Wiki Your favorite underrated coding tools

[jkyles]

I have two that I think are vital but frequently overlooked:
1. National Correct Coding Initiative - including the edit sets and the manual.
2. Appendix A of the CPT manual. It contains the full descriptors for CPT modifiers.

 

[csperoni]

I would add to that list excludes1 diagnoses. I've been doing this a long time, and 10 years ago, I never heard of an insurance denying a claim because of the diagnosis combination. Yes, if the diagnosis did not justify the procedure you'd see a denial. But these days, I think excludes1 diagnoses denials are our number 1. It doesn't help that my healthcare organization currently uses several piecemeal computer systems and excludes1 diagnoses do not hit edits in pre-bill.

 

[amyjph]

I remember the time years ago when I finally had the lightbulb moment about the NCCI manual and edits! Thankfully, it was an experienced coder/manager that helped me understand.

I would say, going back to the basics is underrated. Like, read the guidelines! The answers are in there.

 

[cgaston]

https://www.cms.gov/medicare/physician-fee-schedule/search

I use this daily! You can quickly check RVUs, global periods, whether multiple surgeons, co-surgeons or assistant surgeons are allowed on any code. You can even check list of codes or a range of codes if you want. You can also check pricing for your specific region too.