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SO014 Service Codes

  • Updated
Standard Order Category:
  • Billable: Category 1
  • Non-Billable: Category 2
Who should fulfill this SO? SO Analyst
Link to the SO request form:

Appointment Reason: http://communitysystems.vch.ca/published/UR_-_Appointment_Reason_(VCH).pdf

Intervention Code: http://communitysystems.vch.ca/published/UR_-_Intervention_Code_(VCH).pdf

MSP Service Code: http://communitysystems.vch.ca/published/UR_-_MSP_Service_Code_Correction_(VCH).pdf

Reminder to please follow the Standard Order Guidelines on top of the specific instructions outlined below.


Background
Prerequisite: Requester to Complete the SO Request Form
Prerequisite: Determine if a Service Code exists
Prerequisite: Approval from Clinical Informatics (Non-Billable only)
Fulfillment Instructions
     Create a New Service Code
          Non-Billable Service Code
          Billable Service Code
     Modify an Existing Service Code
     Inactivate\Discontinue Service Code
 

Background

There are two types of Service Codes: billable and non-billable. Both can be handled through the Standard Order process however they have different sets of instructions as they have unique restrictions. Please follow the instructions below closely depending on the type. 

NOTE: Deleting Service Codes is not a standard order and requires a full CC process. 

Prerequisite: Requester to Complete the SO Request Form

If a request was received for this Standard Order but without using the SO request form, send the form's URL link to the requester. After receiving the form submission, ensure all the mandatory fields are completed before proceeding. If not, discuss further with the requester.

NOTE: there are THREE separate SO request forms - Appointment Reason, Intervention Code, and MSP Service Code Correction. Having it split into three request forms is for user comprehension on which area is impacted. From the internal perspective, all three are handled with the Service Code feature.

Prerequisite: Determine if a Service Code exists

1. Sign into Production EMR using an account with a Sys Admin or Support Analyst role

2. Go to Maintain > Services to open the Services window

3. Type the code in the Search field, and then click Search button.

4. Type the key word (s) of the service description you want to check if it exists in the Search field, and then click Search button.

For example, the system provides you the list of service codes with DIABET in their descriptions and their codes.

Review the list of service codes to avoid creating a duplicate. 

Also, if you find a matching description - check the service code status.

 

  a. If the code does NOT exist (no results after the search by the code and by key word), follow the steps in the Create a new Service Code section
  b. If the code DOES exist, follow the steps in the Modify an existing Service Code section

Prerequisite: Approval from Clinical Informatics (Non-Billable Only)

Clinical Informatics approval is required for Non-Billable Service Codes, whether creating, modifying or inactivating. Once the requester has completed the SO request form, copy and paste the below to an email, replace #VALUE# with the appropriate information, then ensure the PDF is attached to the email before sending:

Email Subject: For SO Approval: SO014 Non-billable Service Code

Email Body:

Hello CSSEs,

Can you please review and approve this SO submitted by #VALUE = requester name# from POS #VALUE = POS code#? Please see attached form completed by the requester.

Thanks

After sending the email:

  • Set the JIRA status to Waiting for Approval
  • Create a subtask for SO014 CIS Approval for EMR-XXXXX, where EMR-XXXXX is the JIRA ID. Assign it to the person the email was sent to

Fulfillment Instructions

Create a New Service Code

Note: for both non-billable and billable steps, execute them first in EMR DEV first. After verifying the change, it can then be executed in Production EMR and VTM

Non-Billable Service Code

Please follow the below steps to create a new non- billable* Service Code

Reminder to create a subtask for SO014 Implementation for EMR-XXXXX, where EMR-XXXXX is the JIRA ID. Assign it to yourself. Note: do not create this subtask earlier while waiting for CIS Approval; create it only once CIS has approved. If this is not followed, this will report inaccurate metrics for the monthly performance reports.

*Non - billable service code is a code created to be used for ANY different purposes rather than used in billing claims (i.e. appointment reason, intervention code, etc.) 

  1. Pull the list of all available codes by entering key word in the Search field, and then click Search button.
  2. Highlight a similar code on the list and click on Duplicate
  3. Under the General tab, enter the code in the Code field (see other Service Codes from the list for code convention)
  4. Update the description text in the Description field (see other Service Codes from the list for the Description convention) and Full Description field (optional to have a more complex full description)
  5. Blank out Output Code
  6. Type VCH ? in the Short field (applies for non-standard Service Codes created by VCH)?
  7. Click the OK button to exit from the New Service window.

Billable Service Code

Please follow the below steps to create a new billable MSP* Service Code

*Billable MSP service code is a code created to be used ONLY for billing purpose; the source of truth of these types of codes is MoH; the codes are updated by the Ministry and Profile gets the updates by importing the MSP Reference Data Files; the codes have MSP in the Charges Rates filed on the Financial Tab.

The following information gets updated through the importing:

code Full Description,

Standard price,

the End date if the code discontinued, ( IH confirmation is pending)

  1. Pull the list of all available codes by entering key word in the Search field, and then click Search button.
  2. Highlight a similar code on the list and click on Duplicate
  3. Under the General tab, enter the code in the Code field (information provided by the requestor)
  4. Update the description text in the Description (information provided by the requestor) field and Full Description field 
  5. Blank out Output Code
  6. Type VCH ? in the Short field (applies for non-standard Service Codes created by VCH)?
  7. Enter the value into the Standard Price field (information provided by the requestor) on the Financial Tab 
  8. Highlight MSP in the Charge Rates and enter the price to match the Standard Price 
  9. Click the OK button to exit from the New Service window.

 

Modify an Existing Service Code

Reminder for Non-billable Service Codes: create a subtask for SO014 Implementation for EMR-XXXXX, where EMR-XXXXX is the JIRA ID. Assign it to yourself. Note: do not create this subtask earlier while waiting for CIS Approval; create it only once CIS has approved. If this is not followed, this will report inaccurate metrics for the monthly performance reports.

1. Sign into EMR DEV using an account with a Sys Admin or Support Analyst role

2. Double-click on the code or click on Edit icon

3. Under the General tab, replace the description text in the Description field

4. If the Service Code which needs to be modified is billable MSP all information MUST be provided by the requestor: enter the description text in the Description field; add the value into the Standard Price field on the Financial Tab; MSP price in the Charge Rates field (Standard price and MSP Charge Rates should be the same) 


5. Click the OK button to exit from the Service window

6. Confirm that the changes. If all is good, repeat steps in Production EMR

7. Using the generic ADMIN user account, add the changes done above to EMR VTM. This is so both Training and Self-Training environments will get this update on next refresh. 

 

Inactivate/Discontinue Service Code

Prerequisite for billable codes: 

Ensure that the requestor: 

-confirmed with Teleplan that the code is not valid;

-checked with the medical lead or with Teleplan what code would be a replacement of the invalid code

  1. Sign into EMR DEV using an account with a Sys Admin or Support Analyst role
  2. Double-click on the code or click on Edit icon
  3.  On the General tab, select Inactive for non-billable code or Discontinued for billable code
  4. Click the OK button to exit from the Service window
  5. Confirm that the changes. If all is good, repeat steps in Production EMR
  6. Using the generic ADMIN user account, add the changes done above to EMR VTM. This is so both Training and Self-Training environments will get this update on next refresh.