General Coding & Reimbursement Tools

Contents on these pages can be viewed by hovering over the links with your mouse. These links should be valid as of 1/25/2019. Please let us know if any don't work. Thanks for visiting!

Center for Disease Control (CDC)
ICD-9 - From Center for Disease Control (CDC). Download the Official ICD-9-CM Coding Guidelines and the entire ICD-9-CM Manual from 1996 to 2011, the very last yer.

ICD-10-CM - From Center for Disease Control (CDC). Download the Official ICD-10-CM Coding Guidelines and the entire ICD-10-CM Manual from 2010 to current year.

Medicare Part B Services

Calculators & Tools - From NGS Medicare, for Timely Filing, Appeals, Podiatry, Enrollment, G0179 Frequency, and more.

CPT 99310 - Evaluation and Management Documentation information regarding CPT code 99310, Subsequent Nursing Facility Care from CGS Medicare

Drug Screen Testing - Revised in April, 2016 - Drug Testing CPT codes

Incident To/Shared/Split Billing (Q&As) - FAQs from First Coast Options (FL) Medicare.

Medicare billing certificate programs - The programs are designed to provide education on Part A and Part B of the Medicare program. They each include required web-based training courses, readings, and a list of helpful resources. Upon successful completion of each of the programs, you will receive a certificate in Medicare billing from CMS

Medicare Preventive Services CY - in an interactive chart format, per subject, with ICD-10-CM and CPT codes and pertinent documentation and utilization information.

NCCI procedure to procedure (PTP) Edits Current Year from CMS, links at the bottom for Hospitals and Practitioners.

NCCI "How To" - Excellent guide on "How to Use the Medicare National Correct Coding Initiative (NCCI) Tools" from Medicare Learning Network.

NCCI Policy Manual for Medicare Services - Scroll to the bottom to find the current year & some past years of the NCCI Policy Manual. This is a zipped file covering every chapter of the CPT book and tells the CCI bundling logic & how to code many procedures. Start with "TOC" = Table of Contents. A MUST READ for anyone using CPT codes

LAB NCDs to current year from CMS.

Novitas Drug Screening Codes - Urine Drug Screening Requirements, Documentation and Coding information

Other Coding Links

AHA Coding Clinic- Webinar Schedule.

American Chiropractic Association- Clinical Documentation Guidelines

American College of Emergency Physicians (ACEP)- Coding and Reimbursement Pearls

ACEP: Templated Letters for Appealing Denied Claims - Great Samples!

American Congress of Obstetricians and Gynecologists (ACOG) - OBGyn Coding and Billing tips

American College of Radiology (ACR)- Practice Parameters for Documentation and Reporting

DCFirst.com- Chiropractic Clinic & Exam Forms in Word and PDF formats.

HCC Calculator- From HCC University by SCAN Health Plan

HCC Crosswalk- International Classification of Diseases to Hierarchical Condition Category (HCC)Crosswalk from 2004 to current year.

Lab Tests & Information -Searchable Test Menu. This service provides general reference information for many of the tests offered by Sonora Quest Laboratories, including:

  • CPT Codes
  • General specimen requirements for specific methodologies
  • Specimen transport considerations
  • Methodology information

Medtronic- 2018 Peripheral Vascular Diagnostic & Intervention CodingSheet

NCCI Edits Lookup Tool - From First Coast Options - THANK YOU!

NCQA- HEDIS Measures and Technical Resources

Physicians Advocacy Institute (PAI) has collaborated with the American College of Emergency Physicians (ACEP) to develop a Toolkit for Physicians Facing Medical Audits.

VACCINES

Medicare Part B Immunization Coding and Billing - 2018 Billing and Coding Guide for Seasonal Influenza Virus, Pneumococcal, and Hepatitis B vaccines.

Vaccines/Toxoids and Immune Globulins - Commonly Administered Pediatric Vaccines - Excellent ICD-9 & CPT coded immunization chart effective 11/1/2018. HIGHLY RECOMMENDED if you do any coding for vaccines/immunizations.

Worker's Comp

California Worker's Comp - Fee schedules from 2005 through current year for various specialties:

  • Ambulance, Ambulance fees
  • Durable medical equipment, prosthetics, orthotics and supplies
  • Inpatient hospital
  • Medical-legal
  • Outpatient hospital
  • Pathology and clinical laboratory
  • Pharmaceuticals
  • Physician services

 

Illinois Worker's Comp - Medical Coding and Medical Billing Resources and links to the Fee Schedule lookup tool and Regions information.

Rhode Island Worker's Comp - Medical & Hospital Fee schedules from 2004 to present day.

Wyoming Worker's Comp - Rules, Regulations and Fee Schedules