The 2021 ICD-10-CM Expert for Physicians with Guidelines, with our hallmark features and format, makes facing the challenge of accurate diagnosis coding easier. Developed specifically to meet the needs of physicians, the Optum360 codebook contains the complete ICD-10-CM code set, which is the cornerstone for establishing medical necessity, determining coverage, and ensuring appropriate reimbursement. Symbols in the tabular section identify codes associated with CMS quality payment program (QPP) measures and CMS hierarchical condition categories (HCC) used in risk adjustment (RA) coding. Supplementary appendixes available only in the expert edition include: pharmacology listings, Z codes for long-term use of drugs and associated drug names, and Z codes used only as primary diagnosis.
Delivery might be delayed beyond the September 1, 2020 effective date. Delivery is dependent on when the updated Official Guidelines for Coding and Reporting for 2021 are released from CMS.
Key Features and Benefits
• Optum360 Edge — Intuitive features and format. Visual alerts, including color-coding and symbols that identify coding notes and instructions, additional character requirements, placeholder X, Medicare Code Edits (MCE), manifestation codes, HCCs, QPP, and unspecified codes.
• Updated coding tips. Coding tips are reviewed and updated, and assist in appropriate code selection.
• Clinical definitions. Clinical definitions have been added for a better understanding of complex ICD10-CM diagnostic terms.
• List of code changes and conversion table. A list of all 2021 new, revised, and deleted codes to identify at a glance code changes for your specialty. Plus an ICD-10-CM conversion table from the new and changed codes to the code previously used.
• Updated index with shaded guides. The updated Index to Diseases and Injuries includes vertical shaded guides that show the indent levels for subentries under main terms.
• Guidelines with coding examples. Official Guidelines for Coding and Reporting including chapterspecific coding examples.
• Helpful illustrations. Detailed color anatomy illustration appendix. Plus many illustrations at the code level identifying specific code-related anatomy