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Input Service Code Cross References Section - Cal-PM

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Associate an myAvatar service code with a procedure or revenue code recognized by a guarantor. For example:

  • If a service code is defined as 600 by the facility, and must be filed as 9200 (Medicaid), and as 4355 (Medicare), the cross reference will associate the service code to the guarantor codes.
  • The cross reference will substitute the codes 9200 and 4355 on the Medicaid and Medicare bills in place of 600.
  1. Go to: Avatar PM > System Maintenance > System Definition > Service Codes > Input Service Code Cross References
  2. In the Service Code field, enter the service code, click the Search button, and select the corresponding entry.
  3. In the Default Or By Financial Class field:
    • Select Default for service codes that require one cross reference code for all financial classes.
    • Select Financial Class for service codes that must have different codes for each of the associated financial classes (Financial Class(s) field).
  4. In the Financial Class(s) field, select the financial class.
  5. In the UB-92 Revenue Code field, enter the code, click the Search button, and select the corresponding entry. This value prints in the Payer box (50) of the UB-92 bill.
  6. In the CPT-4 Code field, enter the code, click the Search button, and select the corresponding entry. This value prints in the CPT/HCPCS column of the HCFA-1500 bill.
  7. In the CPT-4 Modifier field, enter the modifier. For multiple modifiers, separate each modifier with a comma, with no spaces (for example: M1,M2,M3,M4).
  8. In the Service Code Cross Reference Name field, enter the name.
  9. In the Medicaid Code fields, enter the associated codes.
  10. In the State Reporting Code fields, enter the associated codes.
    Note: User-defined CPT codes will override the CPT-4 Modifier field when the service duration is in a defined duration range.
  11. In the Service Unit Of Measurement Code field, select how the service code is measured.
  12. In the 'CPT-4 Code' fields, enter the CPT-4 code, click the Search button, and select the corresponding entry.
  13. In the 'Duration (Mins)' fields, enter the duration range. Duration ranges must not overlap.
  14. In the 'Modifier' fields, enter the CPT modifier.
  15. In the 'Quantity' fields, enter the number of service units. This information populates the 837 Professional bill.
  16. When finished, click File Cross Reference. If appropriate, click Delete Cross Reference to remove the service code and cross reference association.