The 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 Optum360 codebook contains the complete ICD-10-CM code set which is the cornerstone for establishing medical necessity, determining coverage, and ensuring appropriate reimbursement. Now with a new symbol in the tabular for codes associated with CMS quality payment program (QPP) measures and a symbol to identify codes associated with 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.

ICD-10-CM 2020: 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. Official coding guidelines for 2020 are bound into this codebook. FEATURES AND BENEFITS - Full list of code changes. Quickly see the complete list of new, revised, and deleted codes affecting the FY 2020 codes. - QPP symbol in the tabular section. The symbol identifies diagnosis codes associated with Quality Payment Program (QPP) measures under MARCA. - The addition of more than 100 coding tips. Obtain insight into coding for physician and outpatient settings. - The addition of more than 300 new definitions in the tabular listing. Assign codes with confidence based on illustrations and definitions designed to highlight key components of the disease process or injury. - Intuitive features and format. This edition includes 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. This icon 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. Detailed explanations and examples related to application of the ICD-10-CM chapter guidelines are provided at the beginning of each chapter in the tabular section. - Muscle/tendon translation table. This table is used to 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 your coding knowledge with information on proper coding practices, risk adjustment coding, pharmacology, and Z codes.

The ICD-10-CM Professional 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 Optum360 codebook contains the complete ICD-10-CM code set which is the cornerstone for establishing medical necessity, determining coverage, and ensuring appropriate reimbursement. Now with a new symbol in the tabular for codes associated with CMS quality payment program (QPP) measures and a symbol to identify codes associated with CMS hierarchical condition categories (HCC) used in risk adjustment (RA) coding.

These guidelines have been approved by the four organizations that make up the Cooperating Parties for the ICD-10-CM: the American Hospital Association (AHA), the American Health Information Management Association (AHIMA), CMS, and NCHS. These guidelines are a set of rules that have been developed to accompany and complement the official conventions and instructions provided within the ICD-10-CM itself. The instructions and conventions of the classification take precedence over guidelines. These guidelines are based on the coding and sequencing instructions in the Tabular List and Alphabetic Index of ICD-10-CM, but provide additional instruction. Adherence to these guidelines when assigning ICD-10-CM diagnosis codes is required under the Health Insurance Portability and Accountability Act (HIPAA). The diagnosis codes (Tabular List and Alphabetic Index) have been adopted under HIPAA for all healthcare settings. A joint effort between the healthcare provider and the coder is essential to achieve complete and accurate documentation, code assignment, and reporting of diagnoses and procedures. These guidelines have been developed to assist both the healthcare provider and the coder in identifying those diagnoses that are to be reported. The importance of consistent, complete documentation in the medical record cannot be overemphasized. Without such documentation accurate coding cannot be achieved. The entire record should be reviewed to determine the specific reason for the encounter and the conditions treated.

ICD-10-CM 2019: The Complete Official Codebook provides the entire updated code set for diagnostic coding. This codebook is the cornerstone for establishing medical necessity, determining coverage and ensuring appropriate reimbursement.

The 2017 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, this code book is the cornerstone for establishing medical necessity, determining coverage, and ensuring appropriate reimbursement. Use the code book that contains the latest HIPAA mandated ICD-10-CM code set, official coding and reporting guidelines, plus the familiar Optum360 coding and reimbursement alerts you have come to rely upon.