User Guide — Research Tools for Medical Billing

Tools for creating claims

The Diagnosis Lookup tool and the Procedure Code Lookup tool let you search for CPT, ICD-9, and ICD-10 codes by number and by description so that you can populate those code fields accurately. To populate any diagnosis code or procedure code field, you can enter a period or question mark to display these tools and find the code that you need.

Tools for resolving coding issues

athenaOne provides tools to reduce your reliance on paper publications and make medical billing easier. On the Main Menu, click Claims. Under RESOURCES, click the tool you need.

When you select Code and Knowledge Base or Code Check, or click the icon provided within a claim, the selected research tool appears in the Task Bar. From there you can search the databases by keyword, code, or index. Your search results appear in the Workspace.

The Code and Knowledge Base page	The Code Check tool
athenaCodesource tool that allows you to search the following databases: CPT/HCPCS ICD-9 ICD-10 Morphology Codes Modifier ASC CCI Policy Manual CPT Manual E&M Guidelines ICD-9-CM Guidelines Federal Register MC Carrier Manual MC Coverage Issues MC Program Integrity Medicare A Bulletin Medicare B Bulletin Natl Coverage Dec OIC Publications Program Memorandum	athenaCodesource tool that allows you to: Verify CCI bundling Validate CPT to ICD (crosswalk) based on state-specific guidelines Check for appropriate modifiers Order procedures by RVU for maximum reimbursement You can search the following databases: CPT/CCI — Research bundling issues, proper modifier usage CPT/ICD-9 — Validate CPT/ICD crosswalks based on state-specific guidelines that apply to the practice

The Code and Knowledge Base page

The Code Check tool

athenaCodesource tool that allows you to search the following databases:

CPT/HCPCS
ICD-9
ICD-10
Morphology Codes
Modifier
ASC
CCI Policy Manual
CPT Manual
E&M Guidelines
ICD-9-CM Guidelines
Federal Register
MC Carrier Manual
MC Coverage Issues
MC Program Integrity
Medicare A Bulletin
Medicare B Bulletin
Natl Coverage Dec
OIC Publications
Program Memorandum

athenaCodesource tool that allows you to:

Verify CCI bundling
Validate CPT to ICD (crosswalk) based on state-specific guidelines
Check for appropriate modifiers
Order procedures by RVU for maximum reimbursement

You can search the following databases:

CPT/CCI — Research bundling issues, proper modifier usage
CPT/ICD-9 — Validate CPT/ICD crosswalks based on state-specific guidelines that apply to the practice

You can also use the Check Fee Schedule page, the Check Allowable Schedule page, or the Check Diagnosis Codes page to resolve coding issues.

Tools for claim follow-up

You can use the View Kick Reasons tool to find kick reasons.