Are you ready? 2020 Optum Code Transition

Add New CPT 1 Billing Codes to existing Funder

For any funder that was set up using the H codes you may add the new CPT 1 Codes to that same funder.

Go to your COMPANY ACCOUNT > open FUNDER >

Click on “Add Billing Code”

Open

Select the CPT 1 (9 codes) from the “Choose a Template” drop down

Open

Then complete the service set up and SAVE

Repeat process until all the CPT 1 codes have been added.

• The new CPT 1 codes will need to be added before new client authorizations created.

Inactivate H-Codes

To make a billing code INACTIVE

SELECT the checkbox in the Inactive Column of the billing code line to indicate a code as inactive

• If you do not anticipate adding new authorizations that will include H Codes; you can inactivate these anytime.

• Inactive codes can no longer be used when adding authorizations.

• Once a billing code is inactivated if it is already attached to an authorization it will still be tied to that client’s authorization.

Locate client authorizations with H Codes connected dated 3/30/2020 and later.

THIS REPORT WILL IDENTIFY:

• Client authorizations with H-Codes

• If authorizations with H-Codes have an end date that is equal to OR greater than 3/30/2020

Run an Expiring Auths Report for applicable funders: (optional)

Go to Reporting Dashboard>Select Expiring Authorizations

In the field “Expiring Next” enter 365 days or more.

Then click “Export to Excel”

After exporting the report you will then need to:

1. Filter by Funder to select applicable Funders

2. Then filter by Billing Code and select all H Codes

3. Auth Status: Active

Then review the “Dates” column and confirm the dates include 3/30/2020 and later.

Last step is to then Sort by Client and this report can be used as a resource as you begin to review which appointments will need to be reassigned.

• This report will assist you to locate any active authorizations that were set up using the H Codes

• After running this report, you may find there are no existing appointments, you will still want to run this report to know which authorizations need to be ended by 3/29/2020 so there are no future appointments that could be tied to the H-Codes

• We recommend ending existing authorizations that include H Codes with the date 3/29/2020 to avoid users from scheduling against them.

IMPORTANT: The following steps are only necessary if you have appointments dated 3/30/2020 and later connected to H Code authorizations.

Locate existing appointments that are connected to client authorizations with dates 3/30/20 and later

THIS REPORT WILL IDENTIFY:

• Client appointments that are on or after 3/30/2020 that may be tied to the old H-Codes

Go to Reporting Dashboard>Select Billing Export

Use the following report parameters:

Start Date: 3/30/2020

End Date: Minimum 1 month ie.. 5/1/2020

Select Applicable Funders

Appointment Requirements: Unselect any appointment requirements to ensure any scheduled appointment will pull in.

Then click “Download File”

• this report allows you to find appointments (if any) dated 3/30/2020 and later that are connected to authorizations that were set up with H Codes. (Refer to Expiring Auths Export)

• you may run this report as far out as you like ie.. 1 month, 6 months etc.

• we recommend the billing export include only funders that the changes apply to

Locate appointments that have H Codes

To turn on Filters in Excel:

First > HIGHLIGHT Row 5 and apply the “Sort and Filter Tool”

choose “Filter”

Using filters, identify sessions that may be incorrectly tied to old H-Codes

Using the Data Filters you applied:

Click on the Funder Column and Select those that are applicable to the transition

Then

Filter by Billing Code column and select all H codes

(Column N of the Billing Export Report, indicates the Billing Code per appointment)

Then

Filter by Appointment Date and select appointments (if any) 3/30/2020 and later.

If you highlight these rows you can then easily identify as you sort by client then start working through your report.

Now you have a report you can use to start working on locating the appointments that will need to be reassigned.

• if you are scheduling recurring appointments without an end date, these are the appointments you may need to correct

• We recommend identifying these appointments, then going into the scheduler to re-assign appointments to updated/new authorizations

Add new Client Authorizations for new codes

If you identify an authorization that uses the H-Codes past the date of 3/30/2020 and need to update a client’s authorization, you have the option to use the Copy Auth feature:

To learn more click here:

When adding a new client authorization, be sure to enter the start date > 3/30/2020:

• Be cautious of the unit type changes between codes

• a 60 minute code moving to a 15 minute code will be 4x as many units

Update Existing Client appointments to client authorizations with the new CPT 1 Codes

THIS STEP WILL RE-ASSIGN APPOINTMENTS TO CORRECT AUTHORIZATIONS:

• Find appointments attached to old authorizations

• Re-assign authorizations

• Confirm end date of appointment series

Open a client’s appointment series >

@Dawn Mackey updated

Update the service, to link to the updated authorization:

Don’t forget when scheduling recurring appointments to enter an end date that is less than or equal to the end of date of the authorization tied to the appointment:

SAVE as of the date your new authorization/or billing codes may be effective - most likely 03/03/2020:

• If there are appointments that were not set up a series then each appointment will need to be reassigned one by one.

• After you have reassigned the appointments to the new authorizations END the previous authorization using 3/29/2020 date.