When creating CPT codes it is very important to understand the Journey a CPT code button takes from the moment you press the button to it landing on the patient's ledger.
When a CPT code button is selected it will follow through a series of gates.
First, it bounces off the price list to see what a clinic charges for a service and any requirements set forth on the Price List.
Second: If using Fee Schedules, it will add or remove requirements based on what the Fee Schedule states.
Third: It will pass through the insurance snapshot to see if the patient has a deductible, policy limits, coverage percentage, etc.
Fourth: Add the charge to the patient's appointment.
If any gate it passes through provides inaccurate information, what you see on the ledger will not be reflected properly.
Below you will see an image of the flow to help understand the process mentioned.
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