Edit a Procedure Transaction

After a procedure transaction has been selected to edit, all of the individual fields for that transaction display.

You may edit any field except the patient number, patient name, or the transaction amount. Click the field(s) you want to edit and make the necessary change(s). The Editing Reason field is required — type the reason for the edit. The editing reason displays when the patient's transaction history is reviewed in detail, along with the date the transaction was edited.

If you edit anything in the top (Encounter level) section, the line items in the bottom section are unavailable until you apply the Encounter-level changes. Likewise, if you select a line item or multiple line items to edit, the Encounter level section is unavailable until you apply the line-level changes. When editing charges that fall in a closed billing period, the Billing Group, Per Dr, Ins Dr, Ins Dr Taxonomy, and Location fields are unavailable.

A Warning! A Refile must be performed if claim(s) should be generated for the changes made banner displays when edits affect previously filed claims.

The Show all fields check box expands the form to show additional fields. The No Attachments indicator next to the Attachment (paper clip) icon shows when no attachments exist for the encounter. The patient's date of birth, age, and gender display to the right of the Accounting Date. If there are multiple active primary or secondary insurance policies on the account, an asterisk (*) displays to the right of the affected policy. For CGM webVERIFY clients, eligibility status icons display next to the Insurance Carrier Codes to show the latest CGM webVERIFY status for each policy.

Two icons appear to the right of the Diagnosis Code magnifying glass: the Delete icon deletes all currently selected diagnosis codes and their associated pointers on each procedure line item; the Sync icon syncs the diagnosis pointers for all procedure line items to match the order of the first four selected diagnosis codes. The Check for Duplicate Transactions function runs automatically when editing a procedure code on a line item or using the Add Procedure function (checks Date of Service, Location, and Performing Doctor).

Action Column Buttons:

History — Opens the patient's transaction history.
Add a Case — Opens the Add a Case window so you can add a new case to the patient's account.
Add Procedure — Opens the Add Procedure window, where you can type a procedure code or use the search to add a procedure to the encounter. The Check for Duplicate Transactions function runs when you add a procedure.
Audit Trail — Displays the changes made to the encounter. The audit trail includes changes made before the encounter was posted (including Unposted Procedures changes), the original source of the encounter (for example, Procedure Entry, E-Superbill, CGM webMOBILE, or an interface), and the before and after values on a single screen, with changes shown in red. Once the encounter is posted, the Comment displays as Posted.

Additional Information (...) button: Each procedure line item has an ellipsis (...) button at the far right. Click it to open the Additional Information dialog, where you can record the insurance EOB (Explanation of Benefits) adjudication breakdown for that charge — how the carrier reported the charge was paid. CGM webPRACTICE uses these values to reproduce the carrier's EOB for the patient. The dialog contains the Allowed Amt $, Coinsurance $, Deductible $, Co-pay $, Other $, and Other Code fields (also described in the Data Field Information table below). Enter the amounts and click Apply to save the information to the charge line, or Cancel to discard it.

This additional information displays on the EOB only if the payment was manually posted using the Payment Entry Function. Manually posted payments do not capture the carrier's allowed, coinsurance, deductible, and co-pay amounts automatically, so you enter them here. Electronically posted payments (from an ERA) already include that detail, so the EOB is built from the ERA data and these fields are not used.

Notes:

The Doctor and Location code fields can only be edited for a debit adjustment, not a credit adjustment.
When the Always Accept Assignment check box is selected in the Procedure Entry Integration, the field in the Procedure Entry Function is always stored as Y, but the Always Accept Assignment integration does not apply to Edit an Encounter — you can change the Y response to N while editing.
If you attempt to change the modifier on a procedure to NF (to not file to insurance) and there is an insurance balance on that charge, the message Claims have already been created for the line item(s). You cannot use the NF modifier while the balance on the line items(s) is still in the Insurance Balance displays.
You can enter up to 400 procedures on a single encounter.

Data Field Information for Procedure Fields

Prompt	Response	Len
Procedure Code	Type the code you want or click the magnifying glass to search the table.	8
Modifier	Type the modifier.	6
Amount $	Informational only. Displays the charge amount.	15
Allowed Amt $	Type the allowed amount.	10
Alt. Desc.	Type an alternate description of the procedure code.	40
Per Dr	Type the code you want or select from the Doctor list. Unavailable when editing charges in a closed billing period.	3
Diag 1	Type the code you want or click the magnifying glass to search the table.	10
Diag 2	Type the code you want or click the magnifying glass to search the table.	10
Diag 3	Type the code you want or click the magnifying glass to search the table.	10
Diag 4	Type the code you want or click the magnifying glass to search the table.	10
Service Date	Type the date you want or click the calendar icon to select a date.	10
Claim Hold	Type the date you want or click the calendar icon to select a date.	10
Location Code	Type the code you want or select from the Location list. Unavailable when editing charges in a closed billing period.	3
Department Code	Type the code you want or select from the Department list.	3
Multiplier	Type a multiplier number greater than zero.	4
Billing Group	Type the code you want or click the magnifying glass to search the table. Unavailable when editing charges in a closed billing period.	3
Comment	Type any comment for the encounter.
Accept Assignment	If you want to modify the assignment status, select or clear this check box.	1
Date of Ill/Inj	Type the date you want or click the calendar icon to select a date.	10
Superbill Number	Type the superbill number.	25
Service Script	Select a date from the Service Script list.	10
Referral Source	Type the code you want or click the magnifying glass to search the table.	6
Case Record	Type the code you want or select from the Case Record list.	3
Ins Dr	Type the code you want or select from the Doctor list. Unavailable when editing charges in a closed billing period.	5
Ins Dr Taxonomy	Select the taxonomy code from the list. Unavailable when editing charges in a closed billing period.	40
Sup Dr	Type the supervising doctor code or click the magnifying glass to search the Doctor list.	3
Batch Number	Type the batch number you want or click the magnifying glass to search the table.	17
Coinsurance $	If this charge was not paid for because of coinsurance, enter the amount that went toward the coinsurance.	10
Other $	If a portion of this charge went toward another reason, enter that dollar amount.	10
Deductible $	If a portion or all of this line item went toward the deductible amount, enter the dollar amount that went to deductible.	10
Other Code	Type the code you want or select from the Other Code list.	3
Copay $	If this charge was not paid for because of copay, enter the amount that went toward the copay.	10
Editing Reason	Type the reason for the edit. The editing reason and edit date display when the patient's transaction history is reviewed in detail.	40