Overview
Creating Billing Code Groups is a mechanism that allows specific sets of codes to be quickly added to either clients or users. These groups can range from specific payer groups (BCBS, Medicaid, State Funds, etc.), non-billables, service line specific (ex. med management codes or psych testing), job or user specific (therapist, IIH, psych, etc.), and a myriad of other possibilities.
Required Permissions and Prerequisites
- Billing code groups can only be created in the Desktop application
- In order to use Billing Code Groups, each billing code must have a value in the Default Unit of the Billing Code set up.
- Please assign the Create, Modify, View, and Delete permissions for the following rule(s):
- Billing Code Group
Step-by-Step Instructions
Step 1: Understanding Billing Code Groups
Instead of adding each billing code one by one, you can streamline the process by adding all necessary codes for a client (or a user) in a single step. For example, if Blue Cross Blue Shield provides a standard package of ten units for the codes 90791, 90832, 90834, 90837, and 90847, you can create a Billing Code Group called “BCBS Auth Group” that includes these codes. Once the group is set up, it can be quickly applied to new clients who require that same package, saving time and ensuring consistency.
If you also bill to United Behavioral Health (UBH) and know that they only authorize twenty visits for codes 90791, 90832, 90834, and 90847 (but do not authorize 90837), you can create a separate Billing Code Group called “UBH Auth Group”. This group should include only the approved codes, allowing you to easily assign the correct authorizations for UBH clients while ensuring compliance with their billing guidelines.
If you have a Psychiatrist on staff, that will need 99212, 99213, 99214, 99215, 90792, 99201, 99202, 99203, 99204, you can create a billing code group labeled "Psychiatrists", so when you hire like credentialed providers, you can use the same group, again ensuring consistency and efficiency by not adding codes one at a time.
Step 2: How to Create a Billing Code Group
To set these up a billing code group go to:
Financial > Billing Code Groups
Next, when the Billing Code Group Creation window appears, enter the name of the group you want to create in the Billing Code Group field. In this example, you would type “Blue Cross Blue Shield” to match the standard billing setup for Blue Cross Blue Shield clients.
Click Save to create the new group. PIMSY will confirm if you want to create the new billing code group. Click Yes.
Step 3: Adjust the Appropriate Codes
You’ll see two columns in the Billing Code Group setup window. The left column (Unassigned) displays all billing codes that are not currently assigned to the group. The right column (Assigned) shows the codes that are assigned to the group.
To assign a code, simply double-click on it in the left column and it will automatically move to the right, indicating it has been added to the group. If you accidentally add the wrong code, you can double-click it again in the right column, and it will move back to the left column.
Once you’ve moved all the appropriate billing codes to the Assigned column, click Save. A confirmation window will appear stating that you are about to create a modify a Billing Code Group named Blue Cross Blue Shield (or whichever name you entered). When the system asks if you want to proceed click Yes to confirm.
Important Notes on Managing Billing Code Groups for Users or Clients
Delete: Use the Delete button only if you intend to permanently remove an entire billing code group from the system. This action deletes the group itself, not the individual billing codes within it. Once deleted, the group will no longer be available for use anywhere in the system.
Remove All: Clicking Remove All will move all billing codes from the right-hand column (assigned codes) back to the left-hand column (unassigned codes). This does not delete the group but simply clears all selected codes from it.
Assign to All Active Clients/Users: This option will assign all codes in the selected Billing Code Group to every active client or user in the system. You will be prompted to enter effective dates before the codes are applied. Use caution, as this action applies system-wide, regardless of user profile and cannot be undone once completed. When adding to All Clients, it will add the billing code with the default units assigned to each under the Billing Code set up.