Click on the Coding and Payment Tools tab and use the drop-down menu to select the tool or calculator you want to use.

Here is a short summary of each tool:

  • OPPS Calculator:  Estimate reimbursement for Medicare outpatient hospital scenarios under OPPS.
  • Professional Fee Calculator:  Estimate Medicare Professional reimbursement under the Physician Fee Schedule.
  • MS-DRG Group/Calculator:  Determine MS-DRG Grouping and calculate provider-specific payment under the Inpatient Prospective Payment System (Opens in a new window)
  • MS-DRG Analyzer:  Utilizes ICD diagnosis and procedure codes to group into Medicare Severity Diagnostic Related Groups (MS-DRG) under the Medicare Inpatient Prospective Payment System (IPPS)
  • MS-DRG Analyzer w/Batch Calculator:  Calculate the payment for a set of records in a CSV file not to exceed 250kb (approximately 200 rows)
  • NCCI Code Pair Check:  Review Correct Coding Edits for CPT and HCPCS codes
  • NPI/DEA Lookup:  Look up provider identifiers