This is a list of the *stock Charge Validation Rules (CVRs) that ship with the software.
*Custom Charge Validation Rules can be created for you for a small fee. Please reach out to Support if you have a need so that we may assist you.
V4 2017 Eval Code Check
Displays a message to the therapist if they try to bill a 2017+ visit with old eval/re-eval codes.
V4 Add GO GP or GN per CGPL
Adds GO, GP or GN modifiers to CPT codes classified as 'Procedure,' 'Evaluation,' 'Modality,' and FLR codes; if the Carrie Type is Medicare; or when the carrier is in Carrier Group Payer List 'GOGPGN'; and therapist is classified as 'Physical', 'Occupational' or 'Speech.' 4.2.125+
V4 Automatic 59 Modifier - By CCI Edit List
Add 59 Modifier to second CPT according to the "MC" CCI Edit List
V4 CCI Edits
Standard CCIEdit Validation
V4 EStim Switch - Medicare and CGPL
97014 will be converted to G0283 for Medicare carrier type and for any carrier groups in CGPL 'GCODE'
G0283 will be converted to 97014 for all other situations
V4 Group Therapy
Alerts therapist if more than one unit of Group Therapy (97150) is charged.
V4 High Units Check
Displays an info message to the therapist if greater than 5 units are charged for any CPT alerting them that they may need to make corrections.
V4 KX Modifier
Add KX modifier to CPTs classified 'Procedure', 'Modality' or 'Evaluation' when visit date is on or after KXDate for Medicare. The KX date is set in the case in Auxillary Information.
V4 Missing dx
Alerts the therapist if any CPT is missing a dx.
V4 No Policy Present
Displays message to therapist letting them know the patient's policy is missing, and the patient does not have a Self Pay account type. NOTE: therapists using the flowsheet will be unable to post charges until charges pass validation.