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Procedure Problem

Bugs, Known Issues, Open Cases

Last Post by Anonymous 1 second ago

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asears

(@asears)

Posts: 49

Trusted Member

Topic starter

Hello,

We are on CPS 12.0.11 and we are having problems with random tickets failing due to a procedure code error. The error states:

"Procedure (99213) was not within the effective date range during the date of service of the procedure."

There are no effective or expiration dates set on the procedures that are failing. The specialties are all checked off appropriately. This is happening with our common E&M codes, xray codes, and a few others. It appears to have no commonality of provider, facility, or insurance carrier.

We've tried a dummy visit with a date of service 12/31/2015 and there was no problem. However if we changed the visit to 1/6/2016, the procedure code can't be found in the search when trying to add 99213 to the charges tab. The only time we can get the procedure code after 1/1/2016 is if we use the white doctor bag. There are also a few charges after the 1/1/2016 date of service that did go through and include some of the procedure codes that are in our Approve Failed list.

Has anyone experienced this or know how we can fix this?

Thanks!

Posted : January 8, 2016 6:52 am

jfitzmd

(@jfitzmd)

Posts: 419

Reputable Member

Check the expiration date of the CPT code.

Posted : January 8, 2016 7:00 am

asears

(@asears)

Posts: 49

Trusted Member

Topic starter

We have no expiration date on these CPT codes.

Posted : January 8, 2016 7:04 am

tgibs

(@tgibs)

Posts: 3

New Member

My only thought would be to look to see if there is an expiration date set on the fee schedule tab of the procedure. Not the information tab of the procedure, but the fee schedule tab.

Posted : January 8, 2016 7:10 am

asears

(@asears)

Posts: 49

Trusted Member

Topic starter

That was it! For random insurance fee schedules there's an expiration date of 12/31/2015 for some reason. We'll have to go through and remove them. Thank you!!

Posted : January 8, 2016 7:20 am

tgibs

(@tgibs)

Posts: 3

New Member

You're welcome!

Posted : January 8, 2016 8:03 am

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