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Billing Groups for Advanced Workflow Rules Engine (OP AWARE)

Version 20.8
Path: Billing tab > More button (Customize group) > Billing Groups 

Overview

Billing Groups are created to group together sets of CPT or Diagnosis Codes, by range or list, to support the OP AWARE functionality. The grouping of codes reduces the number of rules that need to be created to align with specific billing circumstances. 

Create a CPT Code Group

  1. Navigate to the Billing Groups window by following the path above.
  2. Click the Add button. The right-side of the window is activated. The details of the group are entered here.
  3. In the Group Name field, enter a Group Name. To avoid confusion when building an OP AWARE rule for this group, be sure to enter a name that is unique. Do not add any spaces after the Group Name.
  4. In the Group Type, select the CPT Codes radio button.
  5. Select the appropriate Codes radio button:
  • Select Range if the group is being created for a sequential range of codes. Enter up to ten ranges in the fields provided. Use the ellipsis button to search for an select a code, if needed.

  • Select List if the group is being created for a non-sequential list of codes. Enter up to ten individual codes in the Add Code field, pressing Enter on your keyboard to add each code. As codes are added, they populate the group field (pictured below). To remove a code, simply click the X next to the code.

  1. Select the Status of the group. Inactive statuses are not available for selection when building OP AWARE rules.
  2. Click the Save button to save the group.

Create a Diagnosis Code Group

  1. Navigate to the Billing Groups window by following the path above.
  2. Click the Add button. The right-side of the window is activated. The details of the group are entered here.
  3. In the Group Name field, enter a Group Name. To avoid confusion when building an OP AWARE rule for this group, be sure to enter a name that is unique. Do not add any spaces after the Group Name.
  4. In the Group Type, select the Diagnosis Codes radio button.
  5. Enter the diagnosis code in the Add Code drop-down field, or click the drop-down to search for and select the code in the Diagnosis Code Search window.

  1. Repeat step 5 until all codes have been added.
  2. Select the Status of the group. Inactive statuses are not available for selection when building OP AWARE rules.
  3. Click the Save button to save the group.
Version 20.7
Path: Billing tab > More button (Customize group) > Billing Groups 

Overview

Billing Groups are created to group together sets of CPT or Diagnosis Codes, by range or list, to support the OP AWARE functionality. The grouping of codes reduces the number of rules that need to be created to align with specific billing circumstances. 

Create a CPT Code Group

  1. Navigate to the Billing Groups window by following the path above.
  2. Click the Add button. The right-side of the window is activated. The details of the group are entered here.
  3. In the Group Name field, enter a Group Name. To avoid confusion when building an OP AWARE rule for this group, be sure to enter a name that is unique. Do not add any spaces after the Group Name.
  4. In the Group Type, select the CPT Codes radio button.
  5. Select the appropriate Codes radio button:
  • Select Range if the group is being created for a sequential range of codes. Enter up to five ranges in the fields provided. Use the ellipsis button to search for an select a code, if needed.

  • Select List if the group is being created for a non-sequential list of codes. Enter up to ten individual codes in the Add Code field, pressing Enter on your keyboard to add each code. As codes are added, they populate the group field (pictured below). To remove a code, simply click the X next to the code.

  1. Select the Status of the group. Inactive statuses are not available for selection when building OP AWARE rules.
  2. Click the Save button to save the group.

Create a Diagnosis Code Group

  1. Navigate to the Billing Groups window by following the path above.
  2. Click the Add button. The right-side of the window is activated. The details of the group are entered here.
  3. In the Group Name field, enter a Group Name. To avoid confusion when building an OP AWARE rule for this group, be sure to enter a name that is unique. Do not add any spaces after the Group Name.
  4. In the Group Type, select the Diagnosis Codes radio button.
  5. Enter the diagnosis code in the Add Code drop-down field, or click the drop-down to search for and select the code in the Diagnosis Code Search window.

  1. Repeat step 5 until all codes have been added.
  2. Select the Status of the group. Inactive statuses are not available for selection when building OP AWARE rules.
  3. Click the Save button to save the group.