Viewing and Editing CodeSets

To view/edit code sets in HIPAA Claim Master, follow the instructions below.

1. Go to Entry/Edit arrow Claim Entry/Edit CodeSets in the main menu.

The additional code sets that are required for Claim Entry/Edit

Alternatively, you can access the codesets setup from the Claim entry/edit window. Click the Codesets button. Read more in Using the Claim Entry/Edit Function.

The "Codesets" button on the "Professional Claim" window
2. The Code Sets - From the sub-menu, select a code set name. The following menu items are available via the "Code Sets" menu:
Adjustment Reason Codes
Admission Type Codes
Admission Source Codes
Amount Qualifier Code
Condition Codes
Diagnosis Codes — See Creating Codeset Tables
DTP Codes
Facility Types
Filing Indicator Codes
Info Release Codes
Occurrence Codes
Occurrence Span Codes
Patient Status Codes
Place of Service Codes
Procedure Codes - See Creating Codeset Tables
Provider Taxonomy Codes
REF Codes
Remark Codes
Relationship Codes
Report Type Codes
Revenue Codes - See Creating Codeset Tables
Tooth Numbering Codes
Treatment Codes
ZIP Codes - See Creating Codeset Tables

Diagnosis, Procedure, Revenue and ZIP code sets are too large to store in memory. They can be edited like any other codeset but the database tables to store them are created separately.

3. To select, for example, the "Remark Codes" codeset for display, click the Claim Entry / Edit menu item and from the Claim Entry/Edit CodeSets dropdown menu options select Remark Codes:

The "Claim Entry/Edit CodeSets"
4. The Code Set configuration window for the selected codeset, in this case Remark Codes, will displayed. You can add additional codes by typing it into the blank row at the end of the list or edit the existing ones by double-clicking the field to edit it and type in the new value. Click the Save button to save the changes.

The "Remark Codes" code set configuration window

   As mentioned above, the procedure, diagnosis, revenue and ZIP codes are saved to a database. These four codesets have a slightly different codeset editing screen (shown below) but they behave in the same way. Since these codesets can grow very large, search boxes are provided to filter through codes or descriptions.

The slightly different "Procedure Codes" code set configuration window.

The codeset windows provide the following information:

Number of records in codeset — The total number of codes stored in the database.
Codes and their corresponding descriptions. A short description, standards version (ICD), city and state (ZIP) may also be included, depending on the loaded code table. The codes are indicated in the source EDI files. The descriptions are displayed instead of codes in the result easy-to-read files. For example, for Remark Codes there are the following codes and corresponding descriptions:
M1 - X-ray not taken within the past 12 months or near enough to the start of treatment.
M2 - Not paid separately when the patient is an inpatient.
M3 - Equipment is the same or similar to equipment already being used.

4. Click on the "Save" button to save the changes. Changes to the procedure, diagnosis, revenue and ZIP codes are saved automatically to the database.

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