- A clinically appropriate crossmatch between local and CPT® codes, renders the MedCodeLink API a reliable look-up tool.
- 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.
- 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.
- Clinical verification edits on CPT® codes, allowing a platform for negotiations on hospital tariffs, as well as to increase the technical efficiency of hospitals.
- Identification of procedures that warrant the services of specialist assistant(s).
- Validation of important modifiers applicable to Local codes e g 0005, 0010, 0049, 0050, 0051, 0053, 0055, 0058.
- Validation of CPT modifiers® 09950 (bilateral applicatons) and 09951 (multiple procedures performed during same session).
- 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.
ICD-10 LOOK-UP FACILITY
- Validation of ICD-10 codes.
- Clinicaly appropriate Dagger/Asterisk combination codes already linked and available in the ICD-10 look-up facility.
- 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.
OTHER UNIQUE FEATURES
- Complete descriptions of both procedure, and ICD-10 codes on all look-up facilities.
- Continuous updating, refinement and inclusion of new applications as required from time to time.
Subscription includes ongoing specialised coding advice and IT assistance.
