Procedure codes

Your procedure code list is the set of CPT and HCPCS codes your clinic bills, kept per discipline, with your label and unit settings for each. Every code must exist in the code catalog NeatPractice keeps current, so a retired or mistyped code never makes the list.

Open Setup > Billing setup > Procedure Codes to see the list. Anyone with access to Setup can see it; only people whose role can manage codes can change it.

Add codes#

You can add several codes for one discipline at once.

1. Click Add Codes.
2. Choose the Discipline.
3. In Code 1, type a code number such as 92507 and pick it from the list. NeatPractice fills in a starting label and whether the code is timed; change either one.
4. Click Add another code for each extra code, or the trash button to drop a row.
5. Click Add Codes.

NeatPractice rejects a code that is not valid in the catalog today, that is listed twice, or that the discipline already has. Each row shows what to fix. New codes go to the end of the discipline's list.

Choose how a code counts units#

Each code is billed one of two ways:

• Timed: units come from the minutes delivered. NeatPractice uses the catalog's unit length, such as 15 minutes, unless you enter your own Minutes per unit. A timed code the catalog gives no unit length for needs your own value.
• Encounter: the code always bills one unit per visit, however long the session ran. Switching a code to Encounter drops its Minutes per unit and Default units when you save.

For a timed code you can also set Default units, the number a note starts with.

Edit a code#

Open the menu on a row and choose Edit. You can change the label, the order, the billing settings and these switches:

• Not otherwise classified: for unlisted codes. Electronic claims send the code's label as the line description.
• Usually needs a modifier: a reminder for staff to check modifiers when they use the code.
• Active: inactive codes stay on the list for your records but are no longer offered.

The code number and the discipline never change. To use a different code, add it and deactivate the old one.

Code rules#

Open the menu on a row and choose Rules to describe how the code is delivered and who may deliver it. The dialog has three tabs.

Service classifies the code: its service category, whether the patient is present, the provider levels that usually render it, the smallest and largest group, the primary code an add-on bills with (when you need to narrow the catalog's list) and whether it can be delivered by telehealth. A telehealth visit with a code that cannot shows a warning.

Turn on Stays on the visit once booked for a code that must not come off a visit once it was booked on the appointment. Off (the default), a clinician can remove the booked code from a draft visit when the service was not provided, and the visit records it as not provided (see Treatment lines).

For services delivered by several technicians at once, Technicians needed sets the fewest technicians the session needs; booking with fewer shows a warning. On an add-on, turn on Billed per extra technician to add it once for each technician past the first when the session starts. Technicians are the session's providers other than the one booked as Supervising.

Booking limits#

Under Booking limits on the Service tab, set the Shortest booking (minutes) and Longest booking (minutes) one appointment may book the code for, and How often a day: Any number of times, Once per patient per day or Once per provider per day. Booking outside them shows a booking check warning that a user allowed to book past warnings can override, and the claim scrubber flags a line that breaks them. A payer's code rule can set its own limits for the code.

Documentation is the code's validation matrix. For the service address, drive time, provider signature and caregiver signature, choose Required, Optional or Not needed, and choose which note templates the session needs (none, optional, at least one or all). Required items stop the visit from being signed until they are in:

• Service address: an in-person visit with this code must name the home, school or community address.
• Caregiver signature: the caregiver signs on the clinic device that the services were received.
• Note templates: the visit needs a note on the listed templates (the note being signed counts).

Credentials lists credential groups. A provider may render the code when they hold every credential in at least one group, valid on the date of service; a code with no groups is open to every provider. For example, one group with an RBT credential and a training credential, and a second group with a BCBA credential, lets either kind of provider render it. NeatPractice checks the groups:

• when you book, reschedule or drag an appointment (a booking check warning),
• when a visit starts (refused),
• when the note is signed (refused), and
• when the claim is checked before it is sent (blocked).

A payer can accept other groups for the same code in its code rules.

When you add a code that your discipline's module brings a starting profile for, and your clinic holds that module, the code starts with that profile's classification, validation matrix and credential groups (only groups whose credentials your clinic has set up). Edit them to match your clinic.

Set the order#

Each discipline's codes are listed in the order you set. Click Reorder, choose a discipline, move codes up or down and click Save Order. You can also type a number in Order when you edit a code.

Retiring codes#

The catalog announces when a code retires and which codes replace it. A code with an announced retirement shows a Retires badge with the date; hover over it to see the replacement codes. A code that is no longer valid shows Not valid today. Add the replacements before the date so your team can switch over.

Deactivate or delete codes#

Open the menu on a row and choose Deactivate to retire a code your clinic no longer bills. To delete codes, tick their rows and click Delete in the bar that appears. A code that a modality still suggests cannot be deleted; NeatPractice reports it so you can deactivate it instead.

Your fee schedules price codes by their number, so deleting or deactivating a code here never removes its rates.

Filter the list#

Use Filter to show one or more disciplines, billing modes or statuses, or to search the labels.

Import, export and print#

Click Export CSV to download the enabled codes with their discipline, label and billing settings, and Print for a PDF of the list. Click Import CSV to enable codes from a file in the same format: each code must be valid in the catalog today, and a code its discipline already lists is skipped. New codes go to the end of their discipline's list. See Import, export and print.