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Primary Code Sent without Add-On Code (Procentive)


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  • Updated

Overview

When an add-on code is submitted to a payer on a separate claim from the primary code, there are specific steps that need to be taken to re-submit them together on one claim. 
 

Primary Code Sent without Add-On Code

When you notice that a primary code was sent without it's add-on code, or they were both sent but not on the same claim, you'll need to wait for the payer to process the primary code and then follow the instructions below.

 

Primary Code & Add-On Code Sent on Separate Claims

  1. Go to the Payments module > Locate the client and DOS.
  2. Click the DOS link to open the Change Time window on the primary code.
    Payments_DOS_6.17.20.png
  3. Repeat step 2 for add-on code, entering the same replacement information and return to the Payments screen.
  4. Click the invoice number link.
    Payments_Invoice_Link_6.17.20.png
     
  5. Click to select both the primary and add-on service lines.
    Invoice_selected_dates_6.17.20.png
     
  6. Click Resend.
  7. Click the Data link to verify that both codes are appearing on the same claim.
    Codes_on_same_claim_6.17.20.png
    • If they're still appearing on separate claims, please review the DOS details to be sure that all items are the same, except the code, including staff, authorization number, and place of service.
  8. Click Create.

NOTE: If the primary and add-on codes were billed on two different invoice numbers, you will need to combine them on to one invoice.

 

Primary Code Billed, Add-On Code not Billed

  1. Go to the Payments module > Locate the client and DOS for the primary code.
  2. Click the DOS link to open the Change Time window on the primary code.
    Payments_DOS_6.17.20__2_.png
  3. Go to the Time Module > Locate the client and DOS for the add-on code.
  4. Click the DOS link to open the Change Time window on the primary code.
    • In Time tab, change Invoiced to No.
      Invoiced_No_6.17.20.png
    • Go to Extra Info Tab and enter the same Replacement Claim information as the primary code.
  5. Go to the Billing Module > Add window.
  6. Locate the client and DOS.
    Billing_Add_Select_Client_6.17.20.png
     
  7. Click to select the payer and Check.
  8. In the Confirm Invoices window, click the Data link and verify that both codes are appearing on the same claim.
    Codes_on_same_claim_6.17.20__1_.png
    • If they're still appearing on separate claims, please review the DOS details to be sure that all items are the same, except the code, including staff, authorization number, and place of service.
  9. Click Create.

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