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Billing Code Groups (article)

Summary:

Creating Billing Code Groups is a mechanism that allows specific sets of codes to quickly be added to either clients or users. These groups can range from specific payer groups (BCBS, State Funds, etc), nonbillables, service specific (ex: med management codes), job or user specific (therapist, IIH, psych, etc), and a myriad of other possibilities.

Fields, Checkboxes, Buttons:

Billing Code Group – the name you give to the billing code group

Active – indicates the code group is active

Default – indicates these are default billing codes for this group

Edit Name – gives you the opportunity to change the name of the billing code group (when editing a group)

Unassigned Billing Codes – codes not attached to the group

Assigned Billing Codes – those codes assigned to the group

Save – each time you make a change, you must save those changes.

Delete – deletes a billing code group

Add All – adds all unassigned codes to the billing code group

Remove All – removes all codes from the group

Assign to All Active Users – assigns the selected codes to all users (staff)

Assign to All Active Clients – assigns the selected codes to all clients

Instructions

How to Create Billing Code Groups for Clients and How They are Used

In one easy step, rather than adding each code line by line you have the ability to add all the codes that a specific client needs. For example, if Blue Cross Blue Shield allows all new clients to have a standard package of ten units for 90791, 90832, 90834, 90837, and 90847, then create a Billing Code Group Called “BCBS Auth Group” with those codes assigned.

If you also bill to United Behavioral Health, and know they only allow twenty visits for codes 90791, 90832, 90834 and 90847 (and never authorize the 90837), then create a separate group called UBH Auth Group.

To set these up (and any similar code groups):

Go to the Financial menu and click on Billing Code Groups. Next, when the window appears, type the name of the billing code group you want to create in the field that says Billing Code Group. For the example here, we are using BCBS Auth Group.

There are two columns. The column on the left is for the codes that are NOT assigned to the billing code group. On the right, are the codes assigned to the group. To assign a code to the group, double-click on the code from the list on the left. The code will appear in the list on the right. If you accidentally click on the wrong code, simply double-click on it and it will go back to the left, to the bottom of that list.

Once you have the appropriate codes appearing in the right hand column, click Save. A window will appear saying you are about to create a new Billing Code Group Called BCBS Auth Group (or display the name you have entered) and ask if you want to proceed. Click Yes.

Important Notes regarding adding Billing Code Groups for Users or Clients:

  • Only use the Delete button when you want to completely delete a previously created billing code group. This will delete the billing code group from being used through-out the system. It does not delete any code you may have selected in a group- it deletes the actual group itself.
  • Remove All will remove all the selected codes that are appearing on the right hand column and place them back on the Unassigned Billing Codes
  • Assign to All Active Clients/Users will place all codes that are in the Billing Code group to every active client/user in your system. It asks for effective dates and then places the codes on every active clients/user, regardless of profile. This cannot be undone once it is done.

Use Case:

ABC Therapeutic Group has added a few new nonbillable codes to their system that they would like to make available to their staff ASAP to document on all clients if needed. The ABC Group Power User has a created a new Billing Code Group called New Nonbillables and added the appropriate codes. After saving the new group, the Power User clicks on the Assign to All Active Users button located at the bottom of the Billing Code Groups screen.

This action has ensured that all active staff now have access to this new group of codes. This has saved the Power User from manually adding the group to the Codes/Rates tab for each user. Next, the Power User clicks on the Assign to All Active Clients button located beside the previous button. This action has added the new auths in the billing code group to each active client. The new nonbillables are now available to be used by all users, on every client, in PIMSY.

Related Articles:

If you cannot find what you need in this article, please contact Support (email) or call 877.334.8512 ext. 3.

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