Description
The 2025 ICD-10-CM Professional for Physicians with Guidelines, with our hallmark features and format, makes facing the challenge of accurate diagnosis coding easier. Developed specifically to meet the needs of physicians, the Optum codebook contains the complete ICD-10-CM code set, which is the cornerstone for establishing medical necessity, determining coverage, and ensuring appropriate reimbursement.
Symbols in the tabular section identify codes associated with CMS quality payment program (QPP) measures and CMS hierarchical condition categories (HCC) used in risk adjustment (RA) coding.
Key Features and Benefits:
- NEW – Optum Edge – Icons for April updates. Easily distinguish between April and October new and revised codes with green icons for April and black for October changes.
- NEW – Optum Edge – Expanded Table of Drugs and Chemicals. Expanded to include updated drugs and codes listed with associated intent with icon to easily identify the added drugs.
- NEW – Optum Edge – Icons identifying RxHCCs and ESRD HCCs. Quickly identify the RxHCC and ESRD/PACE ICD-10-CM codes used in risk adjustment coding by Medicare Advantage Plans.
- NEW – Optum Edge – Icons identifying HHS-HCCs. Easily identify the Department of Health and Human Services HHS-HCCs used by commercial insurance companies.
- Optum Edge – Intuitive features and format. Visual alerts, including color-coding and symbols that identify coding notes and instructions, additional character requirements, placeholder X, Medicare Code Edits (MCE), manifestation codes, QPP, HCCs, unspecified codes, and more.
- Product Updates. April and other ICD-10-CM changes and updates will be made available on the Optum Product Update page on Optumcoding.com for our valued ICD-10-CM customers.
- Coding tips and clinical definitions. Coding tips assist in appropriate code selection, while clinical definitions provide a better understanding of complex ICD-10-CM diagnostic terms.
- List of code changes and conversion table. A list of all 2025 new, revised, and deleted codes. Plus an ICD-10-CM conversion table from the new and changed codes to the code previously used.
- Updated index with shaded guides. The updated Index to Diseases and Injuries includes vertical shaded guides that show the indent levels for subentries under main terms.
- Helpful illustrations. Detailed color anatomy illustration appendix. Plus many illustrations at the code level identifying specific code-related anatomy.
- Guidelines with coding examples. Official Guidelines for Coding and Reporting including chapter-specific coding examples.
