Types of Failures
When these AP failures are received, the CH should review the bill and records to determine what service, supply, material or procedure was provided and whether it is separately reimbursable from the office visit and/or services provided or if a more appropriate CPT code should be used.
What are non-specific procedure codes?
A handler should do this when a medical bill submitted for payment requires additional information.
What is place the bill in BUI?
One method of accessing the BSS is through participant quick launch in ECS. This is the other method.
What is the CSS - PIP/MPC Injury Details?
A charge for this service will price to $0 because this high level of code is not usually performed more than once during the course of treatment.
What is repeat highest E&M code?
In this screen/application you can place multiple bills in BUI at one time.
What is Bill Summary Screen (BSS) ?
This is the name of the new bill system within MAX
What is Xbos? (neXt Bill Operation Screen)
Manual therapy performed to the same body region as a chiropractic manipulation is not priced for this failure reason.
What is “Included In”?
This is where you find any State required letters that must be sent out once placing a bill in BUI.
What is the Jurisdictional Reference > Required Letters?
An IME has determined that only 2 chiropractic visits per week is appropriate. This tool is utilized to keep A/P on with limitations.
What is the AP treatment plan?