Why Use This Function:

 

Capturing ICD-10 Codes on the Invoice ensures that the Patient’s Diagnosis is recorded accurately and consistently. Correct use of Primary and Prescribed Minimum Benefit Codes supports compliant billing, enables correct claims processing by Medical Aid, and ensures that Diagnoses, treatment justification, and clinical reporting remain aligned across the Invoice. The available search, builder, and editing options allow you to efficiently select, manage, and confirm the required ICD-10 Codes before finalising and saving the Invoice.

?Please Note: ICD-10 Codes that are marked as Primary Codes will display a [P] at the end of the Code. Primary ICD-10 Codes are the main/primary Code used for the Patients Diagnosis. ICD 10 Codes that are marked as Prescribed Minimum Benefit Codes will display an [PMB] at the end of the Code. Prescribed Minimum Benefit ICD-10 Codes are Codes used for a PMB condition that a Patient has, that must be paid for by Medical Aid. PMBs are a feature of the Medical Schemes Act, in terms of which Medical Schemes have to cover the costs related to the diagnosis, treatment and care of an emergency Medical condition; a limited set of 270 Medical conditions (defined in the Diagnosis Treatment Pairs) according to Medical Schemes.

• This user manual will start on the ICD-10 Builder screen, located on the Invoice Details screen. 

• For more information on how to navigate to the Invoice Details screen, please refer to the user manual: The Invoice Screen: Navigation and Use.

• Click on the Search ICD-10 field, where you can search for the necessary diagnosis codes. 

 

• Click on the ICD-10 Code to add the selected Code/Codes on the right-hand side under the Added Codes section. 

• Click on the Drag button to move the position of the ICD-10 Codes you have selected.

• Click on the red Delete button to remove/delete the Added ICD-10 Code.

• Click on the VWXY button.

• The Advanced Options will become available.

?Please Note: For some ICD-10 Codes, like S or T codes, you need to use the Advanced Options because a Cause of Morbidity is required for those codes to process the Invoice. 

• Click on the Save button to add the selected ICD-10 Codes to the Invoice. 

• The Invoice Details screen will open again, with the selected ICD-10 code(s) listed.