AccuChecker Product Line

AccuChecker OnLine BASIC

 The AccuChecker OnLine BASIC is the ideal tool for the practice that demands limited coding but that can take advantage of AccuChecker OnLine comprehensive state-of-the art ICD-10-CM system and FREE-HOTLINE support. The AccuChecker OnLine BASIC costs less than 50 cents a day.

 

The AccuChecker OnLine BASIC is an Internet service with:

    ·         Procedures  – CPT, Category II and HCPCS codes

·         Diagnoses codes (ICD-9-CM and ICD-10-CM)

·         Free HOT-LINE SUPPORT

 

The annual subscription for AccuChecker OnLine BASIC is $169

 

AccuChecker OnLine CLASSIC

 

AccuChecker OnLine Classic has been the only AccuChecker OnLine version since 2000 hundreds users from across the nation use the CLASSIC and renew their subscriptions every year, we are most grateful for their support and loyalty. 

The AccuChecker OnLine CLASSIC is designed for medical practices that require coding techniques and pricing services.

 

• Fast, accurate, easy-to-use Coding, Pricing and Coding Techniques for less than $1.00 a day

 

The AccuChecker OnLine CLASSIC is a comprehensive database with:

 

• Procedures  – CPT, Category II and HCPCS codes
• Diagnoses codes (ICD-9-CM and ICD-10-CM)
• Converter of ICD9 to ICD10
• Medicare fee schedules including OPPS rates in radiology
• Coding techniques like:
• Corrective Coding Initiative (CCI),
• Medical Necessity – procedures matching diagnoses,
• Medicare’s LCD and NCD,
• Surgical modifiers outlining coding guidelines
• Global period for surgical services

 

AccuChecker OnLine CLASSIC is available in two (2) versions:

 

• State Version     – Fee Schedules for the State ONLY
• National Version – Fee Schedules for the entire nation –for each zip code

 

The annual subscription for AccuChecker OnLine CLASSIC:

 

• State Version              $299.00
• National Version:       $399.00

  AccuChecker OnLine  PREMIUM

The AccuChecker OnLine PREMIUM our elite databases assembly consists of:

 

• Procedures  – CPT, Category II and HCPCS codes
• HCPCS including medical and therapy services, diagnostic procedures,

J codes, DME, orthotics and supplies

• Listing of most commonly used tables of information: POS, numeric and HCPCS modifiers, revenue codes, NDC product file definitions, etc.

• Diagnoses codes (ICD-9-CM, ICD-10-CM and ICD-10-PCS)
• Converter of ICD9 to ICD10
• Medicare fee schedules including OPPS rates in radiology
• Coding techniques like:
• Corrective Coding Initiative (CCI),
• Medical Necessity – procedures matching diagnoses,
• Medicare’s LCD and NCD,
• Surgical modifiers outlining coding guidelines
• Global period for surgical services
• NDC products listing
• FDA Listing of Authorized Generic Drugs
• Generic equivalents for many commonly prescribed brand-name medications.

 

The annual subscription for AccuChecker OnLine PREMIUM is $999

AccuChecker Online – P4P

 

The HPP-AccuChecker Management Team is moving into the new frontier in healthcare reimbursement the Pay-for-Performance (P4P) alternative, the new way how healthcare providers receive their compensation, where HEDIS, PQRS and other reporting systems become intrinsic modules of our software reimbursement applications.

 We are committed to keep our customer base ahead of the game and to assist our clients in maximizing the compensation that they deserve for their efforts.

 

Pay-for-Performance works

·         We find that in practices participating in Pay-for-Performance activities, physicians and managing staff show excitement about reporting HEDIS and PQRS measures for two simple reasons they receive compensation from Medicare and Managed Care Plans for enforcing Pay-for-Performance measures and also for improving the quality of care of their patients. Consequently, such actions produce a dramatic impact in achieving cost containment.

·         We have also witnessed that HMO plans with of 4.0 of higher STAR RATINGS are the ones compensating their PCPs handsomely and the PCPs reciprocate to the plans with vigor and enthusiasm. A win win alternative.

 

We have new additions to our product line that work in conjunction with AccuChecker OnLine applications: 

·         ACK HEDIS MODULE – the perfect tool for physicians offices with agreements with managed care organizations WITH Medicaid, Medicare and/or Commercial panels for reporting and handling HEDIS measures

·         ACK PQRS MODULE- the application for physicians for physicians with a Medicare population for reporting and handling PQRS measures

 

Each software module displays pertinent material and measures so physicians’ practices can easily review and manage every measure due for reporting, also in addition:

 

• The system allows practices to summarize measures due for reporting by selecting groups of patients with specific criteria like insurance carrier, line of business (Medicare, Medicaid or Commercial) patients’ age, sex and/or diagnosis codes. 

• If the user can produce from their practice management system an EXCEL table with the entire panel per plan then the software module displays or prints per patient per plan what measures are due for reporting for each patient in the selected insurance panel. 

Both software modules help medical practices to manage and control reporting HEDIS and PQRS modules. 

Pricing Details call 305-227-2383 or 1-877-938-9311 

• ACK HEDIS MODULE    $100.00
• ACK PQRS MODULE      $100.00

 

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AccuChecker - Update 04/21/2014

 

CODING MADE EASIER FOR LESS

AccuChecker OnLine

 Looking for more information on improving your practice's billing and coding and preparing for the ICD-10 transition?  Learn from our experts at AccuChecker.

Coming soon AccuChecker  new and improved web site - AccuChecker OnLine is an Internet database subscription service with procedures, diagnoses (ICD-9 and ICD-10) Medicare fee schedules using RBRVS tables and coding techniques. AccuChecker OnLine is updated periodically.

 

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AccuChecker - Collect Every Dollar Your Practice Deserves

Collect Every Dollar Your Practice Deserves

With AccuChecker you have the tool  that will help you:

·         Advance notice of changes in Medicare Part B reimbursement rules so you can prepare to comply.

·         Guidance on how to get your claims paid by following Part B reimbursement rules.

·         The latest coding policy changes and documentation requirements so you can avoid fraud and abuse violations.

AccuChecker is your reimbursement solution for :

·         HEDIS

·         PQRS

·         CCI

·         National Medical Policy

·         Medicare Fee Schedules

·         ICD-9 and ICD-10 Coding Sets

 

Need multi-user access? Ensure uninterrupted individual access and maximum coding productivity for your whole team. For site license inquiries call: 1-877-938-9311

 

AccuChecker  is how you level the playing field and take control of the financial impact that the changing health care landscape has on your practice.

 

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MCAR – MANAGED CARE REPORTS



MCAR – MANAGED CARE REPORTS

Timely solutions to funding, claims, pharmacy & distributions

·         MCAR analyzes the entire operation from membership and funding

·        It produces a detailed analysis of charges payments and adjustments for Institutional, Professional and Pharmacy claims 

      

      Produces a Summary Report for each PCP outlining activities for each PCP from funding to net profit or (loss)

 

·         A pharmacy report showing prescribing amounts for each provider identifying recap analysis of Generic and Brand Name medications including OTC

 

·         A detailed by-member cost analysis showing – Funding, Risk Values for your MRA evaluation, summary expenditures and the ending net amount

 

·         A PCP Analysis that shows performance for each PCP in the network from funding, expenditures to net profit or (loss). A simple and easy to read report that enables you to compare all PCP’s performance

 

·         STOP LOSS verification.

Our management team formed of risk management consultants can also alert you of situations that need your immediate attention.

 

FOR MORE INFORMATION ABOUT

MCAR – Managed Care Reports

SEMINARS & CONSULTING SERVICES

Please contact us at (305) 227-2383

 

Why medical coders shouldn't worry about memorizing ICD-10 codes

Why medical coders shouldn't worry about memorizing ICD-10 codes

 

You want to scare the beeswax out of a healthcare professional, talk about how many ICD-10 diagnosis codes there will be. Sixty-eight thousand codes. Who's going to memorize all those.

No one. That's because no one needs to memorize all the diagnosis codes. Medical coders will memorize the ICD-10 codes that become most familiar to them. The others can be accessed or found quickly by medical coders who understand how they are memorized.

Be ready to code for gallbladder attacks 

A patient comes in to the ER complaining of sharp pain in the upper abdomen that began after lunch and continued “for some time,” followed by nausea and vomiting.

 

The physician orders an ultrasound and diagnosis the patient with cholelithiasis. The physician recommends surgery and after obtaining patient consent, performs a laparoscopic cholecystectomy with cholangiography. The pathology report states “acute cholecystitis with cholelithiasis.”

Meet the disease

Before determining a diagnosis and coding the procedure, coders might benefit from understanding a little bit about the condition.

Cholecystitis and cholelithiasis are conditions that affect the gallbladder, a sac located under the liver. The gallbladder stores and concentrates bile produced by the liver. Before a person eats, the gallbladder is approximately the size of a pear.

During a meal, the gallbladder pushes bile through ducts into the small intestine. The bile aids in digestion of fats.

After a meal, the gallbladder is flat and empty.

The following diseases may attack the gallbladder:

• Gallstones—hard, pebble-like formations that develop in the gallbladder
• Cholecystitis (chronic/acute)—inflammation of the gallbladder
• Polyps—growths of tissue in the gallbladder
• Tumors—abnormal growths on the gallbladder and bile ducts
• Biliary dyskinesia—bile does not flow from the gallbladder or common bile duct and backs up in the gallbladder

Patients may also suffer from cancer of the gallbladder, which is difficult to diagnose because it does not have specific symptoms. In addition, the location of the gallbladder also makes this cancer difficult to detect.

Gallstones lodges in the duct can prevent the flow of pancreatic enzymes causing acute pancreatitis.

ICD-9-CM includes the following code choices under cholelithiasis:

• 574.00, Calculus of gallbladder with acute cholecystitis; without mention of obstruction
• 574.10, Calculus of gallbladder with other cholecystitis; without mention of obstruction
• 574.20, calculus of gallbladder without mention of cholecystitis; without mention of obstruction
• 574.30, calculus of bile duct with acute cholecystitis; without mention of obstruction
• 574.40, calculus of bile duct with (chronic) cholecystitis; without mention of obstruction
• 574.60, calculus of gallbladder and bile duct with acute cholecystitis; without mention of obstruction

Note that the fifth digit for these codes denotes without mention of obstruction (0) or with obstruction (1).

Other diseases of the gallbladder include:

• 575.10, cholecystitis,(unspecified)
• 575.11, chronic cholecystitis
• 575.12, acute and chronic cholecystitis
• 575.3, hydrops of gallbladder
• 575.6, cholesterolosis of gallbladder (strawberry gallbladder)
• 575.8, biliary dyskinesia

 

 

Diagnose the problem

The first thing to determine is which ICD-9-CM diagnosis code the surgeon should use.

Coders have four possible codes based on the scenario above.

• 789.01, pain right upper abdominal quadrant 
• 787.01, nausea and vomiting 
• 574.20, calculus of gallbladder without mention of cholecystitis
• 574.00, acute cholecystitis with cholelithiasis without mention of obstruction

 

 

 

 

Pain in the upper right side or upper middle of the abdomen is the main symptom of cholecystitis, also known as gallstones. Nausea and vomiting are also common symptoms. The Official ICD-9-CM Guidelines for Coding and Reporting state:

Signs and symptoms that are associated routinely with a disease process should not be assigned as additional codes, unless otherwise instructed by the classification.

Other signs and symptoms of cholecystitis include:

• Pain that wakes a patient a night
• Pain following meals
• Intolerance of fattyfoods
• Burning sensation in the stomach
• Diarrhea
• Loss of appetite
• Fever

Because abdominal pain, nausea, and vomiting are common symptoms of cholecystitis, coders should not assign codes for the symptoms.

That leaves two choices: 574.20 or 574.00. The physician initially diagnosed cholelithiasis (574.00). However, the pathology report provides more information.

The final diagnosis based on the pathology report is acute cholecystitis with cholelithiasis, which makes the correct code 574.00, saysPlouffe.

Dissecting the procedure

Physicians can use three different procedures to perform a cholecystectomy (removal of the gallbladder):

• Laparoscopic cholecystectomy: the physician makes four small slits in the abdomen and uses laproscopic instruments to remove the gallbladder.
• Open cholecystectomy: the physician makes an incision on the right side of the abdomen under the rib cage and removes the gallbladder.
• Single-site da Vinci® surgery: This is a robotic-assisted surgery (da Vinci Surgical System is the name of the device). In this procedure, the physician remover the gallbladder through a single small incision in the belly button similar to traditional single-port laparoscopy.  

In some cases the surgeon begins the procedure as laparoscopic, but converts it to an open procedure. In this case, coders should only report the CPT® code for the open procedure.

In addition to the primary diagnosis code, report ICD-9-CM code V64.41 (laparoscopic surgical procedure converted to open procedure). ICD-10-PCS instructs coders to report both procedures—an open cholecystectomy and an inspection for the laparoscopic procedure. ICD-10-CM does not contain a code equivalent to V64.41.  Outpatient coders will not be able to indicate when a surgeon converts a laparoscopic procedure to an open one.

The possible CPT codes for a laparoscopic cholecystectomy include:

• 47562, laparoscopy, surgical; cholecystectomy
• 47563, laparoscopy, surgical; cholecystectomy with cholangiography
• 47564, laparoscopy, surgical; cholecystectomy with exploration of common duct
• 47570, laparoscopy, surgical; cholecystoenterostomy
• 47579, unlisted laparoscopy procedure, biliary tract

The surgical laparoscopy always includes the diagnostic laparascopy, Plouffe says. Do not code the diagnostic laparoscopy separately.

CPT codes for an open cholecystectomy include:

• 47600, cholecystectomy;
• 47605, cholecystectomy; with cholangiography
• 47610, cholecystectomy with exploration of common duct;
• 47612, cholecystectomy with choledochoenterostomy
• 47620, cholecystectomy with transduodenal sphincterotomy or sphincterplasty, with or without  cholangiography
• 47999, unlisted procedure, biliary tract 

 

AccuChecker has the solution – Call Us 305-227-2383

 

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