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Patient Condition

Patient Condition

 

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CMS-1500 Reference Manual

 

Everything on this tab is laid out to resemble the CMS-1500 form.

 

 

The first three items on this screen ask you to indicate the reason the patient is being treated by asking whether the patient's condition is related to employment, auto accident, or another accident.

 

Related To Employment? [Box 10a]

If the patient's condition is related to his or her employment, place a check in the Yes box. Placing a check in one box removes it from the other. Clicking on a box that is already checked will remove the checks from both boxes.

 

Related To Auto Accident? [Box 10b]

If the patient's condition is related to an automobile accident, place a check in the Yes box and enter the state code for the state where the accident occurred. Placing a check in one box removes it from the other. Clicking on a box that is already checked will remove the checks from both boxes.

 

Related To Other Accident? [Box 10c]

If the patient's condition is related to another kind of accident, place a check in the Yes box. Placing a check in one box removes it from the other. Clicking on a box that is already checked will remove the checks from both boxes.

 

 

On the following date fields, you can enter a date directly or right-click or press F2 on the date to select a date from a popup calendar.

 

Date of Current [Box 14]

If the patient's condition is an illness, enter the date of the first symptom. If the patient's condition is related to an accident, enter the accident date. If the condition is related to pregnancy, enter the date of the patient's last menstrual period.

 

Date of Same or Similar Illness [Box 15]

If the patient has had the same or similar illness, enter the date of the first occurrence.

 

Dates Patient Unable to Work [Box 16]

If the patient is or was unable to work due to their condition, enter the starting and ending dates. Different payers may have different rules regarding the ending date when the patient is still unable to work so you should consult the payer on how or whether the ending date should be entered.

 

Hospitalization Dates [Box 18]

If the patient is or was hospitalized due to their condition, enter the starting and ending dates. Different payers may have different rules regarding the ending date when the patient is still in the hospital so you should consult the payer on how or whether the ending date should be entered.

 

Outside Lab? [Box 20]

If you are billing for purchased services, in other words if the reported services were performed by an entity other than the billing provider, check the Yes checkbox and enter the total charge for the purchased services.

 

Signature on file… [Box 12]

Check this box if you have a signature on file for release of information needed to process the claim. Enter also the date the signature was obtained. When the claim is printed and this box is checked, the signature line will then contain the text “SIGNATURE ON FILE”.

 

Referring Provider [Box 17]

Select a referring provider from the list or use the ellipses button to add a referring provider to the list of providers. The NPI and secondary ID in boxes 17b and 17a respectively will be retrieved from the referring provider record and are not entered on the patient screen.

 

Diagnosis or Nature of Illness [Box 21]

You can enter up to four diagnosis codes here. You can right-click or press F2 to look up a diagnosis code from the list. Aeris is supplied with an empty list of diagnosis codes. You can enter the codes yourself or purchase the Codes Module to install the complete list of codes.

 

 

See Also:

General tab

Miscellaneous tab

CMS-1500 Reference Manual