Using Medical Codes (CPT and ICD)

You can use medical CPT codes up to five digits in length.

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If you define an abbreviation for a CPT code, you can use the abbreviation instead of the code.

 

If the same code exists in the medical (CPT) list and in the dental (ADA) list, use the abbreviation or press Tab in the field to display the transaction code list and select the medical code from the list.

ICD-9 codes (medical diagnostic codes) can be preceded with a character, such as 123.45 or E123.45.

Using Medical Modifiers

You can use modifiers with medical codes to make them more specific. Any code with a modifier must be added into the medical code list as a new code.

Using ICD-10 Medical Diagnosis Codes

Beginning with version 7.9.1, the ICD-10 code set for reporting medical diagnoses and inpatient procedures replaces the existing ICD-9 code set. You can still use ICD-9 codes for procedures performed before October 1, 2015, for existing claims, and for types of claims that do not require ICD-10 codes.

To enter  or edit ICD-10 codes:

  1. Select Lists > Transaction Codes. The Transaction Code List is displayed.

  2. Select the Diagnostic codes filter. The ICD codes displayed selection feature becomes active.

  3. Select ICD-9 or ICD-10. Diagnosis codes from the selected version are displayed.

  4. Select OK, Add, or Edit. The Transaction Code Definition window is displayed. The ICD version defaults to the version being viewed or edited from the previous window.

    The Insurance code field displays the selected code. When adding a code, enter it here.

    • You cannot change the version of an existing code. When editing a code, the option to select the other ICD version is disabled.

To enter ICD-10 Codes manually:

  1. From the Transaction Codes List, select Diagnostic codes and click Add. The Transaction Code Definition window is displayed.

  2. Use the Insurance code field to enter the new code.

Using Diagnosis Codes on Claims

You can assign up to four unique diagnosis codes to a patient's claim. Diagnosis codes labeled A - D are populated with diagnosis codes found on the patient's ledger.

To assign diagnosis codes to a medical claim:

  1. Use the Insurance Submittal Information window during check-out, or select Lists > Insurance Claims, select a claim and click Submission Details.

  2. In the Diagnosis or nature of injury section, enter up to four ICD codes in the fields labeled A - D.

  3. In the Medical Code section, use the Diagnostic code checkboxes to associate ICD-10 codes (A, B, C, or D) with the medical procedure codes.

  4. When no diagnosis codes are present, you can select either ICD-9 or ICD-10 codes. When at least one code has been assigned, you can only select from the code version being used.

To assign diagnosis codes to a dental claim:

  1. Use the Insurance Submittal Information window during check-out, or select Lists > Insurance Claims, select a claim and click Submission Details.

  2. In the Diagnosis section, click Add. The Transaction Code Pick List is displayed.

  3. Use the Diagnostic code filter and select up to four codes for the claim (fields labeled A-D).

  4. Select a procedure from the Dental Code section.

  5. Select A, B C, or D to add the corresponding diagnosis code to the procedure.

Printed Claims

2012 ADA Dental Claim Form2012 ADA Dental Claim Form

 

2012 HCFA Medical Claim Form2012 HCFA Medical Claim Form

 

 

Related Topics

Customizing Transaction Codes

Printing the Current Code List

Evaluating and Marking the List

Editing the Transaction Code List

Assigning Fee Schedules

Importing and Exporting Fee Schedules

Defining Abbreviations

Identifying Super Bill Procedures