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Service General Information

Service General Information

 

See Also:

Money tab

Notes tab

Claims tab

CMS-1500 Reference Manual

 

The General tab contains most of the the fields making up the clinical component of a service. When you add a new service the General tab is what you see first.

 

 

Diagnosis [Box 21]

These fields are filled from the patient's diagnosis which is entered on the Condition tab of the patient record. However the diagnosis is saved with the service and changing it here does not change the diagnosis in the patient record.

 

Prior Authorization Number [Box 23]

Use the drop-list to select an authorization number for this service or enter one directly.

 

Supplemental Information [Box 24 top line]

If necessary to help in adjudicating the claim, you can enter supplemental information on the top line. Separate supplemental information fields are available for boxes 24g and 24h. See the CMS-1500 Reference Manual for more information about this field.

 

Dates of Service [Box 24a]

Enter the From and To dates of service. You can right-click or press F2 to select a date from the popup calendar.

 

Place of Service [Box 24b]

Enter the place of service code. You can right-click or press F2 to select a code from the list of valid codes.

 

EMG [Box 24c]

This is the emergency indicator. Enter Y for yes or leave blank for No. Your payer may have other requirements.

 

Procedures, Services, or Supplies [Box 24d]

Enter the CPT or HCPCS code and optional modifier codes. You can right-click or press F2 to select a code for any of the procedure or modifier codes from the list of valid codes. The procedure codes list is empty by default unless you have purchased the Codes Module that will fill the list with all valid codes.

 

Diagnosis Pointers [Box 24e]

Enter the numbers (1-4) corresponding to the diagnosis codes in box 21 that apply to this procedure. These will be filled for you by from the diagnosis code pointers in the patient record. If you have told Aeris to remember service settings, the pointers here will be saved back to the patient record. However, if you also changed the diagnosis codes, only pointers for matching codes will be saved.

 

Charges [Box 24f]

Enter the charge for this procedure. This may be filled for you when you enter a procedure code if you have entered fee schedule fees for the procedure.

 

Days / Units [Box 24g]

Enter the number of days or units.This field is most commonly used for multiple visits, units of supplies, anesthesia units or minutes, or oxygen volume. If only one service is performed, the numeral 1 must be entered. Enter numbers right justified in the field. No leading zeros are required. If reporting a fraction of a unit, use the decimal point.

 

When required by payers to provide the NDC units in addition to the HCPCS units, enter the applicable NDC units’ qualifier and related units in the shaded line following the NDC qualifier and code.

 

The following qualifiers are to be used when reporting NDC units:

 

F2

International Unit

 

ML

Milliliter

 

GR

Gram

 

UN

Unit

 

EPSDT Family Planning [Box 24h]

For Early & Periodic Screening, Diagnosis, and Treatment related services, enter the response in the shaded portion of the field as follows: if there is no requirement to report a reason code for EPDST, enter Y for “YES” or N for “NO” only.

 

If there is a requirement to report a reason code for EPDST, enter the appropriate reason code as noted below. (A Y or N response is not entered with the code.) The two character code is right justified in the shaded area of the field.

 

In the lower portion, enter an EPSDT code. You can right-click or press F2 to select a code from the list of valid codes.

 

Submit claim to insurance

Check this box to allow this service to be included in batch insurance claims. When not checked, you can still generate a claim for this service by generating a single patient claim from the Print button on the patient list.

 

Provider

Select the provider of the service. This provider's NPI and secondary ID will be used to populate boxes 24i and 24j.

 

See Also:

Money tab

Notes tab

Claims tab

CMS-1500 Reference Manual