I am trying print paper CMS-1500 claims with individual units of a procedure code on their own lines with appropriate justifications. I have been able to print multiple units with multiple ICD9 codes on one line. We have issues with various automobile-medical insurance companies rejecting physical therapy codes when they are combined into one line. When we break them into their individual lines, the rejections stop.
Does anyone have a tip on how I can print 1 unit per line?
Thank you for the quick response. Yes, I have tried that. But when it is actually printed, it combines the multiple units into one row with only one justification code. As an example: code 97035-59 is administered to 2 different areas of the patient and referenced with 726.32 and 844.9 ICD9 codes. I make 2 separate entries for the 97035-59 in the Fee Sheet as you described, with the default “1” unit and each with the corresponding justification code. I then go to Billing to print the CMS-1500 in PDF format. The result is one line for a 97035-59, justified with code 726.32 only, and at 2-units quantity.
I’m sure it is performing as intended, but I need to have it break-out the unit quantities to separate rows.
I totally forgot about this enhancement which prevents duplicate CPT & more than one ICD.
Try this. We use multiple ICD9 codes per charge, but I don’t remember the exact code changes we used in the office. Will post that info after getting back to the office.
Thanks fsgl. I forgot to mention that I am on 4.2. Don’t know if that makes a difference with what I am trying to achieve.
There doesn’t seem to any problem justifying multiple ICD9 codes to one charge. The problem I am having is trying to list the same charge on a separate line with a different ICD9 code.
We are coming from a Medisoft system and are printing all the CMS-1500 claims. Historically, when we have combined all units of a single CPT code and justified with various ICD9 codes, certain insurance carriers would reject 1 or more units of that charge. This seems to happen only with automobile-medical carriers. I don’t recall any rejections from a major medical carrier for printing claims in this way. To fix the rejections we break apart the individual units which would normally be combined into one line.
Attached is an example of how Medisoft prints for us.
The enhancement I mentioned in the previous post is not relevant to your situation. Sorry for the confusion.
The lumping of identical CPT codes into 1 line & totalling all units together are not addressed in openemr/library/gen_hcfa_1500.inc.php & it’s not obvious where in openemr/interface/forms/fee_sheet/new.php.
There is no easy way to have individual lines of the same CPT code without changing the codes. Would suggest that you contact a Certified Contributor.