Maintain Type of Service Codes

With the Maintain Type of Service Codes function you can review information for a specific code, add new codes to the table, change the information for existing codes, print the table, and inactivate or reactivate a code.

Refer to the Type of Service Table for a list of CMS standard Type of Service Codes.

You can also maintain up to five Equivalent type of service codes to be used for various insurance carriers. This can be helpful if an insurance carrier requires claims to be submitted using service codes different from the ones defined by the Centers for Medicare and Medicaid Services (CMS). For example, CMS's code for Medical Care is 1, but you may have an insurance carrier that uses their own internal list of codes and they may define Medical Care as 5. To accommodate this situation, you could define one of the Equivalent Insurance Carrier Names in the CGM webPRACTICE Integration Options function for that carrier. Then, on the 'Medical Care' type of service code, type 5 in the 'Equivalent Type of Service field for that carrier.

Upon accessing this function, the Maintain Type of Service Codes screen displays containing blank data fields.

Data Field Information
Prompt Response Req Len
Type of Service Code Type the code you want or click the magnifying glass to search the table. This code cannot begin with a zero.   3
Description of Service Type a description of the type of service code. This description defines the type of service for this code. For example, if the code is set to '1', a valid description could be 'Medical Care'. 45
HCFA Type of Service Type the equivalent type of service code you want to use on insurance claims for this insurance carrier. For more information see the Equivalent Code help section under Introduction, System Processes.   10
MEDICARE Type of Service Type the equivalent type of service code you want to use on insurance claims for this insurance carrier. For more information see the Equivalent Code help section under Introduction, System Processes.   10
BCBS Type of Service Type the equivalent type of service code you want to use on insurance claims for this insurance carrier. For more information see the Equivalent Code help section under Introduction, System Processes.   10
DMERC Type of Service Type the equivalent type of service code you want to use on insurance claims for this insurance carrier. For more information see the Equivalent Code help section under Introduction, System Processes.   10
Medicaid Type of Service Type the equivalent type of service code you want to use on insurance claims for this insurance carrier. For more information see the Equivalent Code help section under Introduction, System Processes.   10
Nominal Fee $ Community Health Centers only - If you charge a flat fee for this Type of Service, type the dollar amount.   10
Suppress Encounter Community Health Centers only - If procedures posted containing this Type of Service code are not considered encounters, select this check box.   1
Medicare 100% Reimbursement If Medicare reimburses this type of service at 100% of the allowable amount (versus the standard 80% of the allowable amount), select this check box. This ensures that Medicare payments for this type of service will be handled correctly in the Payment Entry Function and in the Electronic Remittance Advice (ERA) function.   1
Surgery Type of Service If this is a surgery type of service, select this check box.   1
Include CLIA Number on Claims If you want the CLIA number to go on claims for this type of service, select this check box.   1
UB Billing Rural Health Centers and FQHC's only: If you want to send UB claims for this type of service, select this check box.   1

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 Type of Service 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 Type of Service 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.