Code Check

athenaCollector

athenaOne for Hospitals & Health Systems   

This research tool allows you to:

  • Verify possible CCI bundling issues
  • Verify appropriate modifier use and check for other possible modifiers
  • Verify possible Medicare CPT, or ICD-9 issues, based on Local Coverage Decisions (LCDs) or National Coverage Decisions (NCDs)

You can search the following databases:

  • CPT/CCI — Research bundling issues, proper modifier usage
  • CPT/ICD-9 — Verify possible Medicare CPT or ICD-9 issues, based on Local Coverage Decisions (LCDs) or National Coverage Decisions (NCDs)

 

On the Main Menu, click Claims. Under RESOURCES, click Code Check. The tool appears in the Task Bar

 

 

 

  1. Display the Code Check page: On the Main Menu, click Claims. Under RESOURCES, click Code Check. The tool appears in the Task Bar.
  2. Select a Function — Select CPT/CCI from the menu. The code entry fields and the RVU options appear.
  3. Enter the code combinations to check.
    Click Add another CPT®/HCPCS row to check more than two codes.
  4. Date of Service — To select a date of service other than today, select a date.
  5. Select Non-Facility RVU or Total Facility RVU.
  6. Click Submit. The results appear in the Workspace (please be patient — it may take a few moments for the search results to appear):
    1. HCPCS Column — analyzes the diagnosis code in isolation.
    2. LMRP — validates CPT/ICD-9 crosswalks based on state-specific policies.
    3. National — for reference only. Serves as a guide when local policy has not been established.
  7. Scroll down to the bottom to view a detailed legend that explains the icons used in the results.

 

  1. Display the Code Check page: On the Main Menu, click Claims. Under RESOURCES, click Code Check. The tool appears in the Task Bar.
  2. Select a Function — Select CPT/ICD-9 from the menu. The code entry fields appear.
  3. Enter the code combinations to check.
    Click Add another CPT/ICD-9 row to check more than two codes.
  4. Date of Service — To select a date of service other than today, select a date.
  5. Click Submit. The results appear in the Workspace (please be patient — it may take a few moments for the search results to appear):
    1. ICD-9 Column — analyzes the diagnosis code in isolation.
    2. LMRP — validates CPT/ICD-9 crosswalks based on state-specific policies.
    3. National — for reference only. Serves as a guide when local policy has not been established.
  6. Scroll down to the bottom to view a detailed legend that explains the icons used in the results.

 

 

Select a Function

Select a function.

CPT/HCPCS ICD-9

This label appears if you select CPT/ICD-9 from the Select a Function menu.

CPT/HCPCS Codes

This label appears if you select CPT/CCI from the Select a Function menu.

RVU Version

This label appears if you select CPT/CCI from the Select a Function menu.

CCI Version

This linked label appears if you select CPT/CCI from the Select a Function menu.

 

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