Managing HIPAA Code Tables

Version 14.8

Overview

The HIPAA Code Tables window manages the codes used in e-Billing. Generally, you should not change or remove the values in these tables. You can, however, add items if you find that your claims and/or adjudications are returning codes that are not currently defined in the database. You can also reorder the lists in which the items will appear in to make it easier to locate.

The following are the available HL7 Code Groups:

  • Entity ID Code
  • Provider ID Type
  • Claim Adjust Code
  • Claim Status Category
  • Claim Status Code
  • Claim Payment Status
  • Eligibility Reject Code
  • ERA Remark Code
  • Claim Filing Indicator

Add to the HIPAA Code Tables

To add a code to a HIPAA Code Table:

  1. Navigate to Utilities > Manage Codes > HIPAA Codes. The HIPAA Code Tables window will open.
  2. Select the radio button of the proper HL7 Code Group where a new entry is necessary. The existing codes in that group will show in the bottom section of the window.
  3. Click the Add Record button .
  4. Enter the details of the new code:
  • HL7 ID required by payer
  • Description of the code
  • List Order
  1. Click the Save Record button  to save your addition.

Editing List Order

You can reorder items in these groups to make them easier to find in dropdown menus. For example, if your practice is 90% Medicaid, you could set the List Order value of Medicaid in the Claim Filing Indicator table so that it is at the top of the list.

  1. Navigate to Utilities > Manage Codes > HIPAA Codes. The HIPAA Code Tables window will open.
  2. Select the radio button of the proper HL7 Code Group where a new entry is necessary. The existing codes in that group will show in the bottom section of the window.
  3. Click the Edit Record button .
  4. Make the edit on the desired code.
  5. Click the Save Record button to save your edit.