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Best way to capture Dx/CPT in billing after the fact?

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Last Post by lkeith 6 years ago

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ranthony

(@ranthony)

Posts: 4

Active Member

Topic starter

First off, the scenario: Patient comes in for a well child check (with labs), provider codes document, signs it, and sends it to billing. A week later, the lab results come back and the provider does a Chart Maintenance to update the problem list and add that the patient is Vitamin D Deficient and signs the update.

Now the problems I'm having with this are:
1) The Dx is in EMR only
2) Visit has already been coded and billed
3) We do not bill labs
4) We can't attach the Dx to another code because it would double the UDS count (for table 5) since it's a second HCPC-Med charge.

Are any of y'all running into this? How have y'all solved it? Any suggestions?

[edit] Sorry, I forgot to mention the whole point of this is to get the Dx (and CPTs) that happen "After the fact", that is after the document is coded and signed, counted for UDS Table 6a.

Posted : February 12, 2019 8:05 am

SLHV

(@slhv)

Posts: 478

Honorable Member

I'm not a billing expert at all. I'm on the IT side of the house, so pardon me if this is not a good question.

We use CPS. I'm guessing you are CPM+CEMR. Why does it matter if the Dx is "in the EMR only?" If you billed the visit already you must have already provided the Dx codes to justify the charges. Why bother with adding more Dx codes on the billing side?

Do you bill for the lab results review? It seems to me that would be a different encounter.

-dp

Edit: Clarified a point

Posted : February 12, 2019 8:20 am

ranthony

(@ranthony)

Posts: 4

Active Member

Topic starter

Yeah, we're using both CPM+CEMR. We're needing to get the Dx/CPT across to billing because the UDS Reporting software (both written by Visualutions) looks there in order to pull Dx/CPT for UDS Table 6a.

I am able to pull this data (somewhat) out of CPS12 using inquiry reports, but it wouldn't be ideal because I'd have run one for every single code and diagnosis and then compile all the data. If I can get it (dx/cpt) over to the billing side (attached to a billable code) then Visualutions will count it properly.

Posted : February 12, 2019 8:27 am

SLHV

(@slhv)

Posts: 478

Honorable Member

Gotcha. We don't use Visualutions, so I don't have any suggestions.

Yeah the way Centricity tracks various compliance reporting data seems a mess to me. Behind the scenes undocumented workflows that are very easy to mess up result in hidden codes being attached to encounters for various reporting. I know SNOMED codes are used for certain peg counters with GE's MU reporting package. Fortunately I have not had to do much with it.

-dp

Posted : February 12, 2019 8:59 am

lkeith

(@lkeith)

Posts: 457

Honorable Member

As I have always understood it, at the time of billing the charges, the provider uses the proper dx at that time to support the tests that were performed. A week later, after the result came back, is when he finds out that the patient had a vitamin deficiency. When the patient returns, then it would be appropriate to use the dx of vitamin deficiency because the provider knows that is now the case. I would think the reporting would be correct based on proper coding at the time of billing.

-lk

Posted : February 13, 2019 8:11 am

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