categories for your specialty. 
• Valid codes. Updated with ICD-10-CM codes for 2023, code directly from the tables contained in the Optum Xpress Coding Matrix with confidence. 
• Coding Instructions. Code first, use additional code and other coding instructions are included in the tables to ensure correct sequencing of all relevant codes.
• Productivity tool. The logical look-up format makes finding the right code easier.

Convenient work flow coding tool. Rely on one at every workstation. 

The ICD-10-CM Fast Finders utilize our Optum Xpress Coding Matrix with ICD-10-CM codes presented by specialty and updated with the 2023 valid ICD-10-CM codes, in an easy-to-use table format that maximizes the number of codes contained in the fast finder and also simplifies code selection. These convenient and reliable coding tools provide complete and valid code selections at your fingertips. Use this coding tool to determine the most specific ICD-10-CM codes for your specialty – codes that accurately identify the patient condition and level of severity as well as support medical necessity.

Key Features and Benefits

• Optum Edge — Optum Xpress Coding Matrix (designed and used exclusively by Optum). Our easy-to-use, streamlined tables present valid code options for each condition.

• Optum Edge — Compact 6” x 9” accordion format. More codes, less space in our compact accordion format which provides 8–10 pages of specialty specific codes.

• Optum Edge — Alphabetically organized tables. Body systems and main diagnostic terms are organized alphabetically in tables that contain a comprehensive list of valid out to the 4th, 5th, 6th or 7th characters.

• Complete and comprehensive coverage by specialty. The Fast Finders provide commonly used ICD-10-CM codes for each specialty as well a comprehensive list of valid codes within diagnostic categories for your specialty.

• Valid codes. Updated with ICD-10-CM codes for 2023, code directly from the tables contained in the Optum Xpress Coding Matrix with confidence.

• Coding Instructions. Code first, use additional code and other coding instructions are included in the tables to ensure correct sequencing of all relevant codes.

• Productivity tool. The logical look-up format makes finding the right code easier.

• Convenient work flow coding tool. Rely on one at every workstation. 

Clinical documentation improvement (CDI) is not about how to code in ICD-10-CM or CPT®; CDI is knowing what to look for in medical records, as well as how to ask for clarification and get ongoing changes to the notes and comments provided by physicians. Important Note: The greater number of ICD-10-CM diagnostic codes means an even bigger need for detailed clinical documentation. Making the right code selection requires having adequate clinical detail and, under ICD-10-CM, clinician's documentation will more than ever translate into reimbursement gained or lost. Key

Features and Benefits

• Optum Edge —HCC and QPP icon alerts added at the code level to aid in coding.

• Optum Edge —A list of medications is noted for codes that are deemed applicable.

• Optum Edge —The “Clinician’s Checklist for ICD-10-CM.” Make copies of this handy trifold, pocketsize card for every clinician. Provides powerful documentation tips for the 5 most important chronic and acute conditions.

• Diagnoses and Procedures — Covers documentation for CPT®, HCPCS, and ICD-10-CM coding. Enhance your code selections with documentation requirements for all three coding systems.

• Physician Documentation Training. Show physicians what they need to document. Includes 21 detailed documentation checklists for the most common and complex medical conditions.

• Don’t teach your clinicians to code ICD-10-CM. Instead show them what you need for optimal code assignment.

• See key terms. Confirm accurate code selection for every chapter of ICD-10-CM.

• Know when ICD-10-CM differs dramatically from ICD-9-CM. Alerts and warnings in the text of this book call your attention to situations where ICD-10-CM coding protocols are different from ICD-9-CM and significantly affect code choices.

• Terminology Translator. This unique feature is now included at the code level.

• Streamline the query process. Show physicians which medical terms are essential to assigning codes in ICD-10-CM. Includes best practice query forms that get results without unduly influencing clinicians.

Commemorating its 175th anniversary, this new edition of the American Medical Association’s (AMA) Code of Medical Ethics (AMA Code) has undergone another comprehensive update. Much has changed in medicine and society since the AMA Code was created 175 years ago, and the AMA Code has changed as well. The Annotations, an important research and reference tool, in the AMA Code has been significantly updated to include more up-to-date and relevant cases, as well as the removal of outdated cases. To celebrate its 175th anniversary, this new edition of the AMA Code also includes artwork and poetry and literary excerpts—all selected to reflect our society and to highlight the importance of diversity and equity—to reflect the AMA’s mission to promote the art of medicine and its ethos of putting patients first. The only national code of ethics for all physicians, the AMA Code articulates the core values and ethical responsibilities of physicians who are charged with curing the sick when possible and comforting the dying. Hence, its wide recognition as the most authoritative guide for physicians who strive to practice ethically.

This modernized and updated edition of the AMA Code breathes new energy into this living document, while staying true to what it means to be a good physician. The AMA Code is grounded in the nine Principles of Medical Ethics, which are the standards of conduct that define the essentials of ethical behavior for physicians.

While the AMA Code provides essential guidance for professional conduct for physicians, it is also regularly cited as the medical profession’s authoritative voice in legal opinions, journal articles and media outlets. It is an indispensable resource that deserves to be in every physician office, medical library, hospital, and place where the public’s health is promoted.

FEATURES AND BENEFITS

• Updated and increased number of case annotations, offering synopsis of facts and legal issues. focusing on the court’s reference to the AMA Code’s Principle(s) or Opinion(s) and the role it played in their decisions.

• Intuitive topical chapter structure makes finding pertinent ethical guidance easy.

• A uniform format that improves the readability and application of specific guidance.

• Consolidation of previously disparate guidance on related topics that streamlines the AMA Code.

• Use of accepted definitions and consistent terminology that minimize misinterpretation of guidance.

• Inclusion of a new preface to clarify the different levels of ethical obligation in the offered guidance.

The Coders’ Desk Reference for ICD-10-CM Diagnoses provides thousands of clinical descriptions of diseases, disease processes, injuries, poisonings, and other conditions to help both novices and seasoned coders attain the knowledge and skill necessary to accurately identify and assign the most specific ICD-10-CM diagnosis code for each documented condition. With these clinical definitions and focus points, you can reduce coding errors and improve coding confidence by gaining a better understanding of the clinical meanings behind the codes.

Key Features and Benefits

• Optum Edge — More clinical descriptions and focus points. Expanded with clinical descriptions and focus points for new and changed 2023 codes as well as existing ICD-10-CM codes.

• Optum Edge — Illustrations at the code level. Often an illustration is needed to enhance understanding. Illustrations of pertinent anatomy and pathological changes related to the disease process are included as a visual aid.

• Optum Edge — Code level clinical description. Code level descriptions are provided for select diseases, injuries, symptoms, other factors influencing health status, and other reasons for contact with healthcare providers.

• Optum Edge — Clinical focus points. Improve overall coding accuracy with additional information for complex diagnoses and injuries that require an understanding of related codes and conditions that might better describe the documented condition.

• Alphanumeric organization by ICD-10-CM code. Locate codes quickly with a resource developed to work hand-in-hand with your Optum ICD-10-CM codebook.

• Enhance understanding of ICD-10-CM. Understanding the clinical condition captured by each code is essential to correct code assignment, and this resource is designed to explain and highlight differences between codes that may appear similar at first glance.

• Designed for both novices and seasoned coders. Coders of every skill level find that these clinical descriptions enhance understanding of ICD-10-CM.

The Coders’ Desk Reference for ICD-10-CM Diagnoses ebook provides thousands of clinical descriptions of diseases, disease processes, injuries, poisonings, and other conditions to help both novices and seasoned coders attain the knowledge and skill necessary to accurately identify and assign the most specific ICD-10-CM diagnosis code for each documented condition. With these clinical definitions and focus points, you can reduce coding errors and improve coding confidence by gaining a better understanding of the clinical meanings behind the codes.

Key Features and Benefits

• Optum Edge — More clinical descriptions and focus points. Expanded with clinical descriptions and focus points for new and changed 2023 codes as well as existing ICD-10-CM codes.

• Optum Edge — Illustrations at the code level. Often an illustration is needed to enhance understanding. Illustrations of pertinent anatomy and pathological changes related to the disease process are included as a visual aid.

• Optum Edge — Code level clinical description. Code level descriptions are provided for select diseases, injuries, symptoms, other factors influencing health status, and other reasons for contact with healthcare providers.

• Optum Edge — Clinical focus points. Improve overall coding accuracy with additional information for complex diagnoses and injuries that require an understanding of related codes and conditions that might better describe the documented condition.

• Alphanumeric organization by ICD-10-CM code. Locate codes quickly with a resource developed to work hand-in-hand with your Optum ICD-10-CM codebook.

• Enhance understanding of ICD-10-CM. Understanding the clinical condition captured by each code is essential to correct code assignment, and this resource is designed to explain and highlight differences between codes that may appear similar at first glance.

• Designed for both novices and seasoned coders. Coders of every skill level find that these clinical descriptions enhance understanding of ICD-10-CM.

Coders at all experience levels may have questions when the 2023 HCPCS code changes go into effect, and the Coders’ Desk Reference for HCPCS Level II is the book to keep close by to find the answers needed. With this one-of-a-kind, comprehensive resource on all the codes for 2023, users can reduce coding errors and improve coding confidence by referencing more than 3,000 HCPCS codes with 2,000 lay descriptions, find answers to frequently asked questions, and obtain other helpful guidance before assigning a code.

Key Features and Benefits

• Optum Edge — More than 3,000 HCPCS Level II codes and 2,000 lay descriptions. Gain a clear understanding of the clinical definitions for thousands of alphanumeric codes for supplies and services to improve coding accuracy.

• Modifier definitions and usage rules. Choose the appropriate modifiers and HCPCS Level II codes with a thorough list of modifiers, accompanied with narrative explanations of each.

• Coding and billing instructions. Reduce research time and improve coding accuracy with tips on the quickest methods to bill and code HCPCS Level II codes.

• Additional chapters for documentation, durable medical equipment (DME), fraud and abuse, compliance, and appeals. Prevent the risk of audits and fines by clearly understanding the regulatory requirements that affect HCPCS Level II coding.

The Coders’ Desk Reference for Procedures is a comprehensive resource for all 2023 CPT® codes. This all-inclusive tool helps identify the minute differences between, and components of, similar CPT® codes. You will code more accurately from operative reports and produce cleaner claims the first time by improving your understanding of the clinical meanings behind the codes and checking billing and coding information for Medicare.

Key Features and Benefits

• NEW — Place of service codes for E/M services. Review list of CMS-1500 place of service codes with grid of evaluation and management codes linked to the appropriate place of service

• Comprehensive CPT® code listing with CPT® procedure lay descriptions. Eliminate the need for multiple resources with a one-stop resource of more than 8,000 CPT® codes and 6,000 lay descriptions for surgery, laboratory/pathology, radiology, medicine, and evaluation and management codes.

• E/M guidelines. Review components of care needed to determine E/M levels of service, assisting in proper E/M code assignment.

• Modifier definitions and usage rules. Reduce research time and improve coding accuracy with a complete modifier list, accompanied by narrative explanations to ensure proper use of modifiers.

• Procedure eponym crosswalk. Locate eponym definitions and code links in an alphabetically organized section.

• Reimbursement and procedure glossary of terms. Understand terminology often used in medical record documentation and terms used in communications with payers.

• Abbreviations, acronyms, symbols, prefixes, and suffixes. Better understand terms and use these valuable tools for more efficient CPT® coding.

• Anatomical illustrations. Recognize the body sites described in operative reports with helpful illustrations.

The Coders’ Desk Reference for ICD-10-PCS Procedures addresses the challenge of translating common procedural nomenclature used by providers to the corresponding ICD-10-PCS coding terminology. Correct procedure coding is dependent on the ability of the coder to translate the terminology in provider documentation to the appropriate procedural terminology of ICD-10- PCS. This resource is organized by common procedural nomenclature used in the hospital setting and then linked to the related root operation table(s); the procedure is described in layman’s terms, translated to ICD-10-PCS root operation terminology, and the corresponding root operation table(s) is identified.

Key Features and Benefits

• Optum Edge — Lay description. Updated with the 2023 ICD-10-PCS codes, lay descriptions are provided for the ICD-10-PCS procedures commonly performed inpatient procedures. Corresponding ICD-10-PCS root operations are identified and defined.

• Optum Edge — Clinical focus points. When more than one root operation may apply, key procedural terms differentiating the root operations are highlighted in focus points to ensure that the correct root operation is selected.

• Optum Edge — Illustrations at the code level. Illustrations of pertinent anatomy and surgical procedures are included to enhance understanding.

• Ease of use. Developed to work hand-in-hand with your Optum ICD-10-PCS codebook.

• Enhance understanding of ICD-10-PCS. The lay descriptions were developed to enhance understanding of the ICD-10-PCS terminology and definitions of root operations, body parts, approaches, devices, and qualifiers.

• Designed for novices and seasoned coders. The lay descriptions, illustrations, and other supplemental resources contained in this resource are designed for coders of all skill levels.

Consolidate the coding process with the Coding Companion, your one-stop coding resource developed exclusively for ENT, allergy and pulmonology. This comprehensive and easy-touse guide is updated for 2023 and organized by specialty-specific CPT® codes. Each CPT® code includes its official description and lay description, coding tip, Medicare edits, and relative value units and is cross-coded to common ICD-10-CM diagnosis codes to complete the coding process. Getting to the code information you need has never been so easy.

Key Features and Benefits

• NEW – Evaluation and Management (E/M) Services Guidelines – E/M codes are used every day in your practice. Now with CPT® E/M Guidelines and our Optum Coding Tips, you have all the information you need to select the correct E/M code for the service provided.

• Quickly find information. All the information you need is provided with the CPT® code, including illustrations, lay descriptions, coding tips, clinical terms, Medicare RVUs and IOM references, and commonly associated ICD-10-CM diagnosis codes.

• Procedure code icons – Quickly identify new, revised, add-on, and telemedicine procedure codes, making your coding process for procedures and E/M services quick and efficient.

• ICD-10-CM code icons – Icons identifying male and female only codes, as well as age-related and laterality diagnosis codes.

• Easily determine fees for your practice and reinforce consistency in the charges. Relative value units including the practice, work, and malpractice components with the total RVUs for nonfacility and facility are included.

• CPT® Assistant references. Identifies that an article or discussion of the CPT® code has been in the American Medical Association’s CPT® Assistant newsletter. Use the citation to locate the correct volume.

• Avoid claim denials and/or audits. Medicare payer information includes references to Internet Only Manual (IOM) guidelines, follow-up days, and assistant-at-surgery.

• CCI edits by CPT® and HCPCS procedure code. CPT® and HCPCS procedure codes with their associated CCI edits are provided in a special section. Quarterly updates are available online at Optumcoding.com Product Update / Support page.

Consolidate the coding process with the Coding Companion, your one-stop coding resource developed exclusively for family practice and pediatrics. This comprehensive and easy-to-use guide is updated for 2023 and organized by specialty-specific CPT® codes. Each CPT® code includes its official description and lay description, coding tip, Medicare edits, and relative value units and is cross-coded to common ICD-10-CM diagnosis codes to complete the coding process. Getting to the code information you need has never been so easy.

Key Features and Benefits

• Evaluation and Management (E/M) Services Guidelines – E/M codes are used every day in your practice. Now with CPT® E/M Guidelines and our Optum Coding Tips, you have all the information you need to select the correct E/M code for the service provided.

• Quickly find information. All the information you need is provided with the CPT® code, including illustrations, lay descriptions, coding tips, clinical terms, Medicare RVUs and IOM references, and commonly associated ICD-10-CM diagnosis codes.

• Procedure code icons – Quickly identify new, revised, add-on, and telemedicine procedure codes, making your coding process for procedures and E/M services quick and efficient.

• ICD-10-CM code icons – Icons identifying male and female only codes, as well as age-related and laterality diagnosis codes.

• Easily determine fees for your practice and reinforce consistency in the charges. Relative value units including the practice, work, and malpractice components with the total RVUs for nonfacility and facility are included.

• CPT® Assistant references. Identifies that an article or discussion of the CPT® code has been in the American Medical Association’s CPT Assistant newsletter. Use the citation to locate the correct volume.

• Avoid claim denials and/or audits. Medicare payer information includes references to Internet Only Manual (IOM) guidelines, follow-up days, and assistant-at-surgery.

• CCI edits by CPT® and HCPCS procedure code. CPT® and HCPCS procedure codes with their associated CCI edits are provided in a special section. Quarterly updates are available online at OptumCoding.com Product Update page.

Consolidate the coding process with the Coding Companion, your one-stop coding resource developed exclusively for cardiology, cardiothoracic and vascular surgery specialties. This comprehensive and easy-to-use guide is updated for 2023 and organized by specialty-specific CPT® codes. Each CPT® code includes its official description and lay description, coding tip, Medicare edits and relative value units and is cross-coded to common ICD-10-CM diagnosis codes to complete the coding process. Getting to the code information you need has never been so easy.

Key Features and Benefits

• NEW – Evaluation and Management (E/M) Services Guidelines – E/M codes are used every day in your practice. Now with CPT® E/M Guidelines and our Optum Coding Tips, you have all the information you need to select the correct E/M code for the service provided.

• Quickly find information. All the information you need is provided with the CPT® code, including illustrations, lay descriptions, coding tips, clinical terms, Medicare RVUs and IOM references, and commonly associated ICD-10-CM diagnosis codes.

• Procedure code icons – Quickly identify new, revised, add-on, and telemedicine procedure codes, making your coding process for procedures and E/M services quick and efficient.

• ICD-10-CM code icons – Icons identifying male and female only codes, as well as age-related and laterality diagnosis codes.

• Easily determine fees for your practice and reinforce consistency in the charges. Relative value units including the practice, work, and malpractice components with the total RVUs for non-facility and facility are included.

• CPT® Assistant references. Identifies that an article or discussion of the CPT® code has been in the American Medical Association’s CPT® Assistant newsletter. Use the citation to locate the correct volume.

• Avoid claim denials and/or audits. Medicare payer information includes references to Internet Only Manual (IOM) guidelines, follow-up days, and assistant-at-surgery. CCI edits by CPT® and HCPCS procedure code. CPT® and HCPCS procedure codes with their associated CCI edits are provided in a special section. Quarterly updates are available online at Optumcoding.com Product Update / Support page.

Consolidate the coding process with the Coding Companion, your one-stop coding resource developed exclusively for emergency medicine, urgent care, critical care, and infectious disease. This comprehensive and easy-to-use guide is updated for 2023 and organized by specialty-specific CPT® codes. Each CPT® code includes its official description and lay description, coding tip, Medicare edits, and relative value units and is cross-coded to common ICD-10-CM diagnosis codes to complete the coding process. Getting to the code information you need has never been so easy.

Key Features and Benefits

• Evaluation and Management (E/M) Services Guidelines – E/M codes are used every day in your practice. Now with CPT® E/M Guidelines and our Optum Coding Tips, you have all the information you need to select the correct E/M code for the service provided.

• Quickly find information. All the information you need is provided with the CPT® code, including illustrations, lay descriptions, coding tips, clinical terms, Medicare RVUs and IOM references, and commonly associated ICD-10-CM diagnosis codes.

• Procedure code icons – Quickly identify new, revised, add-on, and telemedicine procedure codes, making your coding process for procedures and E/M services quick and efficient.

• ICD-10-CM code icons – Icons identifying male and female only codes, as well as age-related and laterality diagnosis codes.

• Easily determine fees for your practice and reinforce consistency in the charges. Relative value units including the practice, work, and malpractice components with the total RVUs for nonfacility and facility are included.

• CPT® Assistant references. Identifies that an article or discussion of the CPT® code has been in the American Medical Association’s CPT Assistant newsletter. Use the citation to locate the correct volume.

• Avoid claim denials and/or audits. Medicare payer information includes references to Internet Only Manual (IOM) guidelines, follow-up days, and assistant-at-surgery.

• CCI edits by CPT® and HCPCS procedure code. CPT® and HCPCS procedure codes with their associated CCI edits are provided in a special section. Quarterly updates are available online at OptumCoding.com Product Update page.

Consolidate the coding process with the Coding Companion, your one-stop coding resource developed exclusively for neurosurgery and neurology. This comprehensive and easy-to-use guide is updated for 2023 and organized by specialty-specific CPT® codes. Each CPT® code includes its official description and lay description, coding tip, Medicare edits, and relative value units and is cross-coded to common ICD-10-CM diagnosis codes to complete the coding process. Getting to the code information you need has never been so easy.

Key Features and Benefits

• NEW – Evaluation and Management (E/M) Services Guidelines – E/M codes are used every day in your practice. Now with CPT® E/M Guidelines and our Optum Coding Tips, you have all the information you need to select the correct E/M code for the service provided.

• Quickly find information. All the information you need is provided with the CPT® code, including illustrations, lay descriptions, coding tips, clinical terms, Medicare RVUs and IOM references, and commonly associated ICD-10-CM diagnosis codes.

• Procedure code icons – Quickly identify new, revised, add-on, and telemedicine procedure codes, making your coding process for procedures and E/M services quick and efficient.

• ICD-10-CM code icons – Icons identifying male and female only codes, as well as age-related and laterality diagnosis codes.

• Easily determine fees for your practice and reinforce consistency in the charges. Relative value units including the practice, work, and malpractice components with the total RVUs for nonfacility and facility are included.

• CPT® Assistant references. Identifies that an article or discussion of the CPT® code has been in the American Medical Association’s CPT® Assistant newsletter. Use the citation to locate the correct volume.

• Avoid claim denials and/or audits. Medicare payer information includes references to Internet Only Manual (IOM) guidelines, follow-up days, and assistant-at-surgery.

• CCI edits by CPT® and HCPCS procedure code. CPT® and HCPCS procedure codes with their associated CCI edits are provided in a special section. Quarterly updates are available online at Optumcoding.com Product Update / Support page.