Home Forums Discussions Coding and Billing Maxixmum # of Diagnosis Pointers

We are live with the PM and the Dr is now having to carefully code his visits when signing off. There is a flaw, however, with regards to the number of dx pointers for each service line. There should only be a maximum of 4 per line but for some reason AC allows for 8. To make it worse, by default AC fills all 8 pointers and when the claim is sent to AC PM each line of service is carrying 8 pointers. This doesn't allow the claims to get through the clearinghouse.

I haven't heard back from tech support. Does anybody else encounter this flaw or know how to prevent AC from filling all 8 dx pointers by default?

As you can see by the image having to manually delete the unneeded pointers would be cumbersome and unexpected for the Dr to do.

Spoke to both Product specialist and Tech Support and they are basically saying that this is their design.

Well, before we began with AC PM I never paid attention to it. But now that we are using the PM and claims are originating from this portion of the chart I realize that this is a major design flaw.

Additionally AC can only generate up to 8 diagnoses per claim and if 12 are needed they suggest to create a second claim with the extra 4. That is quite absurd.

Our previous PM has been able to send 12 diagnoses per claim since 2012 when the CMS guideline was changed to accommodate it.

Does anybody else run into this or have a better workaround?

This is also an issue with MedFx

Yes both AC and the ACPM have these issues. And they should both be responsible to fix it being that they share the process of generating a claim. It shouldn't be difficult, just as a tel# field shouldn't accept more than 10 characters, the pointer field shouldn't accept more than 4.