To add one or more links
Once all intent of service and coding issues have been addressed on a charge, you may want to find associated missing services or items for those charges, on the Linked tab:
- Right-click on a charge item
and select Linkfrom the pop up menu,
(or press Ctrl + L). The Link to CPT® Code
dialog box displays. This shows a list of missing charges that are related
to the current charge item.
If the list is empty and the Description box contains the message: "All links are already in the hospital file" then this means that the suggested links have already been added to the Hospital file. In this case, click OK to move the charge from the Linked tab to the Valid tab.
- Highlight
each suggested CPT® code in turn to view its description. The
can be selected to display more information. - Accept each suitable code by placing a check in the box against its name. (Do this only for suggested codes that are always performed in conjunction with the current charge item.
- Click on the OK button.
The software creates a new charge item for each added link, reviews it, then places it on the appropriate tab. The original charge item is also reviewed and moved off the Linked tab.
To remove the charge item from the linked tab select Include from the right-click popup menu.
It is possible to reprocess charge items that have been included from the linked tab by selecting Tools > Reprocess Included Charge Items from the menu.
See AlsoTo include
After carefully reviewing all the issues identified for a line charge, you may decide that the issues does not apply to this line charge, or you may wish to enter values other than the suggested or default values. In this case, you would perform an override, known in the software as an Include.
When a record is included (overridden) it moves to the Valid tab unless there are other issues that also need to be considered. If there are other issues for additional consideration, then the charge will move to the appropriate tab for review.
- To override an issue or value
suggested by the software
- Right-click on the charge item and select Include from the drop down menu (or press Ctrl + I)
- If enabled by your Supervisor, the Include Mandate dialog box appears. This lets you record the reasons for including this charge item. Add notes explaining why you think this item is valid, then click OK. Your notes are added to the charge item as a memo.
Once Included, the charge will only be returned to an issue tab from the valid tab if new logic has been applied that relates to any field on that charge. In other words, it goes from Valid to a newly suspended charge. However, you can reverse your Include decisions using the Reprocess Included Records feature.
- Example
Surgical components of interventional radiology services appear on the Revenue code tab because the charges are using Revenue code 940. Most payers do not allow the use of that Revenue code on such charges. Your local Medicaid FI (fiscal intermediary) specifically requires the use of Revenue code 940. So, although the Revenue code your facility is using is not that generally approved by most payers, in certain circumstances and for your facility's purposes, it is considered correct. You would, therefore, not change or modify the Revenue codes on those charges. Instead, you would "Include" those charges in your valid file without modifying them. You have chosen to "over-ride" the identified issue of a Revenue code mismatch because it does not apply in this situation.
To deactivate
The deactivated tab holds all charges that have been flagged as deactivated, either at the time of templating the CDM file, or by a user during the review.
Only two actions are allowed on deactivated Charges:
- Adding
a Memo
Click on the "Add Memo" icon or press "Ctrl + M". Memos added to charges under the Deactivated Tab generally state why a charge has been suggested for deactivation or to question whether the hospital truly doesn't provide the service.
- Reactivating
the Charge
You can reactivate a deactivated charge by right-clicking on it and selecting Reactivate from the popup menu. Reactivated charge are sent back to their original working tabs. For example: if a Service Charge was sent to the Deactivated Tab from the Invalid Tab, and you then reactivate it, it will be sent back to the Invalid Tab.
Reactivated Charges must be treated as new Service Charge to be reviewed. You must review each area or subcategory of the charge, correcting or modifying any identified problems.
The deactivate function is used to isolate and flag charges that the hospital no longer wants to be available for billing or statistical purposes. Any line charge or service code, regardless of what tab it is displayed on, can be flagged for deactivation.
All deactivated charges appear on the Deactivated tab.
An active charge may be flagged for deactivation in two ways:
- Right-click on the charge
item you wish to deactivate and select Deactivate from the Popup
menu
- Select the charge item you wish to deactivate and press Ctrl+D.
A hospital can choose to have all of their historical deactivated charges automatically dumped into the Deactivated tab if they have a deactivated flag of some sort to isolate such charges. This flag is typically a separate column with a value, such as A or D, that means that the charge is not an active charge. The hospital must inform the sales support staff if they wish to have deactivated charges handled automatically.
If the flag is a date then you will be asked to input a date when deactivating charge items. This value will be recorded in the column of the charge item.