Maintain Diagnosis Codes

With the Maintain Diagnosis Codes function you can review information for a specific code, add a new code into the table, change the information for existing codes, inactivate or reactivate a code, or print the table.

You can also maintain up to five Equivalent diagnosis codes to be used if an insurance carrier requires claims to be submitted using diagnosis codes that are different from the standard. For example, if an insurance carrier requires a special code for Diabetes Mellitus, you could define one of the Equivalent Insurance Carrier Names in the CGM webPRACTICE Integration Options function for that carrier. Then, within the Diagnosis code you have defined for Diabetes Mellitus, type in the special code in the Equivalent Diagnosis field for that carrier.

Upon accessing this function, the Maintain Diagnosis Codes screen displays containing blank data fields.



Data Field Information
Prompt Response Req Len
Diagnosis Code Type the code you want or click the magnifying glass to search the table. This code cannot begin with a zero. 10
Brief Description Type a description of the diagnosis code. 55
Long Description This field is used primarily for descriptions loaded with the AMA ICD-10-CM code file. You can type a detailed description of the diagnosis code or leave the field blank.   55*5
Equivalent Diagnosis Codes (up to five) A separate field displays for each Equivalent Insurance Carrier Name defined in CGM webPRACTICE Integration Options (for example, HCFA, MED, DMERC). For each carrier that requires a diagnosis code different from the standard, type the equivalent code you want to use on insurance claims for that carrier. For more information, see the Equivalent Code help section under Introduction, System Processes.   10
Paper Submission Only If all procedures posted with this diagnosis code should be forced to a 'paper claim', select this check box.   1
Internal Use Only Select this check box to indicate that the diagnosis code is for internal use only and should not be subjected to the standard diagnosis code validation checks in Procedure Entry or Unposted Procedures. You must still select an ICD Type for these codes. If an insurance claim is created containing one of these codes, it will appear on the exception report because claims cannot be filed with invalid diagnosis codes.   1
CGM webMOBILE Category Select the CGM webMOBILE category for this diagnosis code from the drop-down list.   10
GI Screening DX For Medicare colonoscopy diagnosis codes only - This field has been added to adhere to Medicare's colonoscopy diagnosis requirements. If you perform a colonoscopy as a screening, but a polyp is found and removed, Medicare requires the screening (V) code to be submitted as the first diagnosis code and the polyp code to be submitted as the secondary diagnosis, but the diagnosis pointer needs to point to the secondary diagnosis. If you select this check box for the polyp codes, the claims will be sent correctly.   1
Sex Specific Select Male Only or Female Only when a diagnosis code is gender specific, or N/A. If a procedure is posted with a diagnosis code that has the Sex Specific option of Male Only or Female Only selected and it does not match the Sex stored on the patient's account in the Patient Name and Address Information screen, the claim will be placed on the Exception Report when insurance is created with the exception reason: 'Dx code Sex does not match Pt Sex'.   2
ICD Type Select whether the diagnosis code is an ICD-9 or ICD-10 code. Diagnosis codes loaded with the Load ICD-10-CM Codes function are set to ICD-10 automatically. 2

After you Save the code, the information refreshes on the screen.

Inactive Codes - If you select a code that has been inactivated, CGM webPRACTICE displays the existing information for the code but the data fields will be unavailable and you cannot make any changes. Reactivate will be the only active function in the Action Column. You must reactivate the code before you can change any of the data stored for the code.

If you are the System Manager for CGM webPRACTICE, you should limit access to the Maintain function to select staff members. You should also provide guidelines (customized to your practice) to these staff members for entering table data in a consistent manner. This should protect the integrity of your table information.

Use the Action Column functions to edit or create codes. To create new codes or edit existing codes in the table, a user must have the Allow Table Update check box selected in Maintain Users under System, User Management, and be given the appropriate security level. For additional information about security levels, see the Function Security Menu under System, User Management. For setting up user codes, see Maintain Users. If the Maintain function is accessed and the user is not authorized to 'Allow Table Update', the New, Inactivate, Reactivate, and Save functions in the Action Column will be unavailable. These functions will appear dimmed on the screen and the user will only be allowed to Review codes. If the user does not have the appropriate security level to access the Maintain function, codes can also be reviewed using the Review a Diagnosis Code function.

Action Column Functions
The Action Column functions are provided so you can perform multiple functions quickly and efficiently from within the Maintain function.

Select - Displays a new screen with blank data fields so you can select another code.

New - Displays a new screen with blank data fields so you can enter the information for a new code.

Next - Displays the next code in the table. If you are viewing the last code in the table and click Next, CGM webPRACTICE returns to the main Tables menu. If you make changes to the table and click Next, the changes will not be saved. You must click Save to save the changes before proceeding to the next table item.

Previous - Displays the previous code in the table. If you are viewing the first code in the table and click Previous, CGM webPRACTICE returns to the main Tables menu. If you make changes to the table and click Previous, the changes will not be saved. You must click Save to save the changes before proceeding to the previous table item.

Print - You can print all or part of the contents of the table. For additional information on printing, see Print the Diagnosis Code Table.

Inactivate - Immediately inactivates any active code currently displayed on the screen. When you inactivate a code in the table, it is not actually removed from the table but is assigned an inactive status. CGM webPRACTICE needs to retain information about the inactivated code for any data that was previously entered with that code. After a code has been inactivated you cannot use it for any data entry operation. An entry will be logged in the Changes to Table category in the System Log under System, File Maintenance, Look-Up Functions.

Reactivate - Immediately reactivates any inactive code currently displayed on the screen and allows it to be used in data entry again.

History - Displays the change history for the code currently displayed on the screen.