MediRegs Master Suite

Your complete resource for audit, reimbursement, compliance and regulatory research

Created for high-level health care professionals, MediRegs Master Suite is the most comprehensive coding, payment and compliance audit resource available. The MediRegs Master Suite provides advanced primary source content and expert tools — updated in real time — to ensure the integrity of your program, revenue, and audit documentation. The MediRegs Master Suite is a perfect fit for those high-level health care professionals who require advanced, robust tools. to manage advanced audit and denial management research, complex coding issues, and payment analysis across multiple reimbursement methodologies.

Coding Tool Features

  • Robust archives for coding, payment, local coverage determinations, CMS manuals and federal regulations.
  • Advanced Code Explorer allows users to search across multiple code sets by code, description or key terms for instant coding instruction (Code Notes), outpatient and physician payment rates and coding guidance including local coverage determinations and critical coding guidance in one location.
  • Coding Comply offers complete code lists and descriptions, with archives and a simple way to custom export codes from our database.
  • ICD-10 Explorer provides keyword search functionality for ICD-10 codes and guidelines, as well as translation of ICD-9 to ICD-10 codes using GEMs mapping scenarios.
  • NCCI Code Pair Checking tool demystifies code bundling issues. Now includes Medicaid edits!
  • NEW and improved provider-specific MS-DRG Grouper and Calculator, powered by New Health Analytics, demonstrates MS-DRG grouping and payment logic under IPPS—now includes an integrated grouper, batch grouping capability, and ability to show/hide payment information.
  • E-Code Sets and e-books allow you to search by code, description or common terms. Integrate with the explorer tool and reduce your coding orders and subscriptions.
  • Includes complete electronic codebook content for HCPCS, CPT® , APC, ICD-9- CM, ICD-10-CM, ICD-10-PCS, GEMs, Physician Fee Schedule (RVU), MS-DRG, NCCI, E&M, and Drugs (NDC) in natural language.

Coding Guidance Resources

  • Includes a complete Coding Guidance Library with more than three dozen coding supplements, including AHA Coding Clinic for ICD & HCPCS, CPT® Assistant, CPT® Changes — An Insider's View archives and ASA Crosswalk®.
  • A medical dictionary, select CMS Manuals, and Medicare coding and billing guides further expand the list of reference material you can access before a code is assigned.
  • Customizable daily and weekly alerts, stored search alerts and personal bookmark folders provide you with the information you need, when you need it.

Compliance Resources

  • Includes full versions of CMS Manuals. CMS Claims Processing Manual (Pub 100-04), Benefit Policy Manual (Pub 100-02) and National Coverage Manual (Pub 100- 03) provide you with detailed instructions to comply with Medicare, and outstanding archives for audit and appeal work.
  • WK Week In Review Newsletter keeps you abreast of regulatory, legislative and enforcement activities across Medicare.
  • CMS Transmittals, MLN Matters, Job Aids and CMS Frequently Asked Questions are updated daily to keep you apprised of real-time coding changes and discussions as they are released in one easily accessible place.
  • RAC Tracking tool helps you stay abreast of codes being investigated by government investigators.
  • A medical dictionary, CMS glossary, MLN Matters, Job Aids, fee schedule information, acronym tool and frequently asked questions further expand the list of reference material you can access before a code is assigned.
  • Customizable daily and weekly alerts, stored search alerts and personal bookmark folders provide you with the information you need, when you need it.
  • Includes Wolters Kluwer Health Net Newsletter and MediRegs educational webinars.

Medical Necessity Resources

  • State health care regulations, legislation and Medicaid manuals for all states.
  • Instant access to LCDs and NCDs provide effective validation of the medical necessity of ordered outpatient and physician procedures and services. Additional access to Advanced Beneficiary Notification (ABN) forms and instructions, national coverage guidance (NCD), national coverage analyses (NCA).
  • Choose by contractor: All Medicare Administrative Contractor (MAC) LCDs and bulletins are included for specific local guidance.

Fee and Payment Tools

  • Understand the complexity of Medicare claims payment with real-time adjusted Medicare case calculators: the CCH® Reimbursement Toolkit calculators for OPPS, IPPS, SNF, LTCH, IPF, IRF and Physician Fee Schedule.
  • Easily reference the adjusted Medicare reimbursement rate for your region via the quick calculators for APC, RVU and MS-DRG.
  • Demystify bundled codes with the NCCI Code Pair Checker tool, which is integrated automatically into the APC & RVU calculators.

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