Select the Coding & Payment Tools tab, Code Explorer appears automatically. Alternatively, select from the drop-down menu to the left of the search box.

Confirm or select the Provider options from the left side of the tool:

  • Date: Enter a date of service (or leave today as default);
  • OPPS: Add a new provider (or leave National Unadjusted as default). Alternatively, select a previously entered provider from the drop down;
  • Professional Fee Locality: Choose a locality (or leave National Unadjusted as default);
  • Code Sets: Select which code sets you want to search (or leave default). Check “Remember These Settings”, to save as a preference.

NOTE: Selections will be remembered when navigating to the NCCI Code Pair Check, APC Calculator or RVU  Calculator.

To search by code:

  • Enter a single code; multiple codes separated with a space or a comma; or a range of codes separated by a hyphen.
  • Keep the “Search by Code” box checked

To search by term:

  • Enter key word(s);
  • Utilize partial words or terms without quotes or wildcards;
  • Uncheck the “Search by Code” box.

To select a previously Saved Code Set, place the cursor in the empty search bar.

To search for an obsolete code, check Include Obsolete Code(s) box.

Once your terms/codes are entered, click on the magnifying glass to reveal results.

Results are displayed on tabs by code set, with (#) to reflect the number of answers. Click on any tab to reveal results for that tab.

Explore results:

  • Hover on anything with a dotted blue underline for more information
  • Click on anything BLUE to search further content; additional content opens in a new tab

NOTE:  Based on subscription and tab, access additional information about the code from the AHA, AMA, Coding & Payment library, Coverage library, NCCI Tool, Revenue Code Crosswalk, Code Books and Payment Books.

Features at the top of the results page allow you to perform functions on the selected codes (All codes will be checked ON by default).

  • Utilize the Send To link to query the selected codes in:
    • OPPS Calculator
    • Coverage Tool
    • Pro Fee Calculator
    • NCCI Code Pair Check
    • Search
  • Utilize the Save to My Code Sets link to save the codes for future use;
  • Utilize the Export to PDF or Export to Word links to save your information;
  • Print.

To clear the search and start over, hit the X button in the search box.

Range Search

Range search is available for APC, DRG, HCPCS, CPT, ICD-9-CM, ICD-10-CM (3-character category only)

Excludes: NDC and Limited ICD-10-PCS

Range Search Limitations:

  • Single range per search
  • Separate codes with a single hyphen (no space)
  • For ICD-9-CM, start and end values should have same number of characters, decimal must be in same place.
    Examples:
    • V00.1-V49.9
    • V001-V499
  • For ICD-10-PCS, range search utilizing the first three (3) characters and PCS codes with values in the same exact position.
    Examples:
    • 02Q-08Q
    • 04Q03ZZ-04Q30ZZ
    Note: For ICD-10-PCS, alternatively partial code search using the first 3 characters or see the codebook for a full listing of codes by the first 3 characters
  • If an alpha character is part of the search, start/end values must contain same number of characters and alpha character must be in same position (either first or last).
    Examples:
    • V00-V49
    • J1234-J5678
    • 0000M-9999M
    • 02Q-08Q
    • 04Q03ZZ-04Q30ZZ