In today's podcast, I'm going to be
playing a tutorial that's available on
the Optum website regarding the Encoder
Pro application.The Encoder is used in
all the hospitals and the larger
practices to assist the coder in working with
the codes. I'm unable to show you a
a version where you can physically go in and do something.
If you are able to do the coding practicum ,which is available
through HIT289 University Hospital offers
a coding practicum, but they only take
five students but if you're able to do
that for your final Practicum in 289, I
suggest you do it because it allows you
to see not only the Encoder but also the
CAC or the Computer-Assisted Coding
application. They work together to speed
up the coding process because if you can
imagine when you're coding a very large
chart with multiple procedures and many
diagnoses, it could take a coder manually
quite a bit of time. By using these applications,
you're able to speed up that process
somewhat and the coder becomes more of an
editor to make sure that the
applications are capturing all the codes
that need to be captured.
So I am going to play this video and hopefully
this will work and I will be stopping
it to talk about things as we go through
it. Encoder Pro from Optum is
the industry frontrunner in coding
information and compliance. This online
application service includes everything
you need to streamline coding including
ICD-9-CM and ICD-10-CM and PCS, CPT and
HCPCS Level II code set searches, Medicare
policy information, the Medicare
Physician Fee Schedule and a full
library of Optum publications.
With the power of EncoderPro.com,
you'll accurately research coding and
compliance rules, easily find elusive
codes and quickly access supportive
documentation.
Additionally, EncoderPro.com tools
now allow you to efficiently review
claims for coding errors and make
necessary changes to streamline the
claim submission process. To learn more,
please select a topic from the menu. If
you are working in a doctor's office, for
example, you might use this product to
not only code the patient's chart, but
also in the billing process. In a hospital,
it's going to be separated and the coder
will not be doing that billing part or
(using) any of the tools that are associated
with claims but will be doing only the coding.
So we are going to, one by one, play each of these
modules, hear what they have to say and
in that way, you will have a better idea
of what applications you might see in
the workplace. EncoderPro.com is a
highly functional internet browser-based
solution that puts all the coding tools
you need right at your fingertips. For
easy navigation throughout the
application use the convenient single
click buttons to access code compliance
editing capabilities. Add user notes to
any code that can be viewed by a single
user or across your entire organization.
Create custom lists of your commonly
used codes, read online health and more
or take advantage of the Quick Links to
codebook indexes that mimic the books
and other coding resources that take you
straight to the features designed
specifically for fast and accurate code
research and review. Every aspect of
EncoderPro.com is designed to drive you
to the appropriate code, keep you updated
on code revisions and alert you to
upcoming application changes. Users that
are accustomed to the book formats of
traditional codebooks will appreciate
how the Encoder Pro menus are arranged
in sections identical to the books.
Here's how the code lookups work.
EncoderPro.com lets you search up to
four lay terms,
abbreviations, acronyms and even
misspelled words across HCPCS, CPT, ICD-10
and ICD-9 code sets to retrieve clinically
accurate search results, all in less than
a second. EncoderPro clearly displays
results in the corresponding hierarchy
and allows you to consolidate adjunct code
information with user notes or a notepad
for handy reference. At a glance, coding
instructions, lay descriptions and
multiple crosswalks are also readily
available. Convenient color-coded edits
identify whether a code carries an age
or sex edit or requires additional digits, is
covered by Medicare or contains bundled
procedures. We've briefly seen EncoderPro.com's
comprehensive search
capabilities in action with ICD-9 codes
but it doesn't stop there.
Encoder Pro's
dynamic search engine
extends across CPT, HCPCS and ICD-10 as
well. You can even search multiple code
types all at once.
Additionally, users can view code details
such as Medicare reference information,
code-specific information or Optum code
content as well as print code detail that
includes helpful information such as lay
descriptions, Modifiers, CCI and multiple
crosswalks.
And while users can search ICD-10 codes
natively by entering keywords into the
code search, they can also identify the
most clinically correct ICD-10 codes by
reviewing Optum's
unique mapping
information. Both the CMS GEM and Optum
mapping content is included, both forward
from ICD-9 to ICD-10 and backwards from
ICD-10 to ICD-9. Referential code note
information such as section notes,
category notes and chapter notes can
also be reviewed for each ICD-10 code to
ensure accuracy when choosing a code.
When it comes time to check your work
and review codes, the expert version of
Encoder Pro includes a compliance editor.
Users can enter coding information
directly in the compliance edit screen.
Simply enter criteria as it appears on
a claim. When the Run Check box is clicked,
the Compliance Editor performs a scrub of your
client, automatically checking your code
selections against hundreds of industry
standards including local and national
coverage determination to determine
medical necessity. I want to stop the video
here just to show that you see here that
it's talking about ICD-9 in this
particular screenshot. You may see some
of that but I don't think you're going
to see very much.
This is obviously taken from an older
version. Now, some organizations or
legacy systems do still track ICD-9 so
it's possible you may see it but not as
much. Also, I know this may not make much
sense to you now, but these edits it talks
about, they are extremely important and
something that if you're working in a
Coding Department you will be very aware
of the edits that are possible. When an
edit hits a claim, that means something
has been entered that is not allowed and
that claim has to be cleaned
up so that it can be submitted then. CCI
unbundles age, gender, modifiers and much
much more.
Users can optimize time by performing
compliance checking on the entire batch
of claims using Encoder Pro.com expert
Claims Batch Editor. This tool allows users
to load practice management system-
generated claim files, scrub claims and
review error reports for claim repair
prior to submittal to a claim's payer.
The other thing I want to say about
this is in a hospital,
these (jobs) are performed by different
departments but if you're working in a
large practice, it's possible that you
would be doing coding and billing and
would be using the software to do both
of those functions.
EncoderPro.com takes it even a step
further by providing additional tools to
repair and document changes to claims for
easy repair in your practice management
system. With its unique embedded
note-taking capability, Encoder Pro lets
you attach user notes to any code that
can be viewed by a single user. You see how,
in this screenshot, Blue Cross Blue
Shield has certain things that the coder
needs to be aware of, Cigna, these are payers
obviously. Aetna is another one. For a
global note that can be viewed by your
entire organization, just as you did with
traditional books but without the messy
margin notes.
Users also have the capability to search
notes on keywords, to make user note
organization and lookout a snap. If you
need to reference a code that is new, has
been revised, or has been deleted, Encoder
Pro provides a quick and easy lookup.
Reference all codes the AMA has deleted
since 1998 and if that code has a recommended
replacement, Encoder Pro provides a
hyperlink cross reference to the new
code. When this might be important is if you
are working in some kind of a registry
either a Trauma Registry, a Brain Injury
Registry, Cancer Registry where you are
needing to know how a specific diagnosis
was coded over different
years, you would really be using this
function for that. Users can even see
codes that are not yet effective with
the future codes section.
Want to look up active and retired
local coverage determination and
national coverage determination policies?
Encoder Pro offers a variety of ways to do
this. EncoderPro.com provides access to
content of over two dozen code and
reference books plus the option of
supplementing with numerous add-on
modules including the AHA Coding
Clinics, the AMA CPT Assistant, the Optum
Coders Dictionary and Stedman's Medical
Dictionary. Other add-ons include the
ability to create unlimited custom
patient encounter forms in minutes with
the Patient Encounter Plus module or do
bulk code mapping by using our ICD-10
Map Manager. This add-on module to EncoderPro.com
allows users to upload lists of
ICD-9 or ICD-10 codes and map them all
quickly and accurately using CMS GEM and
Optum Mapping Content.
additionally users can access coding
information from up to seven previous
quarters with the historical application
content at on module simply select the
past quarter and the application will
revert to the actual data for that
period. With all these choices. you can
customize your EncoderPro.com suite
to meet your unique business
requirements.
That's all I'm going to show at this
time. It was at least an introduction to
the Encoder. It does not show you all the
functionality. What I really wanted you to
see was the DRG grouper and how that
worked, taking into account the patient's
sex and age, primary and secondary
diagnoses, procedures, everything else
in order to come up with the DRG. I will
continue to look for something to show
you that but I wanted you to, at least, know the
word :Encoder" so if you have a job interview
that you know what it is, what it does and how
it assists the coder.
That'll do for now. Have a good day.