Add Professional Codes

Overview

This article will instruct on the basic setup of a professional code.

Add Professional Codes

1. Click on the Codes Module.
2. Click Add.
   • The Add Codes Window will open.
     
      
3. Number:  Enter the CPT or HCPC number.
   • This number must be five characters.
4. Modifier: Enter one to four modifiers
   • When entering modifiers, use caps with a space in between each modifier (AA BB CC DD).
   • They will appear on the claim in the order you enter them here.
   • The modifiers UA and HN can be automated based on payer and do not need to be added here.
5. Name: The name field does NOT travel on the claim; therefore, you should name your codes based on the accepted terminology of your clinical staff. This will help staff in choosing the correct code. If they call a 90791 a DA, or an Assessment, or an Intake then we strongly recommend using the same terminology here.
6. Description:  This field is optional.
7. Click on the Billing tab.
   
8. Allow override of time/units ratio:
   • If you always bill 1 unit regardless or time spent with client, choose Always 1 Unit.
   • If there is a time ratio, choose No- Use fixed time/unit ration above and enter the ratio above:
     • Example: If 1 hour = 1 unit, enter 1 Hours and 0 Minutes per unit
9. Label (optional): Enter a label, such as Always 1 unit or 1 hour - 1 unit.
   • This label will serve as a helpful note to providers (as to the proper ratio) when choosing this code. 
   • It does not affect the calculation of the ratio itself.
10. Claim Type: Select Professional (837P/1500).
11. Billable: Select Yes if this code will be billed to a third party, county, or even a self-pay payer. 
    • A billable code is a code that will be billed to a payer. You can also create non-billable codes to record certain services or track staff time.
12. Group Active: Select Yes if a code can be used for documenting group services.
13. Place of Service: If this code is always billed with the same place of service, you can choose it here from the drop-down.
14. Click Save.

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