HCPCS Procedure Edit, Diagnosis

This tab allows you to enter Diagnosis codes that qualify a patient for this Procedure Code (item or service). Once you begin assigning these to procedures, the system will begin suggesting the qualifying code when you are entering a Medical Order for a patient who has several Diagnoses in their chart.

Example: You have a patient John Doe who has 496. COPD and 428.0 CHF. If you have the qualifying diagnoses setup correctly;

1. When you enter an Order for a Hospital Bed, the system will look at the Tie for the Item and pull E0260RRKHKX. It will then look at E0260 and see that the only qualifying diagnosis that this patient has is 428.0, so it will put that in for the Diagnosis on the Order.

2. Then you enter an Order for an Oxygen Concentrator, the system will look at the Tie for the Item and pull E1390RR. It will then look at E1390 and see that the only qualifying diagnosis that this patient has is 496, so it will put that in for the Diagnosis on the Order.