In this article, we will break down the Validations section found within the General Information tab. You can follow the article or jump to the section needed below.
For information on other sections within the General Information Module, you can simply click on the section you wish to explore: [General Information: Billing] [General Information: Case] [General Information: General] [General Information: Schedule] [General Information: Users/Therapists]
Jump to Section [Carrier Group Payer List] [CCI Edits] [LCDs]
Carrier Group Payer List
This list is used with Charge Validation. For more information on Charge Validation please see the Charge Validation chapter.
Right-clicking on the grid provides the following options:
Carrier Group Payer List Menu
|
Add Records |
Adds a record to the current list. |
|
Add New List |
Creates a new list and displays a list of carrier groups from which to choose. Ctrl+click each group you would like added to the list. |
|
Delete Record |
Deletes the currently selected record. |
|
Delete List |
Deletes the entire list. |
CCI Edits
The CCI Edits are used with Charge Validation. For complete information on CCI Edits see the Charge Validation chapter.
The CCI Edits table contains the following columns:
CCI Edits table
|
List Name |
Name of the CCI Edits list. |
|
Col 1 Code |
First CPT Code of the set. |
|
Code 2 Code |
Second CPT Code of the set. If a 59 modifier is to be added, it will be added to the Column 2 code. |
|
Policy Statement |
The message that is presented when the pair are matched in a charge set. |
|
Mod 59 |
Indicates if a 59 modifier satisfies the rule. |
Right-clicking on the grid presents the following menu:
CCI Edits Menu
|
Add |
Adds a CCI Edit to the grid. |
|
Delete Entry |
Deletes the currently selected CCI Edit. |
|
Delete List |
Deletes the currently selected list. |
|
Clone List |
Allows you to take a list and create a new list with a new name. You could then add to or remove entries from this list. |
You can import a CCI Edit file. The file needs to be a tab-delimited file in the following format:
<ListName> <Col 1 Code> <Col 2 Code> <0> <Policy Statement> <IsMod59>
The <0> field is currently unused but needs to be in there for possible use in the future.
LCDs
LCD Lists are used in Charge Validation. For complete information on how the LCDs are used see the chapter on Charge Validation.
The grid has been grouped by list Name. In the above example, you can see the Medicare List (MC) with 104,487 records. The grid contains three other lists: MyList1, MyList2, and MyList3.
MyList2, and MyList3 both contain wild cards represented by an asterisk (*). This means the 97555 matches ALL ICDs and 555.55 matches ALL CPTs.
Right-clicking displays the following options:
LCD Menu
|
Add |
Allows you to add a new record. |
|
Edit |
Allows you to edit the currently-selected record. |
|
Delete |
Deletes the currently-selected record. |
|
Delete List |
Deletes the entire list the currently-selected record is associated with. |
The LCD file needs to be a tab-delimited text file in the following format:
<ListName> <CPT> <ICD>