Diagnostic code
This is optional – put it at the end.
- H123 H124 787
- H123 H124
Two diagnostic codes are required if billing K623 and H1x3 together.
- H123 K623 300 977
ReferrALS
Type in the referral information immediately after the H065, which includes the referring doctor’s name, or billing number, or both. For the doctor’s name, type Lastname comma Firstname.
Examples:
- H065 123123 H104
- H055 Smith, Andy H104
- H065 123123 Smith, Andy H104
Anesthesia
- F028C x 8 E019 E400
Note: Add “C” to the procedure code, “x 8” for 8 units. No need for units for E codes.
Percentage
- H123 Z176 x 50% E413
- H123 F056 x 100% E413 (toe fracture with no ortho follow up)
Units
- G395 G391 x 2
- H123 H124 x 2
Comments
If you have comments or special instructions for the billing agent, add your remarks at the end of the billings. Optional: Use “/” to highlight for biller.
- H103 Z176 /admitted May 25 (inpatients require an admission date)
- H124 /repeat billing (pt was previously billed by you, never left ED)
- H124 /WSIB (WSIB is not required unless pt registered as nonWSIB)
- H123 H124 /billed (private insurance, for your own records)
- H123 /paid (private insurance, for your own records)
Not seen
For a patient that you did not see or do not want to bill for, you can type in a comment such as “not seen” or leave blank.