Developer’s kit for flexible, rapid application enhancement
The move toward clean claims and comprehensive electronic medical records (EMR) is a demanding a shift in thinking about automation and workflow.

But translating a world of clinical knowledge—diagnoses and procedures from patient encounters—into alphanumeric codes requires a world of knowledge of its own.

Alpha II is the expert source for coding, claims and revenue management technologies and a valued partner for dozens of practice management, EMR, hospital information management, and other healthcare information system vendors.

With CodeWizard, our software developer’s toolkit, Alpha II partners have a quicker way to provide the industry-leading revenue cycle improvement functionality their clients are requesting. The CodeWizard content database and rules engine draw on the work of countless software engineers, EDI specialists, certified medical coders, compliance consultants, medical managers, and other healthcare business experts. Well over 100,000 man-hours in the making, it helps you avoid development and focus immediately on rapidly enhancing your own applications.

We work closely with some of the biggest names in healthcare IT. Smaller, specialized developers rely on CodeWizard as well. Because no two clients’ needs are alike, we consult with our developer partners to guide them and ensure they meet their objectives.

CodeWizard functions
CodeWizard is the developer’s toolkit around which all Alpha II solutions have been built. Here are some examples of what CodeWizard can do for you:

• For practice management (charge entry, back office, and EMR–practice management bridge)
• ICD-9, CPT® and HCPCS code search
• ICD-9 ultimate specificity edits
• Prompts for additional code usage
• ICD-9, E-codes, and other diagnosis code edits
• Clinical medical necessity edits
• LCD/NCD coverage edits
• ICD-9 list for supporting CPT
• E&M under-coding and over-coding edits
• Modifier list applicable to each CPT
• ICD-9 and CPT descriptions
• CCI bundling/unbundling edits
• Claim level technical edits
• Modifier usage correction and recommendations
• RVU sequencing
• CPT data in support of coding or billing decisions such as:
• RVU
• Global fee period
• Multiple procedure adjustments
• Anesthesia cross walk
• Professional or technical component
  

• For electronic medical record
• Clinical ICD-9, CPT  and HCPCS code search
• E&M generation:
• Accurate history, exam, medical decision-making determinations
• E&M under-coding and over-coding edits
• ABN generation:
• LCD/NCD coverage determination
• Clinical medical necessity determination
• Compliant forms

• Fee analysis and determination
• Use of RVU and conversion factors
  

• Scheduling (radiology and pathology)
• ABN generation:
• LCD/NCD coverage determination
• Clinical medical necessity determination
• Compliant forms

CodeWizard features
CodeWizard gives developers options. Whether “plug and play” integration or full application customization, our expert staff guides partners through the complexities.

A better clinical medical necessity data base
The Alpha II proprietary database goes beyond LCD/NCD coverage data to add clinical medical necessity guidance for virtually all possible ICD-9/CPT combinations. Our content database, refined over the course of more than 20 years, yields a depth of edits no other coding software provider can match.

Clinically-oriented code search
A pioneer in the field, Alpha II is notable for its database design, which enables clinically-oriented code searches. Users can look up codes based on official condition name, common name, acronym or site.

Sophisticated E&M generation
CodeWizard includes proprietary tools for E&M generation help providers avoid under-coding and prevent over-coding. Given the risks of over-coding, organizations tend to under-code as a precaution. CodeWizard offers the intelligence to calculate medical complexity, providing an accurate basis for the often subjective medical decision-making component of E&M billing.

 

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