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.
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).
- An in-house test or procedure is coded with a corresponding check in the $ box.
- A Survey is carried out and marked Informed or Completed.
- A template is applied to a visit that contains Standing Orders with CPT codes attached.