Apex: Correct CPT Codes for Submitted Claims

 Permissions: You must have Billing Permissions.

Before you Begin:

1. If there are any Payments on the Invoice it will not allow them to change the Service Type. Remove Payment and then reapply it after you have changed the CPT Code. 
2. Check your EDI Files Settings to ensure Ask for resubmission details prior to Re-Submit failed claim is selected.

Correct the CPT Code

1. Click Billing tab in primary navigation bar.
2. Click Claims in side menu and click on Rejected/Denied tab.
   

   NOTE: If the Claim is not there, search for Claim and manually mark it as Rejected/Denied.

3. Click Actions for appropriate Claim and select View Invoice Details.
4. In edit Invoice, select new Service Type from dropdown.
5. Click Save.
   
   
6. Then Resubmit Corrected Claim.
   • When resubmitting the Claim a dialogue box will pop up asking you to choose the resubmission code and enter the original reference number for the Claim. Resubmission details appear in Loop 2300 of the EDI file and Box 22 of form CMS1500.
     Resubmission Code =
     7 - replacement of prior Claim
     8 - void/cancel of prior Claim Original Reference Number(you may need to call the insurance payer to get the Original Reference Number).