Coding at its core | Optum gives you complete confidence with accurate and up-to-date content for all your coding needs.

Improve coding accuracy and compliance

Proprietary content and features that go beyond code updates is a web-based application designed to manage some of the most critical ambulatory coding, billing and reimbursement elements.

With, you can dive deeper into complex regulatory compliance topics, such as Hierarchical Condition Categories (HCCs), National Correct Coding Initiative (NCCI) edits and local and national coverage determination (LCD and NCD) policies for medical necessity. Expert provides ambulatory practices, with an efficient way to check your work by running selected codes through an automated edit review to ensure proper unbundling, correct modifiers, complete diagnoses and more, prior to submittal to a clearinghouse/vendor/payer. It also includes access to a 24-month historical content database for use during claim adjudication.

Specialized software eases the burden of setting defensible fee schedules makes it easier for physicians to set defensible fees while maximizing revenues. data is updated throughout the year to ensure you have immediate access to the most current information available. This powerful data source is an online subscription service that provides access to relative and actual physician charge data*, compiled by FAIR Health, Inc., for services in specific geographic areas, based on geographic location (geozip). In addition, it includes national charge data for HCPCS Level II codes — these are the aggregated fees your competition is charging. Medicare fee schedules are also integrated for a complete perspective.

Physician-based claims submission, education and coding reference resources boost productivity

Claim Appeal and Denial Support Add-on – Provides claims edit sourcing documentation within the Compliance Editor to assist with claim appeal support, access to the Optum Evaluation and Management Coding Advisor and the Auditor’s Desk Reference books as well as access to the Optum® LYNX E/M coding tool.

  • Claims Batch Editor Add-on — Boost productivity by running a batch of claims through the Compliance Editor for code edits. 
  • Plus Add-on — Provides specialty-relevant search capability, access to web-based education, worth 25 continuing education units (CEUs), and the Optum LYNX E/M coding tool to help with proper E/M code assignment
  • Clinical Documentation Improvement Add-on — Provides access to proprietary content from four Optum books: ICD-10-CM Clinical Documentation Improvement Desk Reference, Guide to Clinical Validation Documentation and Coding Reference, Physician Consulting ICD-10-CM CDI Improvement Training Content and Clinical Documentation Guidelines for Facilities. This content, organized by code, helps ensure clinical quality, substantiates medical necessity and aids in justification for appropriate reimbursement. Health record documentation as designated by the clinician is the foundation upon which coding decisions are based.
  • Optum Specialty Articles Add-on — Access a proprietary Optum content database of more than 2,500 specialty newsletter articles that will help you explore specialty nuances and assist with accurately coding unique specialty situations.
  • AMA CPT® Content Module Add-on — Offers unparalleled access to CPT®-associated content delivered by the AMA to provide clarity and accuracy in CPT® code reporting. Gain complete access to the CPT® Assistant newsletters, CPT® Changes: An Insider’s View publication, and access thousands of answers to questions from the AMA’s extensive knowledge base of customer-asked CPT® code inquiries.
  • AHA Coding Clinic® for ICD/HCPCS Add-on — Provides a complete archive of the ICD/HCPCS coding clinics to support you in assigning the most appropriate code to help avoid claim denials and assist with various research projects.

Physician-based tools offered:

Request a demo and get our 2024 coding insiders power pack

Request a demo and receive free, exclusive access to 5 articles detailing the most essential coding updates and guidance for the coming year. Written by our seasoned coding experts, these articles contain 18 pages of information that will supercharge your coding and billing on topics such as telehealth services coding, E/M coding changes and ICD-10 updates.

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Join us as we walk through claim tools and content within webinar will review the Auditor’s Desk Reference and Evaluation and Management Coding Advisor print book content, compliance editor tool and more, to show how this tool impacts your practice’s claims process.

CPT is a registered trademark of the American Medical Association.

Coding Clinics is a registered trademark of the American Hospital Association.

*Data only © 2022 FAIR Health, Inc.