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CPT Procedural Codes


MANAGING YOUR PROCEDURAL CODES (CPT):

I) SET UP/ Procedure Codes (CPT Codes)

a) From the Top Navigational Menu, select ‘Set Up’, then ‘Procedure’.

b) Select ‘Add’ to open a blank ‘Edit New Procedure Code’ form.

c) Code: Enter the actual CPT code number.

d) Modifiers Defaults: If this Procedure Code must always be billed with a modifier, enter the modifier code(s) in these fields. (refer to section ‘J) SET UP/ Modifiers’ for entering Modifier codes).

e) S-Cut: Enter a shortcut/nickname for this code. This feature is especially useful when duplicate codes are created – each with their own fees for different insurers. (Note: the shortcut does not appear on the claim; only the CPT code it represents will appear).

For example:
CPT 99204 = $125 | m99204 (Medicare) = $65 | b99204 (Blue Cross) = $95

Note: You can add up to 5 digits (alpha or numeric) in front of the Procedure Code to create a shortcut. In the future, when creating your claim charges, you’ll only have to type the shortcut in the Procedure Code field.

f) Description: Enter the Procedure Code’s description.

g) Type: Enter the Procedure Code type (Office Visits, X-ray, etc.)

h) Unit(s): Enter the number of units for this code (usually 1 unit).

i) $ Per Unit: Click the box to the left, and then enter the total amount to be charged per unit for this Procedure Code.

j) Do not bill insurance (Patient Only): Click the box in front of these words so that this code is charged to the patient only.

k) Add Sales Tax: Click the box in front of these words and enter the percentage amount to be added as tax when billing this charge.


CONT . . .

II. PROGRAM SETUP ...................3-18
4).   COMPANY INFORMATION
5).   PATIENT ACCOUNT NUMBERS (PAN)
6).   DATES VALIDATION
7).   DIAGNOSIS SITES FIELDS
8).   NPI FORMATTING

9).   CALIBRATING YOUR PRINTER
10). SECURITY 
11). PROVIDERS
12). FACILITY
13). INSURANCES
14). ICD-9 DIAGNOSIS CODES
15). CPT PROCEDURE CODES
16). MODIFIERS
17). CLEARINGHOUSE
18). REFERRING PHYSICIANS



 

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Entering Modifiers
 

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