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What is AOACodingToday and why do I need it?

May 29, 2012

By Ron Rush, vice president, Sales and Marketing

Attention all AOA members! We would like to remind you about the AOA online coding and reimbursement database—AOACodingToday. This is a FREE AOA member benefit. Developed and administered by Physician Reimbursement Systems (PRS), the database is a complete coding and billing tool that will help you determine the proper coding and billing rules for accurate reporting of your services for reimbursement.

Take the time to explore the features of AOACodingToday and tap into the benefits of resource data like the ones mentioned below:

  • All Current Procedural Terminology (CPT) codes with full descriptors;
  • All ICD-9-CM diagnosis codes;
  • The complete national Correct Coding Initiative (CCI) edits used by Medicare
  • Medicare coding rules, including the fee schedule for each state and location, payment status of the codes, modifier rules, and carrier-specific Medicare payment rules.
  • A Fee Multiplier that allows users to multiply fees based on a percentage entered. This allows physicians who have contracts with private payers to provide services based on a percentage of Medicare to check fees against what they are getting paid using the modified Medicare fee schedule.

Do I need AOACodingToday in addition to my EHR if my EHR already has coding information ?

In most cases the answer is YES. You do need the information in AOACodingToday in addition to your electronic health record (EHR) system. The EHR is primarily designed to capture the historical clinical data associated with a patient. The typical EHR system does not include the additional level of support information that is often required to properly submit a claim to an insurance company. Below are a few of the areas that AOACodingToday allows you to review pertinent rules before submitting your claim. By using this information you will likely reduce the chances of costly delays in payment for the services you provide:

1) Medicare Carriers may develop specific rules regarding the services you are providing. AOA CodingToday offers a convenient way to look up those Local Carrier Determinations and National Coverage Decisions. These tell you what diagnosis codes will be paid with the CPT code you selected. Additionally, the determinations will identify circumstances that will result in denial or if additional information is needed to obtain payment.

2) AOACodingToday also includes the up-to-date Correct Coding Initiative and a user-friendly tool called the Bundling Matrix to verify if CPT codes can be billed together on the same date of service and/ or if a modifier is required to obtain payment. The Bundling Matrix also alerts you to any restrictions for modifier use with a given CPT code, with easy access to modifier descriptions to direct you to the information you need to get paid.

3) Rank order billing assistance can be easily viewed in the Bundling Matrix helping you list CPT codes from highest relative value to lowest, avoiding the games played by some insurance companies paying lower-valued procedures at 100 percent while reducing payment for higher-valued procedures under multiple procedure guidelines.

4) It is very easy to identify work relative value units for each CPT code to help determine which services will provide you with better productivity under productivity-based contracts.

All information in this Internet-based program is housed in a secure site and updated as rules change. To access the database, go to AOACoding Today.com. Follow the simple instructions to log on to as a user. Remember AOACodingToday is a FREE member benefit and is made available all AOA members and their staff members!

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