OpenEMR 5.0.x - Coding & Billing & Routing Slips & Fee Sheets & Superbills

(Al) #1

After some research & reading, I do not understand the setup and production operation of:

  1. CPT and ICD10 coding
  2. Routing slips
  3. Fee sheets
  4. Superbills

I have found documentation on the Wiki for billing / fee sheet / etc. for OpenEMR 3.1 and OpenEMR 4.2. However, the documentation for these previous versions seem to offer superceded and/or inconsistent explanations on how to set-up and use coding / routing slips / fee sheets / superbills in OpenEMR 5.0.x.

I do understand the extreme flexibility and customizable nature of OpenEMR coupled with OpenEMR’s recent evolution into V5.0 probably contributes to this situation.

So…if anybody can point to information that helps clarify the setup & operation of coding / routing slips / fee sheets / superbills it would be much appreciated. Thank you.

(Stephen Waite) #2

hi @OptoIT

  1. install icd10 under admin->other->external data loads and add your cpts under admin->codes. Then you can create a fee sheet in an encounter.
  2. not sure what these are
  3. in encounter choose Admin->fee sheet to open the form, then you can build the fee sheet by selecting from the categories and justify the codes by clicking on the cpt4 link
  4. go to admin->Lists-> Fee sheet to link your codes to categories at the top of the fee sheets, you can print superbills under reports->visits click appointments and then superbills

(R Magauran) #3

When you have built your codes for the Fee sheet by altering the list Administration->Lists->Fee Sheet, they will also appear in the Eye Form Billing Engine.

We do not use superbills or routing slips but instead bill right from the Eye Form. You of course can set up your flows however you like.

The Eye Form “Billing Engine” will let you bill right from the form, including modifiers and justification codes. The billing engine gathers your diagnoses listed in the Imp/Plan area along with their ICD-10 codes. You can also open the fee sheet from there to see what happened but it is not required unless you need to refine.

You can then check the patient out from within the form, add your “orders” for next visit and note your plan for f/u. This is totally customizable through another list (note the pencil icons).

The latest files for 5.0.2 have tighter integration for auto-justification and adding modifiers for add on tests such as OCT/VF. It will tell you if you meet requirements for level 4 billing and if you should add on a “neurosensory code”.

Of course each locality has a different way of doing things - we are getting deep in the weeds here - for example our Medicaid requires OCTs to have a TC and 26 modifier but Medicare just requires a -59, and then a -25 to the E&M code if appropriate. The form doesn’t go into that level of detail however so some coding knowledge is required…

(Al) #4

Mr. Waite & Mr. Magauran,

Thank you for the helpful suggestions.
I am working through this, slowly but surely.
(Legacy applications keep conspiring to block migration to replacement.
Treacherous, self-absorbed legacy apps!)
Will update here as my progress with OpenEMR proceeds.
Thank you!