Once the doctor codes the visit 9939x or 9921x, that is transferred to TotalMD automatically. If there are also vaccines, the medical assistant circles the vaccines (90700, 90670, etc.) on the paper superbill. In TotalMD, the biller (also our receptionist) will open the patient file and see the 9939x bill in there already with the right date of service. Then she'll input these additional lines manually:
90700
90460
90461
90670
90460
So all the vaccines & admins are manually entered. However TotalMD has a multicode feature where you can set 1 click to equal multiple lines of code. So we've set up a DTaP multicode. When you click it, it'll add 90700, 90460 and 90461 in the right order & the right quantity & charge amount. (When we have a bill with private vaccines, we do it manually w/o the multicode.)
We think this way is faster than the doctor selecting the vaccine codes in AC since we would have to change the order of the vaccines & admins CPTs anyway.
After this point, the biller also makes sure the AM modifier is in there and checks all the other modifiers if there's a sick visit on the same day, strep test etc. Then the claim is created and electronically sent to the clearinghouse.
At the clearinghouse level, we have edits set up to catch if for a medicaid claim there's no AM mod on the checkup code or no QW mod on 87880. These claims will be stopped and I log in to their website to make the corrections.
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