Do Not Sum Units for CPT4 Code

With Behavioral Health Billing, multiple charges on a single encounter that have the same CPT4 code, the same modifier(s), the same base minutes and the same unit price will roll-up (bundle) to a single line item on claims. The total units on the claim is calculated using the total time entered on all roll-up charges. The amount on the claim for the roll-up line item is calculated using the total units multiplied by the base price in the SIM Library.

Do Not Sum Units for CPT4 Code is an option that will prevent multiple charges on an encounter with the same CPT4 code and modifiers from rolling-up (bundling) to a single line item on claims. The option is available at the Practice level, the Payer level, and the CPT4/Payer level.

• Practice Preferences > Claims: Select this check box to prevent multiple charges with the same CPT4 code and modifiers on an encounter from rolling-up (bundling) to a single line item on claims for all payers in the practice, if applicable.
  

• File Maintenance > Payers > Defaults-2 tab: Select this check box to prevent multiple charges with the same CPT4 code and modifiers on an encounter from rolling-up (bundling) to a single line item on claims for a specific payer, if applicable.
  

• File Maintenance > SIM Library > Payer tab: Select this check box to prevent multiple charges with the same CPT4 code and modifiers on an encounter from rolling-up (bundling) to a single line item on claims for a specific CPT4/payer, if applicable.