To the left of the Suppress Visitometer checkbox is the Current Dx tab (figure 12). If the practice is NOT using Smart Pointer for Automatic Diagnosis Pointing, then the combination of the Current Dx tab with the DX Rel column in the New Transactions window enables the staff to do manual Diagnosis Pointing. Note that the doctor must establish very clear rules for a staff member to perform Diagnosis Pointing. Smart Pointer will be discussed in depth in the next chapter of this manual.
Figure 12
Click on the Current Dx tab to open it. This displays the patient’s current list of active diagnoses in the numerical sequence in which they will appear on the CMS-1500 for insurance claims. For each line item on the Transaction tab, type in the line number for the diagnosis (or diagnoses) that apply to that service or product. It is best if each line item is assigned a different diagnosis. This is important because many insurance carriers use the diagnosis codes to bundle services, provided that the practice has bundled all the services by applying all the diagnosis codes to all the services and products.
Bundling means that all the services provided by the practice would be grouped according to the lowest paying benefit. Example: some insurance programs place a restriction on “spinal manipulation” allowing very few visits. If all the services provided in the practice to a given patient are tagged with all the diagnoses, then once the spinal manipulation benefit has been reached, all the services and products are then denied. However, if each service or product is connected to a different diagnosis, then the services are NOT bundled, and although the spinal manipulation benefit will still end, the other services may be covered under a therapy benefit and continue to be paid.
The bottom line is the Diagnosis Pointing may increase patient compliance as well as the practice income and patient visit average.