QDPM - Adding/Editing Procedure Codes
How to Add/Edit Procedure Codes
CPT Codes will be pre-loaded, unless you have chosen not to have them loaded.
Click to [Add] codes or Click on the CPT to Edit - CPT -
- Use a system delivered code OR create your own 'quick code' in the CPT field.
- In our first example the user will key in EM25, the insurance will receive 99214 with a 25 modifier
- CPT Field is INTERNAL USE ONLY. Submit CPT will show on the claim
- Billable
- Yes- this CPT will be submitted to any party
- No- this CPT will not be submitted to any party
- Do not use this option if this code will ever be used as the ONLY code on the claim.
- If a patient payment is received it can not be posted to an encounter with only a non-billiable code on it.
- Pat Only (Patient)- this CPT will be patient responsibility regardless of insurance
- In this example the CPT code is never submitted to insurance
- Modifier field allows the user to 'set it and forget' a commonly used modifier. This can be overridden in charge entry
- POS - Place of Service
- Make sure to add a Fee if a Default Fee Schedule was not loaded (we can load a fee schedule based on a percentage of the Medicare fee schedule)
How Do I add a Fee to a CPT?
You can add the fee for the new code while adding it to the library, it will be added to the default fee schedule that is loaded into that database.
If RVU or several fee schedules are in play you would need to add the fee to those schedules