Allow Mixed Billable and Non-Billable Codes on Claims
Allow Mixed Billable and Non-Billable Codes on Claims
With the “Allow Mixed Billable and Non-Billable Codes on Claims” group rule enabled, ICANotes users can have both billable and designated non-billable codes in the service code work area of a note, while only including billable service codes in electronic and paper claims. Security Administrators should call Support (443-569-8778) to have this rule enabled for their account.
Group administrators can designate any service code as non-billable in group level Settings and Directories in the Service/Mod codes tab under Service Code Short List by checking the Non-Billable checkbox
In the work areas of a note, add the billable and non-billable service codes from your short list. In this example, the 99212 service code is billable, and the 00000 service code is the designated non-billable code
Now when a claim is prepared for electronic or paper submission in the Billing/Productivity Report, only the billable code(s) will be included, omitting the non-billable from the claim
On the Billing/Productivity Report Search Form, be sure to uncheck the box to exclude non-billable service codes
Prep Claim to Submit (for electronic billing) or Print CMS/HCFA Form for paper billing of either the primary or secondary insurance payer
In the ANSI 837 of the prepped claim, only the billable code (99212) will be included, omitting the non-billable (00000).
Likewise, the CMS 1500 will only carry over the billable code, leaving off the non-billable
Both billable and non-billable codes will push through to Patient Accounts to update the patient’s account balance (this happens when the claim is prepared for submission). You may need to click the icon on the line item for the non-billable code in order to set responsibility to Patient Responsibility
In the top right of the Edit Detail window, select the non-billable service code, then set the responsibility as necessary. Click to save.
Join Tyler as he demonstrates the new group rule Allow Mixed Billable and Non-Billable Codes on Claims.
Video link: https://youtu.be/nT9gqotR1zs
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