The system has added a new FATAL error. This FATAL error will ensure the patient treatment program matches the authorized diagnosis and the primary diagnosis. 

The system has always shown WARNINGS for mismatched diagnosis and program. Going forward, the user will receive a FATAL ERROR in billing if the treatment Program on the patient admit does not match the authorized diagnosis and/or the primary diagnosis. 

• This option is controlled by the setup in the treatment program by checking the Psych or Detox (chemical dependency) boxes on each treatment program.

If a user does not want to take advantage of this option, simply check both boxes.

If one of the boxes is checked, the treatment program on the patients admit is DETOX (for example)

• The authorized diagnosis must also be a DETOX diagnosis.
• The primary diagnosis must be DETOX. 

If any one of these diagnosis codes are mismatched with the Treatment Program, the claim will be FATAL in billing.

The system can enable a feature to not allow the UR staff to leave the AUTHORIZED DIAGNOSIS field if the Program and the UR DIAG are mismatched without correcting the diagnosis or leaving the field blank. If your facility would like this option turned on please contact system support staff.