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and CrossCoder.Com™ are trademarks of Yale Wasserman
D.M.D. Medical Publishers and The
National Medicare Advisory Service™
Medical to Diagnosis Code Crosswalks
ICD10 and ICD9
and HCPCS Level II Codes and find ICD Diagnosis Crosswalks in
Seconds. Also perform reverse searches (ICD to CPT). Over
1,000,000 links including detailed LCD (Local Coverage
Determination) policy information. This product is a must for
validating medical necessity.
DEMO Standard Version
Only $249! Professional
Version (includes exporting privileges) $999
is your low cost Windows
solution for finding "crosswalks" between CPT®
/HCPCS procedure and service codes with supporting ICD9/10 diagnostic Codes.
A "crosswalk" or "link" refers to a relationship between
a Medical Procedure (CPT/HCPCS Code) and a Diagnosis (ICD10 Code).
uses crosswalks to validate or substantiate medical necessity
based on Local Coverage Determinations (LCD) and
National Coverage Determinations (NCD). Private payers also establish crosswalk tables
for validating and auditing medical claims. CrossCoder
provides instant access to all current CMS LCD/NCD policies. This
information is combined with our own NMD (National Medicare Database)
crosswalks based on millions of claim data records.
In brief, physicians are paid by procedure or
service code not by diagnosis. In order to validate proper coding (e.g. the reason for the
procedure or medical necessity) providers must specify a medically
necessary diagnosis. If the diagnosis does
not support the procedure the claim will not get
paid and may leave to an audit if a fraud pattern exists.
CrossCoder allows searches (CPT Code to ICD Code by code or
description) for over 12,000 medical codes including CPT, HCPCS Level II, DMEPOS, J Codes,
Anesthesia, Category II and III ( F and T codes) and 20,000 ICD9/10 diagnosis codes including
accident and injury codes. Exclusive to CrossCoder is the ability
to perform reverse searches from Diagnosis to Procedure Codes.
Medicare and many private payers use medical
necessity crosswalks to audit your claims - why not use a tool that may have the same links they
and lower your audit exposure!
CrossCoder is being used by providers, administrators, private payers, managed care,
HMO/PPO/TPAs, billing services, researchers and health care consultants.
The CrossCoder has two versions: standard
($249) and professional ($999). The CrossCoder Professional
Version provides users with full exporting privileges.
For additional information see the FAQ.
and Local Coverage Determinations (NCD and LCD)
Coverage Determination (NCD): Medicare
coverage is limited to items and services that are reasonable and
necessary for the diagnosis or treatment of an illness or injury
(and within the scope of a Medicare benefit category). The NCDs are
developed by CMS to describe the circumstances for which Medicare
will cover specific services, procedures, or technologies on a
national basis. Medicare Contractors are required to follow NCDs. If
an NCD does not specifically exclude/limit an indication or
circumstance, or if the item or service is not mentioned at all in
an NCD or in a Medicare manual, it is up to the Medicare contractor
to make the coverage decision.
Coverage Determinations (LCD): In
the absence of a national coverage policy, an item or service may be
covered at the discretion of the Medicare Contractors based on a
local coverage determination (LCD)
For Windows PC XP/ 7/8/10