There are several triggers that generate charges for a patient when documenting a visit:
- A provider adds the CPT code(s) in the Coding tab of the visit.
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Note: CPT codes that are duplicated (or triplicated) in the Coding tab of the visit will only appear once on the Electronic Superbill. If a code truly must appear on two separate claim lines, the practice must establish a workflow for communicating this need. |
- A vaccine is documented. It is not necessary for the provider to code the vaccine administration CPT code in the visit. OP automatically applies the admin code based on the charting of the vaccine itself. For example, if a vaccine is given and noted that counseling was performed, OP will automatically add 90460 and 90461 (if appropriate). If no counseling occurred, OP will add the 90471 and 90472 (if appropriate).
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Where does the CPT Code come from? The CPT code for the vaccine must be associated with the vaccine product in the vaccine product table (Practice Management > More (Reference Data) > Vaccine Products > Click the ellipses button next to the Vaccine). |
- An in-house test or procedure is coded with a corresponding check in the $ box.
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Where does the CPT Code come from? The diagnostic test must have a CPT code associated with it in the Diagnostic test setup (Clinical > More (Customize) > Diagnostic test > Click the List button next to the test name > The CPT code should be in the CPT Code field). |
- A Survey is carried out and marked Informed or Completed.
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Where does the CPT Code come from? The Survey must have a CPT Code associated with it in the Survey setup (Clinical> More (Customize) > Surveys > Select the Survey and click Edit > On the right side of the survey the Default CPT field must be populated in order for a charge to drop to the superbill when the survey is marked Informed or Complete). |
- A template is applied to a visit that contains Standing Orders with CPT codes attached.
