Allegheny Messages

Available with Main Office Software Version 5893 dated 01/08/2016, additional data entry fields are now available to accommodate effective dates for the new G/HCPCS codes for RN and LPN visits for other Insurance companies.  Many of these other insurance companies will have different effective dates for use of these new G/HCPCS codes .   Agencies will find a new date field in Insurance Set Up for each Insurance Company, on the Insurance Company tab labeled “Effective date of G Codes G0299 G0300”.  Agencies will need to enter the effective date for the new G codes.

Agencies must then update their Service Setup for the insurance company with the new G Code.  The new G Code can be entered into the HCPCS field.  The update to the Service Set Up can/should  be done now, prior to the effective date.

When invoicing, the software will look at the date of the visits being invoiced.  If the date of service is prior to the effective date, the software will replace the new G Codes with Go154.  When invoicing for dates of service on or after the effective date, he software will use the new G codes already attached to the visits by complying with the previously detailed set up instructions.

ADDITIONAL SERVICE SET UP TO CONSIDER:

Agencies currently using different service codes for RN and LPN visits for the Insurance Company can update the HCPCS field with the new G code.

Agencies that do not currently differentiate in services between RN and LPN visits for the insurance company will need to update their current Skilled Nursing Visit service to reflect the RN visit and enter the new RN G Code in the HCPCS field.  Agencies will then need to add a new service for the LPN Skilled Nursing Visit using the new G code for services by an LPN in the HCPCS field.  If the agency has already added a new Service Code for the LPN visit, the agency should add the Insurance Company into the Insurance Company Billing rate tab with the Insurance company specific billing rate, billing unit, revenue code and the updated HCPCS.  The Service or Revenue code needed for invoicing these services should be verified.  Agencies that have the Insurance Company already entered in the Insurance Company Rates tab will just need to update the existing record with the new G/HCPCS code.

Agencies should contact their commercial insurance or Medicare Advantage/ HMO plans to verify if any changes are required for those payers.