Medcodelink Pty (Ltd)
The key to clinically appropriate coding and claims management

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Local Coding System & CPT® Look-Up Facilities
  1. A clinically appropriate crossmatch between local and CPT® codes, renders the MedCodeLink API a reliable look-up tool.
  2. CPT® codes cross-matched to a comparable local code where no dedicated local code is available for a particular CPT® code (Rule C applications - local code 6999) simplifies the funder’s responsibility to provide the healthcare professional with fair and justifiable benefits.
  3. Clinical verification edits on local coding system, e.g. ‘cost driver’ procedures, for implementation on pre-authorisation level up to processing the doctor’s account.
  4. Clinical verification edits on CPT® codes, allowing a platform for negotiations on hospital tariffs, as well as to increase the technical efficiency of hospitals.
  5. Identification of procedures that warrant the services of specialist assistant(s).
  6. Validation of important modifiers applicable to Local codes e g 0005, 0010, 0049, 0050, 0051, 0053, 0055, 0058.
  7. Validation of CPT modifiers® 09950 (bilateral applicatons) and 09951 (multiple procedures performed during same session).
  8. Identification of procedures that may require insertion of prosthesis, catheter, graft, internal fixation, etc, - important information required by case managers when pre-authorising hospital admissions.
  1. Validation of ICD-10 codes.
  2. Clinicaly appropriate Dagger/Asterisk combination codes already linked and available in the ICD-10 look-up facility.
  3. All PMB codes are available on the ICD-10 look-up facility, as well as the applicable Diagnosis and Treatment Pair (DTP) numbers relevant for a particular PMB code.
  1. Complete descriptions of both procedure, and ICD-10 codes on all look-up facilities.
  2. Continuous updating, refinement and inclusion of new applications as required from time to time.
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