All healthcare providers code and bill with the International Classification of Diseases, Clinical Modification (ICD-9-CM) Volume 1 diagnosis codes, published by the National Center for Health Statistics and the Centers for Medicare and Medicaid Services. Healthcare facilities including hospitals, nursing homes, and rehabilitation centers also use the Volume 3 procedure codes.

Finding the ICD-9-CM codes in SpeedECoder™ is easy; you have several ways to find them. You can search specific codes with SpeedESearch™ or browse through the code book's chapters and sections.

The ICD-9-CM Code Detail pages are annotated with the following information and claims edits so that you can be sure you are coding and billing correctly:

Both Diagnosis and Procedure Codes

• Code First, Code Additional, Includes and Excludes information
• Age and gender edits

Diagnosis Codes

• Manifestation as principal diagnosis
• Questionable admission
• Unacceptable principal diagnosis
• Secondary diagnosis required
• Not applicable principal diagnosis
• V code 1st listed, 1st or additional, additional only, and non-specific edits
• Index entries so that you can compare related entries from the Volume 2 index

Procedures

• Non-specific OR procedure
• Open biopsy check
• Non-covered procedure
• Bilateral procedure

SpeedECoder also contains downloadable SpeedEBooks™. These searchable and printable manuals are PDF documents that you can load on laptops or handhelds for offline use.

The Common Procedural Terminology (CPT) published by the American Medical Association (AMA) and Healthcare Procedural Coding System (HCPCS) codes published by the Centers for Medicare and Medicaid Services (CMS) are required to bill physician services, labs, and durable medical equipment. Several other categories of services comprise the HCPCS codes including ambulance, dental, temporary Medicare services, and some mental health care.

Procedure codes are searchable by keyword and code number, and the Detail Display pages contain the following specific information if applicable to the code:

• Gender edits
• Correct Coding Initiative (CCI) current bundling/unbundling rules
• Medicare fee schedule pricing for each service paid by Medicare and customized to your Medicare locality. This information helps you understand your reimbursement and can determine co-pay information for your Medicare beneficiaries.
• Links to the full text of applicable local coverage decisions (LCDs) that contain the medical necessity rules published by your local Medicare Administrative Contractor. With these policies you can determine whether a patient has a diagnosis code that substantiates payment for a particular covered procedure, and if there are any special coding or billing requirements.
• For Medicare fees and policies, each coder has the option of changing the contractor at any time to comply with rules that apply in one practice area but not another or just to compare policies or pricing between contractors.

Available to all SpeedECoder coders is a downloadable HCPCS SpeedEBook that contains all of the codes and descriptions that you can use offline, on your handheld, or even to print out.

CodeWords both speed coding and improves consistency. A CodeWord is a term or phrase that you map to a single code. This means if you search the term or phrase, the code you assigned to the CodeWord will always be the first search result.

For example, if a physician always writes NIDDM for controlled Type II, adult, non-insulin dependent diabetes, you can create a CodeWord that links that particular abbreviation directly to code 250.01, or whatever code you believe accurately reflects that abbreviation.

When you or coders in your multi-user group search NIDDM in the future, code 250.01 will appear first in the search results even though NIDDM does not appear in the any of code descriptions for 250.01.

CodeSwaps™ provide you with a powerful way to identify medical abbreviations and specify ways to expand your searches.

There are thousands of medical abbreviations that are used that do not have direct correlations in the coding manuals. For example, CHF, the common abbreviation for congestive heart failure, does not exist the text of the standard ICD-9-CM manual.

SpeedECoder identifies abbreviations and asks you if you want to substitute the full name of the disease instead of the abbreviation in your search. Besides using the built-in system library of thousands of medical abbreviations, you can also create your own CodeSwaps and share them with other coders in your multi-user group.

In the Browse Code Books section, users can page through the coding books as if they were looking at the regular text. The quick drill down navigation can provide you with the correct code in just a few clicks.

Each individual code is then link to a detail screen and the detail screen links back to the full coding text. This helps coders identify the proper diagnostic and procedural data they need to include to properly code a condition or service.

Sometimes you may not be around a computer and need another way to do coding. SpeedECoder contains a library of Provistas SpeedEBooks to help you get coding information whenever you need it.

SpeedEBooks are searchable, printable PDF documents. Desktop and handheld computers alike can read these files providing a great way to access coding information when you do not have access to the Internet or want a paper copy.

Available as SpeedEBooks are the ICD-9-CM Volumes 1 and 3, HCPCS, and CCI edits.

The bread and butter of any primary care practice are Evaluation and Management (E&M) services, coded with CPT codes that start with 99. These codes are consistently a component of the Centers for Medicare and Medicaid Services Office of the Inspector General (OIG) annual compliance plan. Both undercoding and overcoding are frowned on and with the guidelines for coding E&M codes comprising hundreds of pages, it can be difficult to be sure that the level assigned to a visit is correct.

The E&M Wizard allows you to enter information about a clinical encounter: the components of history, the parts of the physical, and the intensity of the medical decision making to determine the final E&M code. Based on the 1997 guidelines, this tool can help you feel confident you are not over- or under-coding any patient visit in any practice setting.

CodeLists speed coding by making your most commonly chosen codes available in one place.

When you identify a useful code, you can add the code to your personal CodeList with one click.

You can share your list with other users in your practice group to quickly create a customized group CodeList that speeds code selection.

CodeNotes help you and your practice record and share critical coding information in the course of your work.

For example, CodeNotes can be created to clarify payer-specific rules for a given procedure.

A core element of SpeedECoder's power is its ability to share user customizations.

You have the ability to allow other users to view their CodeNotes, CodeList, CodeSwaps, and CodeWords.

In addition, you can specify that others may make changes to these customizations.

The Medicare ESearch is an integrated search tool that searches the IOMs, National Coverage Decisions (NCDs), and Local Coverage Decisions (LCDs) simultaneously, providing comprehensive coverage information about a particular procedure or type of procedure.

Based on statutes, regulations, guidelines, models, and directives, the Internet-only Manuals (IOMs) are an official copy of Medicare program issuances, day-to-day operating instructions, policies, and procedures. These manuals can be of great value to understanding the rules and claims adjudication process of the Medicare program.

Long a part of Medicare's automated cost savings approach to claims adjudication, the National Correct Coding Initiative is comprised of thousands of procedure code combinations that cannot be billed together due to 1) one of the codes being considered a component of the other code or 2) one code is a separate, mutually exclusive approach from the other code.

In the Code Detail display, CCI edits are shown with every accompanying procedure code. In some cases, an edit can be bypassed using an appropriate applicable modifier. Code pairs for which this is possible are highlighted in green. In addition, each code in the CCI list is linked to its Code Detail page so that you can compare and contrast the codes, which may point you to the correct procedure code.

The CCI edits are updated on a quarterly calendar basis within SpeedECoder so there is no need to update paper manuals or any other source. If you do need CCI edits on the go, SpeedECoder contains a downloadable SpeedEBook™, a searchable, printable PDF document, that contains all the edit details.

In your account, you enter the Medicare locality for your practice, and SpeedECoder calculates the actual payment that you will receive from Medicare. For laboratory tests and durable medical equipment, the appropriate fees for your locality are displayed. The Medicare Physician Fee Schedule (MPFS), which contains the CPT and HCPCS codes that physicians can bill to the Medicare program through Part B, contains additional billing informationin addition to the fee.

For procedures paid by the MPFS, the Code Detail display shows a host of information. The fees from Medicare can differ when the procedure is performed in a establishment that the treating physician owns or at another third-party owned facility. Both fees are reported in the Code Details page for the procedure along with the -26 (professional component) and -TC (technical component) modifiers.

In addition to the fees, SpeedECoder displays the relative value units (RVUs) that underlie the fee calculations and the flags that determine the final billing rules for the code. The first flag is the status code that indicates whether the code is in the fee schedule and whether it is separately payable if the service is covered. The next flag is describes whether a code can be broken down in the professional and technical components as described above. The next flag describes whether there are discounts on multiple procedures performed at the same time.

When a code is surgical, the Global Surgery Period, pre-, intra-, and post-op percentages, and bilateral, co-surgeon, assistant, and team modifiers if applicable, are displayed. If the procedure is an endoscopy, the endoscopic base code is included since endoscopies are considered related if they have the same endoscopic base code.

With the SpeedECoder API, software developers can access the content of the SpeedECoder databases and present search results within their own online applications.

Any of the components of the database can be accessed so developers can pick and choose which content they want.

Provistas can tailor the features and content of SpeedECoder to fit any enterprise or educational facility's needs. The sky's the limit, and it only takes imagination, coordination, and a clear development plan.

We can incorporate proprietary databases, security features, or new functionality at reasonable prices since the SpeedECoder platform is already modular and customizable. Contact us for a quote.

By customizing SpeedECoder's colors, fonts, backgrounds, images, and borders, Enterprise and Education clients can rebrand SpeedECoder as their own application.

The rebranded portal, accessible a special URL such as portal.speedecoder.com, keeps students', teachers', and staffs' experience seamless between printed materials and the online application or between online applications.

AHA Coding Clinic for ICD-9-CM

Aimed at hospitals, physician offices, ambulatory and other health care settings, the AHA Coding Clinic for ICD-9-CM is the only official publication for ICD-9-CM coding guidelines and advice as designated by the four Cooperating Parties (AHA, AHIMA, CMS, NCHS) and the Editorial Advisory Board.

An essential component of your coding education and compliance program, the content includes selected questions of greatest interest to the coding community and guidelines developed and approved by the Editorial Advisory Board.

AHA Coding Clinic for HCPCS

Expert coding advice from the American Hospital Association! AHA Coding Clinic for HCPCS is the newest coding resource developed by the Central Office on ICD-9-CM, publishers of AHA Coding Clinic for ICD-9-CM. Make AHA Coding Clinic for HCPCS a part of your education and compliance program. Contains actual examples drawn from our HCPCS coding advice service, correct code assignments for new technologies, articles and topics that offer practical information to improve data quality and a bulletin of coding changes and/or corrections to health care providers.

CPT Assistant newsletters from the American Medical Association provide critical coding information and commentaries that provide insight and clear up confusing coding issues. Use CPT® Assistant's accurate, reliable tips and interpretations to appeal insurance denials, validate coding to auditors, train their staff and answer day-to-day coding questions.

Thanks to HIPAA, all providers need access to accurate NPI information to bill referrals electronically. The NPI Search tool allows you to search by NPI number, legacy UPIN, provider name, specialty, and practice location. Both individual providers as well as organizations are searchable.