Coding at its core | Optum360

Leverage the most accurate, enriched and complete set of medical coding information across every department and user in your organization.

Our online solutions keep hospitals, physicians and health plans up to date and connected to industry-wide coding intelligence and expertise.


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Achieve clarity at the code level

Access the most current CPT®, HCPCS, DRG, ICD-10 code sets and COVID-19 related updates.

We regularly compile information from the World Health Organization (WHO), Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS), American Medical Association (AMA), American Hospital Association (AHA) and the Centers for Medicare and Medicaid Services (CMS) so you can easily access the most up-to-date medical code detail and compliance guidance in one convenient place.

Employ the widest array of crosswalks

We make it easy for any organization to map across distinct code sets from within each of our online coding solutions and through our add-on tools. Users can search relationships, view all available crosswalks and stay current on code changes and updates – including all valid CPT®, ICD-9, ICD-10, Medicare modifiers and HCPCS codes.

Refer to Medicare guides and CMS regulatory updates

We make available over 40 regulatory reference guides so our clients can take command of complex 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.


Tools for every health organization

Our deep references, crosswalks, claim-level calculations and regular updates support a complete range of coding, billing, compliance and reimbursement needs. Optum helps physicians stay compliant and increase coding accuracy with a wide array of products. Starting with EncoderPro.com, you can pair other products to fulfill your coding, billing and reimbursement referential content needs in one place.

Our CPT® /HCPCS crosswalks, Medicare coding and billing tips, CMS edit guidance and clinical documentation guidelines embedded in RevenueCyclePro.com and DrugReimbursement.com enhance critical coding, billing and reimbursement elements within a hospital’s revenue cycle. Our chargemaster management solutions help promote revenue integrity through a wide assortment of features that improve efficiency and productivity while eliminating the costly issues that lead to billing rejections and denials.

EncoderPro.com for Payers brings sophisticated search and guidance capabilities designed specifically for payer organizations, including comprehensive physician, outpatient and inpatient coverage information, payment and policy details from CMS, and other industry standards. With these tools, your staff can quickly access CPT® procedures, HCPCS supplies and services, and ICD-10 diagnosis and procedure codes.





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