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Set Associated Codes

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Associated codes are CPT, revenue, and diagnosis codes that will be treated as equal when a claim is being adjudicated.

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  • Code groups can be assigned in the Plan Definition form (Plan Coverage Definition section).

  • Code groups can be selected in claims processing forms.

For example:

  • If CPT code 90806 is authorized for a member

  • a claim is received that has CPT code 99251

  • No authorization exists for CPT code 99251

  • CPT code 99251 will be processed as CPT code 90806, and will not be denied.

  • Standard service authorization rules apply.

  1. In the Select Funding screen, enter the funding source, click Select Funding Source. Click Ok.

  2. The Funding Source Name field displays the funding source.

  3. When finished, click Submit.