[MEDITECH-L] BAR Alt codes and modifiers - Client Server 5.5

[Chad Mcconnell]

Hi all, I know quite a while back I brought this up and some people tried to help however we still seem to be having difficulties with it. I'm hoping that some additional information might help.

PA Medicaid requires us to submit to them CPT's with modifiers that other insurances do not want to see(the additional modifiers). We have an alt code called "CPTMA" set up, we have it showing first in the Alt Code Priority of the claim dictionary for Medicaid, and we have it added in the "codes" section under type for the procedures that have to be overridden. For instance our normal CPT code for a charge is 70450 however for Medicaid they want to see 70450 with a modifier of "TC" so we have "CPTMA" also added under the type with an Alt Code of 70450TC. I tried added to spaces after the number and then adding the "TC" but it didn't seem to make a difference. When we bill create a Medicaid claim it only comes out with a 70450 without the modifier.

Our Meditech specialist has the issue sent to a programmer to look at however believes the issue is because the modifiers we want on the claim aren't in our DRG screen under the CPT codes. Something just seems to be missing to me. I was pretty sure if you created an alt code with modifiers in it that Meditech should accept this and understand how to process the modifiers even if they weren't in the DRG screen.

The whole problem comes down to Meditech just not seeing that we have modifiers added to the alt codes for our Medicaid claims when we go to bill them.

We are Client Server v5.5

Thank you to anyone who might have an idea.

Chad McConnell
Wayne Memorial Hospital
Honesdale, PA
Information Services
Senior Programmer/Analyst
570-251-6503

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[Amber Adkins]

Hi Chad,

How you build your claim sections will determine if the claims report
the 'hardcoded' alt code from the CDM; or the 'softcoded' alt code from
the DRG screen. You should start there. If your claim section is built
to pull from the DRG screen then you MT specialist is correct; the CDM
no longer matters.

You may have to build special claim sections for this payor; if you
don't want other payors to pull from the CDM.

Amber Adkins

[Desiree Sundet]

You may also want to make sure that this ALT code type has been added to
your Z.APC claim first. If BAR is not sending the information to ABS
then they would not be able to return the information, this may be what
is causing the information to no longer appear on the account or on your
claim since anything ABS does overrides BAR. Then I would try building
new claims sections and make sure that if you go that route, that the
Z.APC claim gets updated as well. We tend to see that this claim gets
forgotten when updating things and usually is the cause of our problems
like this.

Hope this helps and good luck!

Desiree Sundet
Business Office Systems Specialist
Brookings Health System

phone: (605) 696 9000 ext. 7216
fax: (605) 696 7758
email: dsu...@brookingshealth.org
web: brookingshealth.org

Brookings Health System: "Inspiring Health"

Hi Chad,

Amber Adkins

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[Purvins, James A.]

Below is some Magic 5.63 documentation for the Claim Section dictionary,
specifically, the Print Alt Code prompt documentation.

Some questions with regards to your setup:

1) Do you have a Medicaid alt code defined where you can put your TC
modifier?
2) Make sure your Claim Section - print alt code prompt is either set to
P or S?
3) Make sure the Alt Code priority on your Medicaid claim is set to the
Medicaid alt code type?

Determine the types of alternate codes that you want to
appear in the claim section.

To print Enter
------------------------------- ---------------
All surgical CPT codes and no E
alternate codes

Only the primary surgical CPT R
code and no alternate codes

Only alternate codes Y

Nothing N (or leave the
field blank)

All alternate codes and only P
the primary surgical code

All alternate and all surgical S
CPT codes

Good Luck,

James Purvins
Inland Northwest Health Services
(509) 232-8384

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-----Original Message-----
From: meditech-...@mtusers.com
[mailto:meditech-...@mtusers.com] On Behalf Of Amber Adkins
Sent: Monday, December 21, 2009 9:39 AM
To: Chad Mcconnell; medit...@mtusers.com

[Vicki Whipple]

We had the same issue with California Medi-Cal. The codes from ABS
overwrite any of the chargemaster codes you have hardcoded...so all our
modifiers disappeared. Ask your Meditech specialist to look up issue CL
#4422835. They had to do special programming for us: They added a "CDM
CPT" claim field and then we made a map of codes that ABS was not to
replace. If you have questions you can give me a call.

Vicki Whipple
PFS Application Coordinator
Enloe Medical Center
(530)332-6303

-----Original Message-----
From: meditech-...@mtusers.com
[mailto:meditech-...@mtusers.com] On Behalf Of Amber Adkins
Sent: Monday, December 21, 2009 9:39 AM
To: Chad Mcconnell; medit...@mtusers.com

Hi Chad,

Amber Adkins

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[Chad Mcconnell]

Thank you to everyone that responded and/or called on this. With all of the information that was given to us I believe we have come to the conclusion that something did change within one of Meditech's service releases. Since it was working for us initially and then just stopped all of a sudden and another hospital close to us called me and said the same exact thing, we believe it to be caused by an one of the updates for version 5.5.

I am reviewing everything sent to me and have updated our Meditech task accordingly. If I have any questions I'll let you know. If anyone is interested in the outcome let me know.

Again, thank you very very much, the replies were extremely helpful.

Chad McConnell
Wayne Memorial Hospital
Honesdale, PA
Information Services
Senior Programmer/Analyst
570-251-6503

**This email may contain confidential information. If you have recieved this email in error, please contact me and make me aware and then delete all information/attachments which pertain to this email. Thank You

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