tsvas wrote on Friday, March 16, 2012:
One of our insurance company says we should send “CHCUP Referral Code” (AV, NU, S2, ST) for well visits, and they should be in box 24H.
In OpenEMR Fee Sheet, we entered in “Note Codes” column and sent them. They were sayng that they didn’t receive them.
is “Note Codes” is right place to enter chcup referral codes? Or, we need to configure some thing else?…?
tsvas wrote on Monday, March 19, 2012:
Billing Manager coding experts… appreciate any help on this.
ajperezcrespo wrote on Monday, March 19, 2012:
Take a look in the encounter tabs (under administrative) at Misc Billing Options for HCFA-1500.
Additional Notes.
If memory serves right that is what your looking for.
Note Codes on the Fee Sheet are used for additional notes for specific codes (ie Biopsy and other stuff).
Alfonso
ajperezcrespo wrote on Monday, March 19, 2012:
Maybe not…I just took a peek at the gen_hcfa_1500.inc.php file and see
// 24h. EPSDT Family Plan
// Not currently supported.
You may need a developer to do this for you.
Sorry.
tsvas wrote on Monday, March 19, 2012:
Thanks Alfonso. Right now we are not using “Note Codes”. As a temporary solution, can we use Note Codes to send CHCUP referral code with the following changes?
1. Comment the line #456
2. Insert a new line after “// 24h. EPSDT Family Plan” as
put_hcfa($lino, 63, 2, $claim->cptNotecodes($hcfa_proc_index));
sunsetsystems wrote on Tuesday, March 20, 2012:
In the case of electronic claims (most of us will use those):
Looking at the 5010 837p spec, it appears EPSDT can be indicated at the claim level (CRC segment) or the procedure line level (SV1 segment). However the spec says the Review Code itself is not used at the procedure level, only the claim level, so I’m not sure exactly how this works; sounds like both are required.
Electronic claims are a whole different ball of wax from paper claims, and it’s not very helpful for a payer to explain in terms of “box 24h” when the topic is electronic claims. You need to ask them exactly what segments and fields they are expecting for this in electronic claims.
I suspect the most reasonable way to implement this is to add fields for it in the “Misc Billing Options” form (claim level) and then have the claim generation logic figure out which CPT code is applicable. But again, need more detailed info from the payer.
tsvas wrote on Tuesday, March 20, 2012:
Thanks Rod. I am waiting for the call from claims specialist. I will update you as soon as I hear from them.