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Keeping Current with LYNX E/Code & UB-04
On May 23, 2007, the National Uniform Billing Committee released the new Facility services billing form into production nationally. The introduction of this form requires hospitals to report outpatient services with new information. With legacy form UB-92, Form Locator 76 was designated as admitting diagnosis for inpatient type bills. On April 1, 2000, Form Locator 76 on the UB-92 form was changed to read as follows:
“The ICD-9-CM diagnosis code describing the patient’s diagnosis or reason for visit at the time of admission or outpatient registration.”
The change allowed the field to serve a dual purpose. If patients made an unscheduled visit to a facility’s Emergency Department or Urgent Care Center to receive treatment on an outpatient basis, the diagnosis code describing the patient’s reason for the visit would be reported on Form Locator 76. If the encounter resulted in an inpatient admission, the diagnosis code for the reason for admission would be reported rather than the patient’s reason for the visit.
With the introduction of UB-04, Form Locator 76 has changed. Now the reporting is separated into two different components on the bill. Form Locator 69 is designated for use only with inpatient bill types and is representative of only the admitting diagnosis associated with a patient’s encounter. A new Form Locator with three fields, 70 a-c, is designated for use with outpatient (unscheduled) bill types and allows for assignment of three diagnoses in place of only one for a patient’s reasons for visit.
Software Tools
LYNX E/Code helps ensure that the transition to the UB-04 is seamless. The E/Code field entitled “admitting diagnosis” accepts entry of one diagnosis code. Meant for outpatient services, this code is representative of the patient’s primary reason for visit.
In August 2007, E/Code will be updated to accommodate the titles from the UB-04 form. An area will be added to the Facility pathway representing the patient’s Reasons for Visit. Per the UB-04, there will be three fields for this component. In an extract to your billing system, these fields will be identified as reasons for visit and will map accordingly to the Form Locators 70 a-c. In the interim, LYNX recommends mapping the admitting diagnosis ICD-9 code as the patient’s reason for visit from the E/Code extract to the Form Locator 70a on the UB-04. This code would currently be designated with an A in the DG segment for easy identification. Since reporting the admitting and reason for visit are now separate, Form Locator 69 will no longer be populated by E/Code.
Coding Services
LYNX Coding Services clients are already receiving the benefits of the UB-04 change as the update to E/Code has been implemented. Rest assured your extract contains the appropriate information to populate the new UB-04 segments. Plus, your reporting of reasons for visit will increase, thus enhancing your UB-04 billing process.
E/Code Update Information
For more information, contact:
Current Extract Technical Questions: Technical Support at 866.295.8858 or Support@lynxmed.com
E/Code Service Pack Implementation Dates: LYNX Account Executives at 800.767.5969 or ClientCare@lynxmed.com
Software Requirements: Product Management at 800.767.5969 or ProductManagers@lynxmed.com
Additional Resources
EMRs and the ED: Where’s the Content?
EMRs and the ED: Where’s the Content?
The difference between thorough and poor ED documentation can be the difference between millions of dollars of revenue captured or lost. The quality and availability of this ED content has a profound impact on coding and billing, compliance, liability exposure, and the quality and continuity of patient care.
With the advent of the electronic medical record (EMR), hospitals may find themselves even more vulnerable to lost ED revenue. While EMR providers promise ED documentation capabilities and access to ED clinical content through standardized content libraries, the reality is quite different. The ED is unlike any area of your facility, rendering many EMR ED applications insufficient or unable to drive the ED coding and charging process.
If you've made an investment in a hospital-wide EMR, chances are that it can only be populated with incomplete ED data. And worse, because that documentation is incomplete or inaccurate, your ED is not capturing or coding for all services and materials. It all adds up to lost revenue.
The solution is to let LYNX work with you and your EMR vendor to populate your EMR with LYNX ED Clinical Content. Our EMR-ready content is the proven product of a comprehensive system of ED documentation—a methodology built on a presenting problem-based model that has been refined over 10 years of experience and a database of millions of encounters. LYNX can seamlessly integrate our system of documentation with your EMR to ensure that all aspects of a patient ED encounter are captured and recorded.
The result is your organization can enhance the value of its EMR investment with a powerful, reliable ED documentation system. Plus, if used in conjunction with LYNX’s E/Code ICD-9 & CPT coding application, your facility can have the industry’s premier ED revenue cycle solution. Staff can quickly access a structured, presenting problem-based system for ED documentation that includes:
- 10 age groups and gender specificity
- Detailed problem list
- Questions and answer sets that are specific to the identified problems
- Detailed capture of information to assign procedures
We have developed an Integration Guide to help navigate and simplify the implementation of EMR-ready ED Clinical Content. Plus, LYNX consulting is available to ensure a seamless implementation process.
By using our prescribed methodology and XML to facilitate the sharing of data, our ED Clinical Content is an elegant solution that seamlessly integrates with any EMR. LYNX content populates your EMR, helping to provide complete and thorough patient documentation. Coding workflows are streamlined; compliance risk is minimized; and appropriate revenue is generated, based upon complete, defensible patient documentation.
For more information on LYNX Clinical Content, contact your LYNX account executive at ClientCare@lynxmed.com or call 800.767.5969.
LYNX Shines at the Health Finance Management Association’s Annual National Institute in San Diego
LYNX premiered a new trade show booth at the Health Finance Management Association’s (HFMA) Annual National Institute (ANI) in San Diego on June 25-26. The sleek new look accentuated our message of driving value in emergency medicine with two demo stations and a presentation area where attendees could learn more about LYNX products and services.
LYNX vice president of Clinical Services, Dr. Jeff Wajda, DO, MS, FACEP led a break-out session entitled, “Achieving Optimal Revenue in the ED through Physician and Hospital Alignment.” Dr. Wajda co-presented with Kaveh Safavi, MD, JD of Thomson Healthcare, with Dr. Ronald Dobson, MD, FACEP, former medical director at Swedish Medical Center, offering real-world experience.
The session identified ED issues, myths and realities; trends and challenges; and opportunities to improve ED value through physician and hospital alignment. Dr. Wajda discussed the importance of standardizing ED documentation and facility charging with a resource-based methodology to improve compliance and ED. Another approach presented focused on an ED disposition decision support methodology to expedite care, improve ED value and solve the Inpatient/Observation status conundrum which affects many hospital EDs.
For more information on Dr. Wajda’s session, feel free to contact him via email at jeffw@lynxmed.com.