CodingSystem Functions

• ICD-9 (International Classification of Diseases, Revision 9) – A medical code set maintained by the World Health Organization (WHO). The primary purpose of this code set was to classify causes of death. A US extension, maintained by the NCHS within the CDC, identifies morbidity factors, or diagnoses. The ICD-9-CM codes have been selected for use in the HIPAA transactions.,CPT (Current Procedural Terminology ) – A five-digit medical code set used in medical billing and records systems that defines the medical procedures and medical services provided. This procedure code set is maintained and copyrighted by the AMA, and has been selected for use under HIPAA for non-institutional and non-dental professional transactions®, and HCPCS (HCFA Common Procedural Coding System) – A medical code set that identifies healthcare procedures, equipment, and supplies for claim submission purposes. It is maintained by HCFA and has been selected for use in the HIPAA transactions. The HCPCS Level II Coding books contain codes and descriptions for durable medical goods, injections, supplies, and services not listed by CPT Coding books. Also described as a medical coding system used to describe what treatment or services were provided by a physician codes
  • ICD-9 ultimate specificity
• Comprehensive, proprietary medical necessity edits
• CCI (Correct Coding Initiative or Correct Coding Policy) bundling/unbundling edits
• Modifier usage correction and recommendations
• E&M code generator
• RVU (Relative Value Units) sequencing
• CPT notes in support of coding or billing decisions
• Global fee period calculation

Alpha II CodingSystem’s comprehensive front-end code search and coding edit capabilities power essential revenue improvement efforts.

An interactive software tool, CodingSystem helps medical coders work many times faster than possible with manual reference books. But more importantly, the Alpha II content database practically guarantees that the resulting work will be both accurate and complete.

Precise coding can minimize denials, demonstrate medical necessity, ensure compliance, and help organizations capture more legitimate reimbursement.

The original coding software for outpatient healthcare, conceptualized by a physician in the early 1980s, CodingSystem serves thousands of professional coders, nurses, charge entry personnel, schedulers, and consultants. Today, due to its clinically-oriented design, it’s also used by doctors. Even a state Medicaid agency puts CodingSystem’s support for advanced medical decision-making to work as an auditing tool.

CodingSystem Features

CodingSystem is both an intuitive, stand-alone application and complete desktop solution that allows users to look up codes and perform edits all in one program.

Sophisticated E&M Generation

Alpha II’s proprietary tools for E&M (Evaluation and Management) generation help healthcare providers strengthen reimbursement by avoiding under-coding and maintain compliance by preventing over-coding. Given the risks of over-coding, many organizations tend to under-code as a precaution. But because CodingSystem has the intelligence to calculate medical complexity, the application can provide an accurate basis for the often subjective medical decision-making component of E&M billing. Based on documentation, number of diagnoses, amount of data, and mortality and morbidity risk, CodingSystem can generate compliant, objective E&M coding.

Clinically-Oriented Search Methodology

Alpha II’s database design enables clinically-oriented code searches. Users can look up codes based on official condition name, common name, acronym, or site. With CodingSystem, code searches more closely resemble the way patients are actually diagnosed.