The following are questions that a biller or coder may consider as part of the review of the Incomplete Charges:

• Is the correct Appointment linked?

• Is the Insurance correct?

• Is a Case needed? (For example: Worker's Compensation or a visit countdown for an Authorization)

• Is a Worker's Compensation accident date needed?

• Should there be an Authorization? If so, is the correct one attached?

• Is the Facility correct?

• Is the Provider correct?

• Billing/Rendering?

• Does this Insurance require a Referring Provider?

• Do the Diagnosis Codes support the CPTs?

• Are the CPT codes correct?

• Are the Modifiers correct?

• Are the correct Diagnosis Codes linked to the correct CPT codes?

• Are the Units correct?

• Are the Procedure line items In the correct order (line 1,2,3 etc)?

• If this is an injectable, does it have the NDC number?

• Add an NDC number to the Procedure Code

• Enter an NDC on an Existing Encounter

• If you see a Copay popup window, should you post it to this Encounter?

• Most of the time, you should select the Receipt link to apply the Copay.

• However, there are instances where there is more than one Encounter per visit, and you must determine which Encounter the copay belongs to.

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