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Billable Items & Procedure Codes Setup

Contains Internal Codes and Procedure Codes used for Base Rates, Mileages, and Other Charges. These codes are created for internal use and identification of charges billed.

Changes in this setup screen synchronize to AIM Dispatch/ePCR, if installed for your AIM System.

The Billable Items & Procedure Codes Setup lists all the options that can be used during data entry under the Charges Tab in Billing. This setup should be reviewed before starting data entry.

  • Internal codes are up to 8 characters long, including numbers and letters.
  • Codes can be made unique, or the same code can be utilized to reflect price increases by adding an effective date range (see below). However, when using the same Code, the description must be unique.
  • The descriptions and Procedure Code, not the internal codes, are included on claims.



There are 3 charge types that Billable Items/Procedure Code information can be added to:

Base Rate: Will be available when entering Base Rate on the Charges tab and represent services like BLS, ALS, Wheelchair van, or other basic billing charges.  

Mileage: Will be available when entering Mileage Rate on the Charges tab and represent charges for mileage rates.

Other Charges: Will be available when entering Other Rates on the Charges tab and can be used for contracts, fees that are different from the coded charges for Base Rate or Mileage Rate, and Mileage Rates for part of the service that needs to be billed differently.

Before the finalization of the Ambulance Fee Schedule, Other Charges Codes were typically used for disposable supplies, extra attendants, night differential, oxygen, etc... With the finalization of the Ambulance Fee Schedule, these Other Charges are often bundled into the Base Rate Charge.

Some companies are still paid for these charges. If Other Charges are used, it is important that all Payers are billed, not just Payers who pay for these codes.

Important Notes

  • These codes must represent the full charges, not just what a payer pays on the service.
  • Make codes and descriptions simple so that they can be remembered and make sense when a biller is selecting the internal code from the drop-down box in the Charges Tab.
  • This setup area should be reviewed on a regular basis.

Dashboard Category can be assigned for each entry.  This will categorize billable items by service level and allow for Service Level Statistics in the Dashboard.  

Add: A new value can be added to the list using the plus button in the top right.

When add is selected, it opens the data entry for adding a new Billable Item/Procedure Code for the selected Field Type. The Code, Description, and Price are required for the Save and Save & Add buttons to be activated. Selecting Cancel will take the user back to the Billable Items & Procedure Codes Setup without adding a new Billable Item/Procedure Code.

Users can also configure an Effective Date Range for a new billable item. By configuring an Effective Date Range, that billable item will only be available for selection if the date of service of that bill falls into the effective range. This will allow for multiple billable items to be entered with the same code, but with different prices, and billers will have the correct price for that billable rate automatically populated based on the date of service of the bill. This is especially helpful for when rate increases occur at the beginning of the calendar or fiscal year. 

Effective Date Ranges are optional and can be left blank if not needed.

Note: The Default procedure code is optional, but if nothing is entered, the setup will not auto-populate a procedure code when the entry is selected during data entry.

Payer Specific Procedure Codes can be added to a Billable Item by clicking on the plus button located under the Default Procedure Code box. 

A payer can be selected from the drop-down Payer Category field. This drop-down will list all Payers that have been set up in the Commercial Payers Setup. Enter the Default Procedure Code for the selected category. The entry can be deleted by clicking on the trash can icon beside the entry.

Filter: To narrow the results of a list, begin typing the Code or Description you are searching for.


Actions:

Edit: If changes need to be made to an entry, use the edit button.
Delete: Remove an existing entry.