Procedure Code Groups

athenaCollector

This page allows you to add, update, and delete procedure code groups in your organization. Procedure code groups allow you to aggregate information pertaining to a group of procedures (for example, OB services, ultrasounds, surgeries, etc.). Procedure code groups are used for reporting purposes and for tracking the revenue generated from established office visits, new office visits, and minor and major surgery codes.

 

On the Main Menu, click Settings > Billing. In the left menu, under Practice Links — Fee and Allowable Schedules, click Procedure Code Groups

 

 

 

  1. Display the Procedure Code Groups page: On the Main Menu, click Settings > Billing. In the left menu, under Practice Links — Fee and Allowable Schedules, click Procedure Code Groups.
  2. Click Add new.
  3. Enter the name for the new procedure code group in the Name field.
  4. Click Save.
    The new procedure code group appears in the list below.
  5. To assign a procedure code to a procedure code group, use the Procedure Fees page. You can access the Procedure Fees page using the edit procedure fees link located on the Fee Schedules page.

 

  1. Display the Procedure Code Groups page: On the Main Menu, click Settings > Billing. In the left menu, under Practice Links — Fee and Allowable Schedules, click Procedure Code Groups.
  2. Locate the procedure code group in the list.
  3. Click the edit link. The procedure code group name appears in the Name field at the top of the page.
  4. Update the name as needed.
  5. Click Save.

 

  1. Display the Procedure Code Groups page: On the Main Menu, click Settings > Billing. In the left menu, under Practice Links — Fee and Allowable Schedules, click Procedure Code Groups.
  2. Locate the procedure code group in the list.
  3. Click the delete link. The procedure code group is deleted from the list.

You can restore the procedure code group by clicking the undelete link immediately after you delete it. Also, you can click Show deleted on the Procedure Code Groups page to display the group that you deleted and then click the undelete link to restore it.

  

 

 

 

If you use procedure code modifiers to sort procedure codes into procedure code groups, you must configure the procedure code modifiers as fee-affecting on the Procedure Code Modifiers page; athenaOne recognizes a procedure code-modifier combination only if the modifier is set to Fee affecting = Yes).

 

For example, if CPT code 99213,25 is assigned to procedure code group A and CPT code 99213,59 is assigned to procedure code group B:

  • Modifier 25 and modifier 59 must be configured as fee-affecting on the Procedure Code Modifiers page.
  • Each procedure code-modifier combination must be entered in the fee schedule for the correct procedure code group.

Note: If you update a fee schedule after claim creation, an incorrect procedure code group is not retroactively corrected in the claim or in the Transaction Activity and Transaction Aging reports that you can run using the Report Builder.

 

 

 

 

 

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