CodeQuest is an application which analyses Medicare Billing Policies from the 56 Medicare Carriers in the United states, and provides a sophisticated decision support system for categorizing CPT and ICD9 Codes. CodeQuest extracts the CPT-ICD9 codes at a 99.96% accuracy rate from a variety of formats including HTML originating from widely varied sources and generators. The extraction process automatically breaks out code ranges at the individual code level. For example, a policy line such as V70.0-V70.9 results in 10 valid ICD9 codes.
The extracted codes are then reviewed by an operator using a highly developed decision support system which categorizes entire ranges with a single click, shift click exception, and "swipe". This enables the operator to easily remove extraneous data such as page numbers that match ICD9 codes from the dataset, and categorize the valid codes as covered, non covered etc. The code under selection also automatically displays the text it comes from in the lower window with the phrase highlighted for easy operator review.
The decision support system enables a single operator to review and categorize over 100 policies in a single day, and to easily review rapid changes in policies and incorporate those changes into the database.
CodeQuest also provides a set of highly sophisticated tools to analyze and compare policies and policy differences between Carriers.
Until now, there has never been an easily generated digital file of CPT-ICD9 billing pairs for a Carrier at the individual code level, let alone a single source for all carriers in the country. Maintaining current Medicare billing codes are no longer problematic for on-line medical billing. A valid current billing code set removes the necessity of guessing billing pairs in on line billing systems. Operators simply enter a valid CPT code and are presented with a Popup listing the valid ICD9 codes for the Carrier.