We are currently updating the OP Help Center content for the release of OP 14.19 or OP 19. OP 19 is a member of the certified OP 14 family of products (official version is 14.19.1), which you may see in your software (such as in Help > About) and in the Help Center tabs labeled 14.19. You may also notice that the version number in content and videos may not match the version of your software, and some procedural content may not match the workflow in your software. We appreciate your patience and understanding as we make these enhancements.

Using the HCPCS Level 2 Code 3008F for Pay for Performance (P4P)

Version 14.19

Overview

Many users question how they can get more room on their well visit claims to report all of the pay for performance (P4P) items that the payer wants them to report. Consider the use of HCPCS level 2 code 3008F, "BMI assessment."  You can charge for it (or just charge $0.01 as a placeholder if you are concerned about triggering a copay).

So, how do you do this? This article is intended to explain how to add the 3008F code for your P4P items.

Well Visit Template Editor

  1. Navigate to the Well Visit Template Editor (Utilities > Manage Clinical Features > Well Visit Template Editor). Select a template to work on, and click the Edit pencil
  2. In the Well Visit Notes tab: 
  1. Add all of the ICD-10 codes that you want attached to your 3008F in the Diagnoses section. 
  2. Use the nonspecific BMI code (Z68) as a placeholder for children in your age 2+ templates, along with whatever ICD-10 codes that you want to routinely use for reporting on a well visit.

  1. Because this diagnosis code is not as specific as required for billing purposes, click OK in the following confirmation box:

  1. In the Procedures tab: 
  1. Add a Procedure called 3008F BMI Evaluation. 
  2. Attach Z68 (the nonsepcific BMI placeholder) as the diagnosis code as well as whatever other ICD-10 codes to would like to add.
Note: If 3008F is not currently in your system, you will need to add it.
  1. Click the Lookup CPT button.
  2. Search for 3008F. If the code appears, it already exists in your system and you do not have to add it. If it does not show, then continue with these steps to add it.
  3. Click the Edit button .
  4. Click the Insert Record button .
  5. In the CPT Code field, enter 3008F.
  6. In the Description field located next to the code, enter the BMI Evaluation.
  7. You can then add this code to a category or select the checkbox next to Include in Frequently Used list.
  8. If you'll be charging for this, complete the appropriate fee schedules or simply enter .01.
  9. Click the Save Encounter Note in Progress button to save.
  10. Click OK to save changes and exit the CPT window.

While Charting

In the Assess/Plan tab, your providers will have to remember to change the nonspecific BMI diagnosis code to the correct BMI code. It will look like the item indicated in the image below:

But, it should be changed based on the weight of the child:

If your providers don't want to do this, then your practice will want to institute a scrubbing process where outgoing claims are reviewed for the Z68 code. Z68 is not specific enough and may cause claim denials. That is why it is necessary to update it according to the child's weight.

Now, when you select the Coding tab to add your E&M code, you will see your 3008F all nicely premarked with all the diagnosis codes it needs! When you click the Use Suggested button, the E&M code appears.  It also has some of those codes on it! If you don't want them to there, the provider or biller can simply remove them.

But Wait! There's More!

What if this patient also has Asthma and ADHD that needs to go on the E&M code? No problem! Just add them to the Diagnoses in the visit note.  Then, be sure that the ones you want attached to the E&M are sorted in the first four positions (you can type 1, 2, 3, 4 how you want them to appear):

When you click the Use Suggested button, the Z00.12x code plus the child's other top three diagnosis codes as per your ranking will appear attached to the E&M.

Version 14.10

Overview

Many users question how they can get more room on their well visit claims to report all of the pay for performance (P4P) items that the payer wants them to report. Consider the use of HCPCS level 2 code 3008F, "BMI assessment."  You can charge for it (or just charge $0.01 as a placeholder if you are concerned about triggering a copay).

So, how do you do this? This article is intended to explain how to add the 3008F code for your P4P items.

Well Visit Template Editor

  1. Navigate to the Well Visit Template Editor (Utilities > Manage Clinical Features > Well Visit Template Editor). Select a template to work on, and click the Edit pencil
  2. In the Well Visit Notes tab: 
  1. Add all of the ICD-10 codes that you want attached to your 3008F in the Diagnoses section. 
  2. Use the nonspecific BMI code (Z68) as a placeholder for children in your age 2+ templates, along with whatever ICD-10 codes that you want to routinely use for reporting on a well visit.

  1. Because this diagnosis code is not as specific as required for billing purposes, click OK in the following confirmation box:

  1. In the Procedures tab: 
  1. Add a Procedure called 3008F BMI Evaluation. 
  2. Attach Z68 (the nonsepcific BMI placeholder) as the diagnosis code as well as whatever other ICD-10 codes to would like to add.
Note: If 3008F is not currently in your system, you will need to add it.
  1. Click the Lookup CPT button.
  2. Search for 3008F. If the code appears, it already exists in your system and you do not have to add it. If it does not show, then continue with these steps to add it.
  3. Click the Edit button .
  4. Click the Insert Record button .
  5. In the CPT Code field, enter 3008F.
  6. In the Description field located next to the code, enter the BMI Evaluation.
  7. You can then add this code to a category or select the checkbox next to Include in Frequently Used list.
  8. If you'll be charging for this, complete the appropriate fee schedules or simply enter .01.
  9. Click the Save Encounter Note in Progress button to save.
  10. Click OK to save changes and exit the CPT window.

While Charting

In the Assess/Plan tab, your providers will have to remember to change the nonspecific BMI diagnosis code to the correct BMI code. It will look like the item indicated in the image below:

But, it should be changed based on the weight of the child:

If your providers don't want to do this, then your practice will want to institute a scrubbing process where outgoing claims are reviewed for the Z68 code. Z68 is not specific enough and may cause claim denials. That is why it is necessary to update it according to the child's weight.

Now, when you select the Coding tab to add your E&M code, you will see your 3008F all nicely premarked with all the diagnosis codes it needs! When you click the Use Suggested button, the E&M code appears.  It also has some of those codes on it! If you don't want them to there, the provider or biller can simply remove them.

But Wait! There's More!

What if this patient also has Asthma and ADHD that needs to go on the E&M code? No problem! Just add them to the Diagnoses in the visit note.  Then, be sure that the ones you want attached to the E&M are sorted in the first four positions (you can type 1, 2, 3, 4 how you want them to appear):

When you click the Use Suggested button, the Z00.12x code plus the child's other top three diagnosis codes as per your ranking will appear attached to the E&M.