Healthcare Data & File Services

YEI provides medical coding and claims processing data with ongoing updates. We continually monitor all data sources so that you don't have to, and we accuracy-check every line of data before it reaches you. ata is provided with a one year subscription so that you receive all updates and changes throughout your subscription year.

Why YEI Data and Libraries?

Yost Engineering is a leading provider of data services and back-end processing services for healthcare clients of every si!e. In addition to our competitive pricing and rigorous "uality controls, we are fully dedicated to serving the needs of our clients, knowing that our success depends on their success. We provide expertise and assistance for all the data that we provide, and help clients through all phases of data usage, including:

implementation of data sets interpretation and appropriate use of data content programming and database logic workarounds for legacy systems content changes during migration and upgrades

Formats and Content

#ur data is generated and published in standard flat-file delimited and $%& formats, compatible with any commercial database system. 'ustom (&), $*+, and other proprietary formats are also available to meet your uni"ue re"uirements. ,ile format changes, as needed, are also provided at no additional charge to our clients. ata files can be provided in ready-to-use reference file formats, or in files to be used to import the data into third party systems or databases. 'ommonly re"uested content and data elements are listed in the form below, and standard formats can be directly ordered via the #rder link below for use within a single physical site. ,or multi-site use or for deployment to third parties and clients, contact us at support-YostEngineering.com or ...-/01-02+0 for a redistribution license. 3ll data elements and components can be mi4ed and matched to support your specific needs, and additional filtering to include or e4clude certain types of data is also available as part of our service. ata ,iles for medical necessity are compatible with /rd party systems, such as '56I, Epic 6ystems, ,letcher-,lora 7,,le4 e6uite, &ab5ak8, Iatrics 7%9#, &3: e-&aborate8, %edi;ech, and other vendors. ;hey are also available in custom formats for homegrown systems, for claims scrubbing systems, and for historical purposes.

Available Content Areas Include:

%edical 9ecessity &ibraries 7%edicare, 5rivate 5ayer, and 'ustom8 'oding ,iles 7including '5;, ('5'6, I' , ental, 9 ', modifiers, 5<=I, 5#6, :E;#68 ,acility 'oding 735', =>, =evenue 'odes, % ', '5; to 35' crosswalks, =>% '-I' crosswalk8 %edicare ,ee 6chedules 75hysician, =:=?6, &aboratory, 5E9, E%, ambulance, ambulatory surgery, 5art : drugs, anesthesia8 'ustom ,ee 6chedules 'orrect 'oding 7''I, 9''I@#'E, %AE8 Bip 'odes 7A6, 'anada8

Delivery and Updates

#ur standard data delivery service is via a secure website that clients can log into and download their latest files. Email notices are provided to alert you to updated files when they are posted. ,or licensed distributors, data may also be dropped or loaded directly into a third-party system via ,;5 or secure login, ac"uired via web-based "uery service, ;'5@I5 "uery service, or accessed through components embedded within other software. Apdates are made on an ongoing basis, with data posted as fre"uently as daily, depending on how fre"uently %edicare and other content sources are making changes.

updated data made available on a daily 7%onday through ,riday8 basis ready-to-use formats to copy to your system ready-to-load formats that you upload or import into your system files that you redistribute or push to your clients files that we redistribute or push to your clients for you

6ubscriptions are available for facility and in-house use, as well as for redistribution to clients and use within claims processing systems.

Web !ased "#ery and !atch Services

In addition to files, we also offer web-based "uery systems, so that clients can completely avoid data maintenance issues. Web-based services can be custom-developed, or put together on a mi4and-match basis using popular components such as theseC

custom web interfaces and utilities, hosted by us or through your servers

3ctive$ components for easy integration of coding tools and reference data 3D3$-based client web service 7for a desktop application look and feel8 ;'5@I5-based "uery service ata validation services 7batch and transaction modes8 ,ull claims scrubbing systems 7batch and transaction modes8

3ll solutions can be branded according to your specifications, and seamlessly integrated into your e4isting services.

"#ality Data
In order to maintain accurate and continually updated records for the entire Anited 6tates and territories, we monitor an e4tensive list of primary sources. ata is compiled and validated from these primary sources, and e4tensively audited, using both certified coders and proprietary artificial intelligence systems. #ur automated and manual auditing systems consistently correct errors from the original data, and we work with the source organi!ations in verifying and correcting their incorrect or inconsistent data. 3ll data and systems are maintained in-house by our employees, and no work is outsourced. #ur compulsive attention to "uality control and data accuracy is documented by audited results that includeC

00.00EF accuracy rate 3verage of only ** error corrections per year for the past / years ata updated 3I&Y #ver +.. million uni"ue medical necessity linkages across over eight thousand '5; and ('5'6 codes. ;he most comprehensive, detailed, and documented data in the entire industry.

%EDIC$L %ECESSI&Y DIC&I'%$(IES) &$!LES $%D D$&$!$SES 5rocedure@ iagnosis matching ate specific coverage at policy and diagnosis level &inks directly to the policy 9on-coverage rules 3ll 12 states plus territories %edicare &' s - ,iscal Intermediaries 7,Is, 5art 3, (ospitals8 5olicy names 5olicy numbers &imited coverage rules 5ermissive edits %edicare 9' s 7'%68 %edicare %E

%edicare &' s - 'arriers 75art :, physicians8 5rivate 5ayers 3etna 'are,irst E4cellus 5remera Wellmark

%edicaid 3nthem 'I>93 =egence Wellpoint 'all to check on other payers :lue 'ross@:lue 6hield Empire Anited (ealthcare

(ighmark (ori!on

ICD * C'DE FILES $%D D$&$!$SES I' -0 diagnosis codes and descriptions 6hort, medium, long descriptors I' -0 procedure codes and descriptions I' -0 guidelines I' -0 hierarchy Geyword inde4 C+& $%D HC+CS C'DE FILES $%D D$&$!$SES '5; and ('5'6 procedure codes 6hort, medium, long descriptors '5; (ierarchy Geyword inde4 5<=I codes 75hysician <uality =eporting Initiative8 +H$(,$CEU&IC$L C'DES 9 ' 79ational rug 'odes8 numbers osages, forms, packaging 3ctive ingredients %anufacturer name, address =$ 7prescription only8 designation $%CILL$(Y C'DES '5; %odifiers ('5'6 %odifiers 5lace of 6ervice 'odes 5hysical 6tatus 'odes US$-E W$(%I%-S $%D -UIDELI%ES ,re"uency restrictions 3ge restrictions %aternity designations 6ituational coverage >ender restrictions 3dd-on code designations rug names 3dministration route , 3 approval numbers %anufacturer product codes #;' 7over the counter8 designation 5rocedure descriptions '5; >uidelines ('5'6 (ierarchy 6earch tools 6earch tools

Inpatient-only restrictions 5rimary code designation 'onscious @ moderate sedation designation C'((EC& C'DI%- I%F'(,$&I'%

;runcated code designations 6econdary code designation

''I 7'orrect 'oding Initiative8 9''I 79ational 'orrect 'oding8 #'E 7#utpatient 'ode Editor8 9on-reportable codes %utually e4clusive codes %odifier over-rides (EI,!U(SE,E%& $%D +$Y,E%& D$&$ =evenue 'odes =>-% '-I' -0 crosswalks 35' categories 73mbulatory 5ayment 'lassifications8 >lobal 6urgery ays :ilateral 6urgery 3llowed 'o-6urgeons 3llowed E6= file sets A:-2I formats and instructions 7also A:-0+8 A:-2I billing manual content 7also A:-0+8 '%6-*122 formats and instructions 7also (',3*1228 '%6-*122 billing manual content 7also (',3-*1228 CL$I, +('CESSI%- D$&$ 'laim 3dHustment =eason 'odes 7'3='8 ;a4onomy codes =emittance 3dvice =emark 'odes 7=3='8 'laim status codes FEE C$LCUL$&I'% D$&$ =?As 7=elative ?alue Anits8 5re, Intra, and 5ost-#p allowances and percentages 5E9 75arenteral and Enteral 9utrition8 supply fee schedule 5hysician fee schedule 7=:=?68 'linical &aboratory fee schedule %E@ %E='@ %E5#6 fee schedule => 7 iagnostic =elated >roups8 % ' 7%aHor iagnostic 'ategories8 'omponents

#556 data 7#utpatient 5rospective 5ayment 6ystem8 5rimary I' -0 based =>@% ' grouper %edicare 6tatus 'odes %ultiple 5rocedure 5ayment 3ssistant at 6urgery 3llowed ;eam 6urgery 3llowed %edicare %anuals A:-2I help files 7also A:-0+8 A:-2I help utilities 7also A:-0+8 '%6-*122 help files 7also (',3-*1228 '%6-*122 help utilities 7also (',3*1228

3mbulance fee schedule 3nesthesia fee schedule and base units 'ustom fee schedules .I+ C'DE /E(IFIC$&I'% A6 !ip code validation 'ity and state verification Bip code statistical J demographic data CUS&', D$&$ SE(/ICES 'ustom dataset compilations

3mbulatory 6urgery fee schedule 5art : rug fee schedule

'anadian !ip code validation Bip code look-up utilities

ata conversions

%anagement and maintenance of proprietary data &egacy system interfaces and crosswalks