If a patient has more than one diagnosis code saved in a note, TherapyNotes allows you to either include up to four diagnoses, or only the primary diagnosis on the electronic claim. Currently, CMS-1500 forms and superbills generated through TherapyNotes only include the primary diagnosis listed in the corresponding clinical note. This article overviews how to include multiple diagnosis for one patient on an electronic claim.
Note: If some services for a single patient include multiple diagnosis codes and others only include the primary diagnosis, TherapyNotes will split the services into different electronic claims for $0.14 each. Additionally, if the multiple diagnoses are listed in a different order in two different notes, those services will be split into two separate $0.14 electronic claims.
Turn On Setting
This setting is automatically turned on for new accounts. Older accounts should have a Practice Administrator, Practice Biller, or Clinical Administrator turn on the setting.
- Click the User Icon > Settings > "Practice Billing"
- Under "Diagnosis Codes on Claims" select "up to four diagnosis codes".
- Click the green "Save Billing Settings" button.
Next, the clinician must include all diagnosis codes in the clinical note. The primary diagnosis code is the first valid code listed.
Finally, the Practice Biller has the option to include multiple diagnoses or only the primary diagnosis code when submitting electronic claims. To submit claims, follow one of these pathways:
- Click BILLING > "Submit EDI Claims"
- Click PATIENTS > Click patient > "Patient Billing" tab > "Submit EDI Claims"
- Click PAYERS > Click payer > "Payer Billing" tab > "Submit EDI Claims"
A dropdown appears on the bottom of the "Submit EDI Claims" screen. To include multiple diagnosis codes, configure the dropdown to "Include up to four diagnosis codes per service". If you only want to include one diagnosis code, select "Include only the primary diagnosis code per service".