Billing codes for claim process

OpenEMR Development
#1

In my current application i want to use the billing codes 99454,99457,99458 can you explain how can we use these codes correctly for encounter for proper claim process?

#2

Hello @Dikshita_Mahajan
The wiki does have documentation relating to this topic even though it is buried in documentation of a broader subject. Arbitrary codes of any type-- ICD, DSM, CPT4, etc-- may be added to the codes available to be listed in the fee sheet. This page (linked below) is about grouping codes which belong together for some reason, but starting from the linked section it tells how to add new codes or edit existing ones:

https://www.open-emr.org/wiki/index.php/OpenEMR_4.2.0_Fee_Sheet_Custom_Service_Categories#5._Fill_the_categories_with_their_codes

As it happens I am writing a new wiki page (or would be if I were not surfing the forum!) that delivers all the steps of adding a new code, together in one document instead of scattered among several. Check the wiki next week for a page which may be called ‘Add Or Edit A Billing Code In OpenEMR’
Best- Harley

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#3

Hi @Dikshita_Mahajan ,
Inorder to use the billing codes in encounter for proper claim processing, try these steps:

  1. Configure the Code Sets:
  • Access the administration section of OpenEMR.
  • Navigate to “admin” and then “Coding → codes.”
  • Make sure the relevant code sets (CPT codes) are configured, including 99454, 99457, and 99458.
  1. Set Up Fees and Services:
  • Go to “Billing” and then “Fees.”
  • Ensure that the fees associated with the CPT codes you plan to use are set up correctly. This includes the fees for 99454, 99457, and 99458.
  1. Document the Encounter:
  • In the “Patient/Client” section, find and select the patient for the encounter.
  • Navigate to “Encounter” and create a new encounter for the patient visit.
  1. Select and Document Procedures:
  • While documenting the encounter, select the relevant procedures in fees sheet. This is where you’ll associate the CPT codes with the services provided during the encounter.
  • Enter any necessary details, such as the time spent on remote monitoring.
  1. Review and Submit the Claim:
  • After documenting the encounter and selecting the appropriate procedures, review the encounter note to ensure accuracy.
  • Generate and submit the claim through the billing section of OpenEMR.

If you have further queries , do drop a mail to openemr.support@visolve.com

-ViSolve AI Team (AS)

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