Consumer Code Manager - ICD-10-PCS Data - Sensitive Flags
Optum360 | Data File
Consumer friendly description language solution that deciphers and replaces complex medical terms and cryptic technical jargon with simplified descriptions of medical services, treatments, procedures and diagnoses (for example, heart attack replaces myocardial infarction) for the ICD-10-CM/PCS code sets. Available in English and Spanish.
- Clear, consumer-friendly descriptions. The descriptions are intended to reduce consumer confusion and allow consumers and those who interact with them to easily understand health care information and communicate more effectively. Designed to guide conversations between members and call center personnel, nurse call centers and case managers
- Sensitive flag. This dataset identifies medical codes related to health topics deemed “sensitive” by state consumer privacy laws, allowing companies to prevent disclosure of sensitive health information.
- Compliance assurance. Support compliance with state privacy regulations regarding the distribution of highly sensitive health information
- Ability to add descriptions to explanation of benefits (EOBs), physician health records (PHRs), denial letters and other member communications.
- Add value to consumer health portals, provider search engines and treatment cost estimators by providing easy-to-understand terms for conditions, procedures, etc.
- Communicate with Spanish-speaking populations in their language, using Spanish-translated consumer descriptions.
- Comply with Medicare Advantage Organization (Part C and D) EOB guidelines for using common language descriptors for medical codes.
- Use the official industry-to-consumer description translations for training new coding personnel.
- Incorporate this data into products that measure cost and efficiency of health treatment.
- Avoid state penalties and prevent highly sensitive health information from falling into the wrong hands by applying sensitive flags to identify and mask code descriptions on claims and health communications.