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 year.

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. OR use their new ICD-10 Browser Tool

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

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

How to Document Split-Shared visits in 2022 from NAMAS (National Association for Medical Auditing Specialists)

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.

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

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 2022Coding resource for Selected cardiothoracic procedures

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

Vaccines/Toxoids and Immune Globulins – Commonly Administered Pediatric Vaccines – Excellent ICD-10 & CPT coded immunization chart effective 2022-2023. 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 current year.

Wyoming Worker’s Comp – Rules, Regulations and Fee Schedules to current year.