Create a Telehealth Procedure Code (Custom Code)

One way to set up a telehealth-specific procedure code is to create a Custom Procedure Code. A Custom (or "Dummy") Code is a code which does not follow the standard structure for a CPT/HCPCS Code, but can be billed as one. This makes an easily identifiable code on a Superbill/Claim.

  1. Go to Setup: Procedure Codes.

  2. Click the New button on the toolbar. A window will open. Enter the Custom Code; click Next. For example, the code could be 99213TH, 9921302, etc.

  3. A box will pop up asking you to choose how you would like to add the code: From the QuickEntry selection window, or From the Procedure Code setup screen. This guide is using the QuickEntry selection window

  4. Enter the Code Start Date, Code Type, and Code Description. Select a Code Class if appropriate. Under Procedure Fee, select a Procedure Fee Type, and enter the Fee Per Unit.

  5. The window will return to the new fee's Code Summary page.

  6. On the left, select the Billing tab.

  7. Remove the custom identifier, and select the code which should be sent/printed on a claim to the payer(s).
  8.  Save.

  9. To pre-load any Modifier(s), select the Default tab.

  10. On the Default tab, add a Default Modifier, if appropriate, and Save.

  11. Repeat as needed for each code to be added.