ICD-10-CM Expert for Home Health and Hospice 2016

Pinned on October 3, 2015 at 1:08 am by Mary Barnhart

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ICD-10-CM Expert for Home Health and Hospice 2016

The 2016 ICD-10-CM Expert for Home Health and Hospice with our hallmark features and content is designed specifically to address the challenges faced by home health agencies with hospice services using the new ICD-10-CM coding and reimbursement system.

Use the code book that contains the HIPAA mandated ICD-10-CM code set, plus the familiar Optum360 coding and reimbursement alerts you have come to rely upon in your ICD-9-CM code books.

Set the standard for coding accuracy, the cornerstone of health care analytics and revenue cycle management, with the confidence only an Optum360 product can deliver.

Key Features and Benefits

New Optum360 Edge Appendixes added. Supplemental appendixes have been added that address home health and hospice reimbursement and coverage issues including:

Home Health Prospective Payment System

Clinical Dimension Case Mix Groups

Selection and Assignment of OASIS Diagnoses

Valid Diagnosis/Etiology Pairing List

Non-routine Supplies Case-Mix Adjustment Model, Variables, and Scores

Medicare Coverage of Home Health and Hospice Services

New Optum360 Edge Detailed Examples of ICD-10-CM Coding Conventions and Coding Guidelines that apply to Home Health and Hospice. The official ICD-10-CM coding conventions and guidelines lack detailed examples.

This supplementary appendix provides examples and scenarios that illustrate the application of conventions and coding guidelines to ensure correct code assignment.

Optum360 Edge Hallmark page design and features. Ease into the new classification system using intuitive visual alerts to highlight code groupings as well as the distinctions between code choices plus, added features that make finding specific sections easier.

Optum360 Edge Key Word. Green font is used to differentiate key words that appear in similar code descriptions in a given category.

Optum360 Edge Color-coding and symbols specific to the home health PPS edits. Quickly identify coding and reimbursement issues specific to home health for improved coding accuracy and work efficiency.

Optum Edge360 Hospice non-cancer diagnosis codes. Use the supplementary information in the appendixes to determine which conditions qualify a non-cancer patient for hospice care.

Optum360 Edge Placeholder X. A reference icon (designed and used exclusively by Optum360) alerts the coder to a new ICD-10-CM convention the use of a placeholder X.

Optum360 Edge Exclusive Following references in the indexes. The Following references help coders locate those alphanumeric codes that are out of sequence in the tabular.

Optum360 Edge Additional character required symbols. Know when an additional character is required for code specificity and validity to avoid invalid code submissions (provided in index and tabular section).

Optum360 Edge Highlighted coding instructional and informational notes. Recognize important code usage guidance for specific sections more easily with highlighted notes.

Optum360 Edge Unspecified and Other code alerts. Find official coding guidance that suggests home health agencies avoid using diagnoses that are unspecified or vague.

Notations for diagnoses that group to clinical dimension. Expedite identification of diagnoses that group a patient to expanded clinical dimensions case mix groups to ensure appropriate reimbursement.

Non-Routine Supply (NRS) diagnosis alert. Every condition that may qualify to receive non-routine supply reimbursement adjustment is identified.

Manifestation code alert. Properly use codes that represent manifestations of underlying disease by knowing when two codes are required and by knowing alerts to sequencing rules.

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