To set up a SIM code for roll-up billing by CPT4 code, do the following:
Access File Maintenance.
Select Libraries, and then Service Items.
The Service Items List window opens.
From the list, select a library and then select Open Menu and select Open.
The Service Item Library Maintenance window opens.
Do one of the following:
To add a SIM code, select Open Menu and select New.
To modify a SIM code, search for the code and then select the code from the list on the left.
Select the General tab.
Each SIM code that is to roll-up to a single line item on the claim must have the following parameters defined.
Revenue Code: Select the appropriate revenue code for UB/837I claims. This is the default revenue code for all UB payers. If the roll-up payer requires a different revenue code, the Alt Rev code must be defined on the Payer tab for the roll-up payer.
Form: Select 1500. This is the default type of form for all payers. If the roll-up payer requires a different form (e.g. UB), additional setup must be done in the Payers master file on the UB sub-tab, on the Practice tab of the Modify Payer Information window for the roll-up payer.
Select the Payer tab.
Each SIM code that is to roll-up to a single CPT4 code line on the claim must have the following parameters defined for the roll-up payer. This does not include carve-out SIM codes that should not roll-up on the claim.
Payer: Select the roll-up payer.
Single Unit CPT4 Code Roll Up: Select this check box.
Effective/Expiration Dates: Enter the appropriate date range.
Form: Select 1500 or UB.
Alt CPT4: Enter the Alternate CPT4 code to which the SIM should roll-up to on claims.
