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Intelicode User`s Manual Version 8

1. Do you want to base the Reviewer EEN on the Complexity of Medical Decision Making Copyright O 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved 1 Note Macros Click selected areas on the image areas where the d cursor appears Le E amp M Codes below for more information and to preview the various screens Note Macros Note Macros can be an extremely helpful tool for auditors to help them more clearly elaborate their findings in encounter documentation Note Macros can also be extremely beneficial as an educational tool for providing physicians providers with additional information about problems and or recommendations concerning documentation Think of them as saved information tidbits that can be pasted into an encounter anytime you wish To begin using Note Macros simply click on the Note Macros button appearing in the lower portion of the screen on the Patient History and End Screens A Note Macro Maintenance pop up screen will appear Select the Add New Macro button The bottom of the pop up screen will change to have a section labeled Create Edit A Note Macro In the field Macro Name enter the name you wish to give this macro what you will be able to identify this macro by from a list e g hand writing or legibility The next field is Mac
2. All Rights Reserved Modifier Codes Maintenance If you choose to enter and maintain your own Modifiers you can do it from the Utilities Modifier Code Maintenance menu 62 Maintenance Modifier Code Maintenance Enter Edit Modifiers Code Description 2d Unrelated EM service by same physician during post op pernod Help Text 24 Unrelated E JM service by same physician during post op period Print List of Modifers Save Send Modifier 2 To Other OfficeDepartment or File Delete Modifier Copy Modifers From Other Office Department or File Close Number Marne 2 Prolonged evaluation and management services e Unrelated E M service by same physician during post op period Separately identifiable EM service Same physician Same day Mandated services Reduced services Decision for surgery Multiple procedures Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved Requesting Provider Maintenance To add a new Requesting Provider choose Add New Requester from the Requesting Provider drop down list on the Patient screen or choosing Requesting Provider Maintenance from the Utilities menu The only required fields are ID Number Last Name and First Name 63 Intelicode User s Manual Version 8 Requesting Provider Maintenance Requesting Provider Maintenance ID Number Last Name Fir
3. The audited code the code produced by the information entered by the reviewer will appear in the upper right corner of the End screen in Yellow font Visit Information The information reflecting in this section of the End screen is a culmination of the encounter information the reviewer has entered up to this point If information reflected on this portion of the End screen is incorrect return to the screen where the original information was entered to make the appropriate changes Time If Time is a factor in the encounter being audited enter the Face to Face time in the appropriate field by clicking on the drop down arrow and selecting the documented Face to Face time Additionally enter the documented Counseling time in the appropriate field by clicking on the drop down arrow and selecting the documented Counseling time If the Counseling time is 50 or more of the total Face to Face time Intelicode will automatically adjust to reflect the appropriate code in the selected service category in relation to the times entered If you wish to remove Face to Face and Counseling times simply click on the drop down arrows and select the blank space at the top of the times listed in each field Comparison Intelicode calculates the Reviewer E amp M based on what has been selected in each of the screens History Exam Decision When you get to the end of the review and are on the End Screen select the Provider E amp M from the list of E amp M
4. Generating and Printing Reports Generating reports could arguably be the most important and valuable part of Intelicode Step Six showed how you can print an Encounter Detail Report at the end of the encounter Intelicode does so much more See Generating Audit Summary Reports and Issues and Recommendations Reports for details on how to get the most of Intelicode s reporting capabilities 26 Navigation 1 Patient Screen Click specific areas on the image below areas where the d cursor appears i e History for more information and to preview the various screens Patient ID This field is required to generate an audit The Patient ID can be the patient s medical record number or any other unique number by which the auditor could identify the encounter being audited Last First Name Patient names are optional fields and are not required to generate an audit D O B Date of Birth This field is only required to generate an audit if the services are those that are dependent upon the age of the patient e g preventive services The Date of Birth must be entered in mm dd yyyy format Press the tab key to progress through the date fields Patient Status This is the status of the patient during the encounter being audited Intelicode will load all patients as new patients the first time they are entered into the software and will subsequently default existing patients those already loaded into the software as established pat
5. Initial Visit along with the Service Category i e Office or other Outpatient Possible Cause If you are auditing a time based code i e Preventative Medicine codes make sure that you choose the face to face time on the End Screen Possible Cause Make sure that you have enough documentation to support the level that you think it should be A common one that we see is Initial Hospital Care 99221 which requires a detailed or comprehensive history a detailed or comprehensive examination and medical decision making that is straightforward or of low complexity Make sure to check that there is adequate levels of History Exam and MDM Intelicode will not calculate a Reviewer E amp M unless the requirements are met Possible Cause If you are auditing an age based code make sure that you have the Date of Birth field completed e Problem Intelicode is not calculating a Variance Possible Cause In most cases Intelicode will calculate a Variance when the Reviewer E amp M and the Provider E amp M are part of the same Service Category i e Office or other Outpatient In most situations where the Service Categories don t match Intelicode will calculate a wrong category wc Occasionally Intelicode will not calculate either It would take far too much space to try to explain the technical reasoning behind it here Simply know that in the occasional times that a variance or wc is not calculated you can select a variance
6. highlight or select it Highlighted or selected elements will appear in red There are exam elements in the 1995 exam that are specifically designed to allow the auditor reviewer to reflect examination as accurately as possible These elements indicate a Limited exam or a Detailed exam relating to how the presenting problem was performed The Limited exam element will allow the auditor reviewer to keep the level of exam at Expanded when appropriate when 2 to 7 Body Areas or Organ Systems are selected The Detailed exam element will allow the auditor reviewer to make the level of exam Detailed when appropriate when 2 to 7 Body Areas or Organ Systems are selected Joints Bones Muscles Only for use with applicable 1997 Exams To access the individual elements or bullets pertaining to J oints Bones Muscles click on the J oints Bones Muscles button Select the desired individual elements or bullets by clicking the check box next to the desired area Click on the x in the upper right corner to close when finished Head And Neck A Spine Ribs and Pelvis Right Upper Extremity Left Upper Extremity Right Lower Extremity Left Lower Extremity WK Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved 1 Decision Diagnosis Management Options Click an area on the image
7. 5096 of the Face to Face or unit Hoor time visit is spent counseling the code may be determined based on the entire time of the visit Documentation must be stated as 40 45 minute visit spent counseling the patient on or Spent the majority of the 45 minute visit counseling the patient regarding Ce 21607 New Office or Other Outpatient Initial Man Detailed Detailed 97 High 99203 99203 D Provider Dx 1 SEPTICEMIA NEC 033 8 Reviewer Dx 1 SEPTICEMIA NEC 038 8 Provider Dx 2 URINARY CALCULUS NOS 592 9 Reviewer Dx 2 URINARY CALCULUS NOS 592 9 Total isits Accurately Coded Under Coded Billed Over Coded Billed Wrong Category wc a 2 40 00 1 29 00 2 40 00 1 20 00 E Page 1 of 1 I NTELICOD Report generated by INTELICODE Copyright 1998 2007 TSI All Rights Reserved Saturday March 24 2007 Intelligent Crding Es freare Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved 40 Reports and Printing Encounter Detail Report The Encounter Detail Report can be printed at the end of the audit or later from Visit Summaries To print from Visit Summaries follow these simple steps Step One choose Visit Summaries from the Visits menu Step Two Choose the criteria you wish to report by i e Status Service Category Sub Category Provider etc Select as many as you deem necessary to achieve the r
8. Ce Print Preview C Send to Word C Send to Excel C Send to POF C Email Report Choose a sort column Ce ID C Name Printer Setup l Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved Retrieving Saved Reports Intelicode gives the user the ability to save reports in different formats i e Word Excel PDF You can access your saved reports by going to the File drop down menu located at the top of the page and select Retrieve Saved Reports Office Del ed Reports l Print Setup Exit An Open pop up window will appear Select the file name containing your saved reports and click the Open button or double click the file name 55 Intelicode User s Manual Version 8 wy SuditReportallProviders doc A el SuditReportByProvider pdf My Recent Ht AuditReportByProviderwithDxNoDollars doc SE ale E QuditReportTeachingallProviders xds aad Au dit eportTea C hin gByF o vider xls ge Wl lissuesrecom doc Desktop My Documents Mu Computer a File name audit eportl eachingbyProvider xls x My Network Files of type All Files D Cancel Places Open az read only Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved Maintenance Utilities Menu The Util
9. Exam Type is displayed at the top left side of the Exam screen To change the Exam type click the drop down arrow and choose the desired exam type You may audit any given encounter in multiple Exam Types and Intelicode will save all of the utilized exam types and will tell you when you have not chosen the exam type displaying the highest level of service For the 1997 Exams all Exams the applicable Systems Body Areas are displayed on the left side of the screen To select a desired System Body Area click on the check box beside the System Body Area name or click on the System Body Area name itself The individual exam elements bullets for the selected System Body Area will be displayed on the right side of the screen under Elements of Examination Exam elements or bullets that appear in a Shaded box in the original 1997 Exams will be underlined for easy identification To select individual elements bullets click on the element itself to highlight it Highlighted or selected elements will appear in red Intelicode will count the highlighted or selected 29 Intelicode User s Manual Version 8 elements for you and will display them at the top of the screen next to the Elements of Examination header For the 1995 Exam the Body Areas and Organ Systems are displayed on the right side of the screen under Elements of Examination To select individual elements bullets click on the element itself to
10. Fixes As always there are those pesky features also known as bugs We have fixed some that you may have known about and some others were not so obvious STrailblazer Support Including in Version 8 of Intelicode is support for the Trailblazer medical decision making component Diagnosis and Procedure Accuracy Report This report shows the percentage of accurate diagnosis and procedure codes Deleted Visits There is an updated visits summaries screen You now have the ability to delete multiple visits at one time Just for a safe measure we have added a recycle bin to the visits menu which is called Deleted Visits This grid contains all the visits that have been deleted in Intelicode From here you can restore those visits or delete them permanently Getting Started System requirements Hardware The minimum hardware requirements are CPU Pentium II or later Memory 64MB or greater Available disk space 50MB Software The minimum software requirements are Operating System Windows 2000 SP1 Other software Microsoft Office 2000 or later Other software Adobe Acrobat reader 5 or later Installing INTELICODE Follow these simple instructions 1 Close all programs 2 Insert the CD labeled INTELI CODE into your CD ROM drive If Autorun is enabled on your system the installation starts automatically and you can skip steps 3 and 4 From the Start menu select Run 4 Type D setup substitute the appro
11. List of Requesting Providers in Requesting Provider Maintenance See more on Report Printing Options 52 Reports and Printing Report Printing Options Select a report from list Please select a print option Print to Printer Requesting Provider List f Print Preview C Send to Word C Send to Excel C Send to POF C Email Report Choose a sort column Ge ID Name C Specialty Printer Setup l Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved Resident Listing To print a list of Providers click Print List of Residents in Resident Maintenance See more on Report Printing Options 53 Intelicode User s Manual Version 8 Report Printing Options Selecta report from list Please select a print option Print to Printer Ce Print Preview C Send to Word C Send to Excel C Send to POF C Email Report Choose a sort column Ge ID Name C Specialty Printer Setup l Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved User Listing To print a list of your Patients click Print List of Users in User Maintenance See more on Report Printing Options 54 Reports and Printing Report Printing Options Select a report from list Please select a print option Print to Printer
12. SOFTWARE APPLICATION YOU AGREE TO BE BOUND BY THE TERMS OF THIS AGREEMENT INCLUDING THE WARRANTY DISCLAIMERS LIMITATIONS OF LIABILITY AND TERMINATION PROVISIONS BELOW IF YOU DO NOT AGREE TO THE TERMS OF THIS AGREEMENT DO NOT INSTALL OR USE THE SOFTWARE APPLICATION AND EXIT NOW LICENSE TERMS Following acceptance of this Agreement you may install and execute and use one 1 registered copy of the Software Application If you are installing this Software Application for the thirty 30 day trial period your license to use this Software Application expressly expires thirty 30 days from the date of installation If you have purchased a fully licensed version of the Software Application or agree to purchase a fully licensed version of the Software Application after the expiration of the trial period TSI hereby expressly grants you a one year license to use the Software Application subject to the terms and conditions contained herein If you already purchased a one year license you are entitled to receive a full refund of any payment made for the Software Application by so requesting and returning any media and materials to TSI within fifteen 15 days after the date of payment In the event you request a refund you agree to destroy all copies of the Software Application and all of its component parts and TSI may suspend or deactivate your use of the Software Application with or without notice 71 Intelicode User s Manual Version 8 TSI
13. areas where the d cursor appears Le History below for more information and to preview the various screens or to see additional information about that item Here you select the number of diagnoses or problems that are applicable to the encounter being audited by selecting the appropriate number from the drop down box Intelicode keeps track of the counting The level or counts for the Diagnosis Management Options portion of the encounter elements selected will appear in the upper left corner of the screen When the mouse is positioned over a specific statement the actual corresponding quotation from the Documentation Guidelines will appear in the blue green help box across the bottom of the page as an additional reference 30 Navigation 1 Decision Amount Complexity of Data Click an area on the image areas where the d cursor appears i e History below for more information and to preview the various screens Recording the Amount Complexity of Data documented in a record being audited is easy Simply select those items that have been documented by clicking on the check box next to the statement or clicking on the statements words themselves Select as many elements or statements as are relevant Supported by the encounter documentation To unselect an item simply click the check box or statement again The level or counts for the Amount Complexity portion of the encounter elements selected will appear in the upper left corner of th
14. codes in the middle of the screen To the left of the list of E amp M codes you will notice a Comparison area This Shows the Reviewer E amp M and the Provider E amp M and will calculate a Variance based on the code difference A Fee Difference will also be calculated based on your fee schedule selected Provider E amp M The code used by the provider for billing the encounter being audited Reviewer E amp M The audited reviewed code the code produced by the information entered by the reviewer will appear in the upper righ corner of the each screen in Yellow font and in the Reviewer E amp M field in the Comparison area Modifier This is the Modifier field located next to the Provider and Reviewer E amp M fields for the Provider and Reviewer E amp M Select the appropriate modifier if applicable by clicking on the drop down arrow and clicking on the desired modifier Fee Schedule The fee schedule field will display the fee schedule utilized to produce the comparison Overbilled or Underbilled amount This field also allows the reviewer to change fee schedule for the encounter being audited if more than one fee schedule is loaded If no fee schedule amounts are loaded the Overbilled or Underbilled field will remain blank in applicable situations Diagnosis Codes Select the diagnosis code s used by the provider when billing the audited encounter when applicable if desired Select the Reviewer diag
15. does not render any medical or legal advice in support of the use of the Software Application and any use thereof is understood to be done under the sole control determination and responsibility of the medical staff and or physician using the Software Application It is the user s full responsibility to have a working knowledge of the Documentation Guidelines and CPT Furthermore the user assumes full responsibility for the accuracy of the input of data and any subsequent output of data from the Software Application based on the inputted data It is understood that the user will keep current with respect to any changes in the CMS AMA guidelines and is responsible for any and all data inputted and generated using the Software Application TSI will use its best efforts to furnish updates to the product within a reasonable period of time to address such changes in the HCFA AMA guidelines Use on a PC You may install the single registered copy on one hard disk or other storage device for one computer and you may access and use the Software Application at that location so long as only one copy of the Software Application is in operation If you area private business rather than an individual you may authorize the personnel associated with your business to use the Software Application but only one person at a time on one computer at a time The primary user of the computer on which the Software Application is installed may make a second copy for his or
16. her exclusive use on a backup or portable computer so long as each registered copy of the Software Application is used on only one computer at a time Use on a Network You may store install and access the registered version of the Software Application through an internal network provided that you must obtain and pay for a license for each workstation that will access the Software Application through the network For example if 5 different workstations will access the Software Application on the network each workstation must have its own paid up license regardless of whether the workstations use the Software Application at different times or concurrently OTHER LIMITATIONS You may not rent lease or lend the Software Application You may not reverse engineer decompile or disassemble the Software Application except and only to the extent that such activity is expressly permitted by applicable law notwithstanding this limitation TSI may provide you with support services related to the Software Application Support Services Use of Support Services is governed by TSI policies and programs described in the user manual in online documentation and or in other provided materials Any Supplemental software code provided to you as part of the Support Services shall be considered part of the Software Application and subject to the terms and conditions of this Agreement With respect to technical information you provide to TSI as part of the
17. on the Patient screen Once the check box has been clicked an additional button tab will appear across the top of the Intelicode screen between the Decision and End buttons tabs labeled Teaching The Teaching screen displays a field for the Resident s name followed by a series of questions to determine if the encounter being audited meets the Teaching Physician Guidelines as issued by CMS The Resident s name field operates like the Attending Provider amp Referring Provider fields Simply click the drop down arrow in the field and choose the Add New Resident option The Attending Resident Maintenance pop up screen will appear Complete the resident s identification number chosen by the user last and first names then click the Save and Close buttons The questions should all be answered by choosing the appropriate Yes or No answer to each question Once the Teaching Guidelines have been met a GC modifier will be displayed with the audited reviewed code in the upper right hand corner of the screen An asterisk will be displayed when the Teaching Guidelines have not been met Copyright O 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved End Screen Click selected areas on the image areas where the d cursor appears i e E amp M Codes below for more information and to preview the various screens 32 Navigation Code
18. other than the patient Review and summarization of old records and or obtaining history from someone other than patient A Walk Through Patient 16 Betty Bebee Sample Office File Utilities Preferences Visite Office Department Documentation Guidelines Intelicurve Help Patient History Exam S End Straightforward Diagnosis Management Options Amount Complexity of Data i Presenting Problem s Diagnostic Procedure s Ordered Management Option s Selected One self limited or minor problem 2 or more self limited problems 1 stable chronic illness Acute uncomplicated illness or injury 1 or more chronic illnesses with mild exacerbation progression or side effects of treatment 2 or more stable chronic illnesses Undiagnosed new problem with uncertain prognosis Acute illness with systemic symptoms Acute complicated injury 1 or more chronic illnesses with severe exacerbation progression or side effects of treatment Acute or chronic illnesses or injures that may pose a threat to life or bodily function An abrupt change in neurologic status Step Five End Screen The end screen displays a cumulative total of all information entered through this point in the audit It is advisable to check the information entered thus far to ensure accuracy The Visit Information section displays informa
19. populated with the corresponding subcategory types i e For a Consultation the subcategories could be an Office or Inpatient for example The Subcategory will be a determining factor of the overall code Teaching Physician Visit Only for Intelicode P A T H users this field will be accessible to indicate whether a service is a teaching visit or not If the service being audited is a teaching visit click this check box to add the Teaching tab to the encounter and activate the Teaching Guidelines Notes This field allows the user to add their own comments free text about the encounter or the documentation etc for future reference or educational opportunities The Note Macros button allows the reviewer to store specific notes for use in future audits Using Note Macros can save the reviewer the time and effort of retyping the same information over and over Patent 1167 Betty Bebee Sample Orfice File Utilities Preferences Visite OFFice Department Documentation Guidelines Help Patient History Exam Decision End Last Name First Name DUR Service Type 7 f 67 Bebee Betty 07 2771 957 Office or Other Outpatient Hospital Observation Services Hospital Inpatient Services Consultations Se Emergency Department Services C Male f Female Pediatric Critical Care Patient Transport Critical Care Services lnpatient Pediatric Critical Care Inpatient Neonatal Critical Care Attending Provider e Met Da
20. reports easy to generate Audit Summary Reports Encounter Detail and Issues and Recommendations reports Step One choose Visit Summaries from the Visits menu Step Two Choose the criteria you wish to report by i e Status Service Category Sub Category Provider etc Select as many as you deem necessary to achieve the results you are looking for This will filter the information to suit your needs In our example we chose Dr Welmore from the Provider list Patient 156 Suzie Singleton Sample Office File Utilities Preferences Visits OFFice Department Documentation Guidelines Help Date Range Du Visit Audit Status Service Category SubCategory Provider 2 26 2005 To 2 2642007 ell ei Usel E Specialty E Requester Var z Macro Patio ven Taugp SubCategory Provider Reviewer EM TP Provider Ett 1 30 Ger 1120 2008 SS or Other gg Initial Vist Feelgood MD Dr 4 811222005 1 20 2006 Office or Other Qutpe Follow Up Welmore MD Me 2 4172005 1 20 2006 Office or Other Qutpe Initial Visit Feelgood MD Dr 1 34132005 1 20 2006 Office or Other Qutpe Follow Up Carrington MD Li 9292005 1 20 2006 Consultations Office Consultatic Carrington MD Li 10 20 2005 1 20 2006 Critical Care Services First Hour Carrington MD Li EEE 1 20 2006 Est Preventive Medicine Periodic Comprek Wrelmore MD Me 99396 99215 57854 12 10 2005 1 20 2006 Est Consultations Office Consultatic Farmood MD El 99244 8945 12
21. statements Selected risk elements will be highlighted in Red The highest corresponding level of Diagnostic Procedures Risk e g minimal low moderate high will appear to the left of the selected statements To unselect any element simply click that element again it will turn blue again 1 Risk Screen Management Option s Selected 31 Intelicode User s Manual Version 8 Click an area on the image areas where the d cursor appears Le History below for more information and to preview the various screens The Management Option s Selected tab of the three Risk screens is used to indicate the level of risk associated with the management options documented for the encounter being audited To select the desired level of Management Options Risk click on the risk elements or statements Selected risk elements will be highlighted in Red The highest corresponding level of Management Options Risk e g minimal low moderate high will appear to the left of the selected statements To unselect any element simply click that element again it will turn blue again 1 Teaching Physician Screen 1 Click selected areas on the image areas where the d cursor appears i e Navigation Buttons below for more information and to preview the various screens The Teaching Physician Screen is available only to Intelicode P A T H customers This screen is activated by identifying an encounter as a Teaching Visit by clicking a check box
22. users may choose to use their own diagnoses which would be user loaded In the latest version of Intelicode we allow the user to enter four diagnosis codes for both the provider and the reviewer Theses codes can be accessed by click either the Provider or Reviewer DX tab The Note Macros field gives the reviewer the ability to document specific information about an audit encounter documentation issue etc Note Macros can be developed to insert in the Notes field or the reviewer may type freeform text as desired This aspect of Intelicode provides reviewer with the ability to enhance their audit reporting without a lot of additional work For our audit we inserted a Note Macro we developed called Legibility We developed an Issue macro and a Recommendation macro Both macros explain what the documentation issue is and the recommended steps to improve that issue The Medical Necessity questions allow the user to override the Reviewer E amp M by setting the Medical Decision Making level as the key component in determining the level of service The example below shows both questions that need to be answered If you do this the program will place a DC behind your CPT identifying that the code has been down coded to the Medical Decision Making level of service The Diagnosis or Procedure Codes are accessed with the tabs on the right side of the screen The agree check boxes will set the Reviewer E amp M code equal to the Provider E amp M code Any
23. you have changed it but you can print it or delete it Right Click on a visit to print or delete it Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved 1 Retrieving Saved Reports Intelicode gives the user the ability to save reports in different formats i e Word Excel PDF You can access your saved reports by going to the File drop down menu located at the top of the page and select Retrieve Saved Reports ed Reports Print Setup Exit Tr ir An Open pop up window will appear Select the file name containing your saved reports and click the Open button or double click the file name 37 Intelicode User s Manual Version 8 Look in IS Saved Reports de E eg DES Mu Recent Documents Desktop Mu Documents Mu Computer ei Mu Network Places H auditReportallProviders doc pel AuditReportByProvider pdf 07 auditReportByProviderwithDxNoDollars doc SS xls e eon mm File name Auch eportleachingByProwider xls T Files of type All Files D Cancel Open az read only Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights 38 Reserved Reports and Printing Generating Audit Summary Reports Intelicode makes creating custom
24. you wish to archive your data at the end of each year For example Say you have a clinic named Cardiology North To archive your data you would create a new Office named Cardiology North 06 for the new year Next you would copy your Users Providers Patients Fee Schedules etc See more on copying data Copyright O 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved Copying and Sending From Office to Office Pro and P A T H only Intelicode gives you the ability to Send or Copy various things from office to office i e Note Macro Diagnosis Codes Patients Providers etc Send Macros to another UfficeDepartment or File l l l You can send certain selected items i e at least one but not all items to another office or multiple offices at once If you choose this button with no items selected it will send the entire list NOTE If you have any items selected you will be asked if you want to send just the selected items or all the items Copy Macros From Other Office Depariment or File When Copying from another Office all records from that table i e all Diagnosis codes for example will be copied from the other Office Department Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved Ed
25. 10 2005 1202006 Est Emergency Departmi Emergency Depe 99281 65432 12 70 2005 1202006 New Hospital Inpatient Se Initial Hospital Ca Welmore MD Me 99223 B236 12 3 2005 120 2006 Est Office or Other Outp Follow Up Swelman MD Ne 99214 17040 12 7 2005 1 20 2006 New Hospital Observation Initial Observatior 99220 5544 11152005 120 2006 Est Office or Other Qutpe Initial isit Fanwood MD Eh 99213 Af l Total Visits Accurately Coded Under Coded Billed Over Coded Billed Financial Eror Wrong Category we Non Compliant TP a2 5 15 63 H 2500 2 19 5938 2907 amp E 18 75 1 313 2 K 2824 00 195 00 1016 00 LH I Some portions or this entire note includes documentation where legibility is at least questionable or extremely poor E APE Legibility A The first iter stated in the General Prinicples of Medical Record Documentation states el he medical record should be complete and legible This reference can be found in both the 1995 and 1997 Documentation Guidelines A good definition of legibility to work by is if the note or documentation is legible to someone outside the practice or facility then the document is considered Step Three Select the report from the list of reports then choose where you want to send it i e Printer Word PDF etc and click OK In this example we chose the Audit Report by Provider With Dx 39 Intelicode User s Manual Version 8 Report Print
26. 127102005 1120 2006 Est Consultations Office Consultatic Farwood MD El 39244 8945 12 10 2005 1 20 2006 Est Emergency Departmi Emergency Depe 35251 kuke 12 70 2005 1720 2006 New Hospital Inpatient Ge Initial Hospital Ca Welmore MD Me 99223 636 12 3 2005 1202006 Est Office or Other Outpe Follow Up Swelman MO Mc 99214 ford 1222005 1 20 2006 New Hospital Observation Initial Obzervatior 99220 15544 11152005 1 202006 Est Office or Other Qutpe Initial Visit Farwood MD El 99213 Total Visits Accurately Coded Under Coded Billed Over Coded Billed Financial Error Wrong Category we Non Compliant TP dit Visit H 32 5 15 63 5 25 00 13 59 38 2907 E E 18 75 1 3 13 Se 2024 00 135 00 1016 00 Legibility l Some portions or this entire note includes documentation where legibility is at least questionable or extremely poor Legibility A The first tem stated in the General Prinicples of Medical Record Documentation states The medical record should be complete and legible This reference can be found in both the 1996 and 1997 Documentation Guidelines A good definition of legibility to work by is d the note or documentation iz legible to someone outside the practice or facility then the document is considered Step Three Click the Print Reports button and you will see the Report Printing Options dialog Step Four Fill in any comments i e the Type of Audit Provider nam
27. Body Areas Orean 3 ysters 95 Expanded 95 Organ Systems Cardiovascular Organ Systems Constitutional Organ Systems Respiratory Medical Decision Moderate Complexity Diagnosi Or Management Opnons 2 Established diagnosis improved well controlled resobarg or resolved Amount Complexity of Data Review and or order of climcal lab tests CPT codes in the 0000 series Review andlor order of tests in CPT medici section EEG EEG echocardiography cardiac cath nrimane vascular studies pulmonary fincton stadies CPT codes in the 20000 series Independent review of nage tracing or specuren Risk MODERATE Presentme Poblemi e Zor more stable chrome 1llnesses Diagnostic Procedures Laboratory tests requiring vempunchire ERG EEG Management Opnor Presenpton dmg managerrent Encounter Notes EKG with report found in medical records however there was no charge submitted and it was not signed initialed Page 1 of 1 INTELICODE d Reporte he eed by INTELEG DBE Cop kite Ire TS 2 FRK IE Rese med hartos ra Sapisan TT us Saturday March 24 2007 Issues and Recommendations Report The Issues and Recommendations Report depends greatly on how well you utilize your Note Macros in Intelicode In the course of your auditing you will utilize the various macros that you have developed Each time you insert a macro that is an Issue problem Intelicode 43 Intelicode User s Manual Version 8 keeps a tally When you ins
28. Intelicode User s Manual Version 8 Table Of Contents Welcome to INTEL CODE ee ee 1 Basic Tea turescorIiNTELICODED calco conose 3 Whats New ini Version EE 5 Getting Started ninia lali ad dai 7 KEE Re El nn 7 po OEA AE E A E E A a A E AETA A 7 SOWA EE 7 HEO INTEL ODE Cirer ea do a aa aa 7 Cu CDO INTEENCODES EEN 7 Basiesteps to Use INTELICODE EE 9 Creating a new Office Department 10 Changing Omices RTE Ted TEE 13 Eo GE 14 ASWI ETOUR areo alc ER 17 SEP OMG rir A a a il o N 17 SOD WW Oriara a O O A aA a e A E A 18 Step A ebe 19 StD FOUN eeh 21 EE e e A aN E dE 23 DEC KE 25 SECO S CV Cla dE EE Eh 26 Navigacion acta 27 TP Patieint S DEE 27 LISTO E da A A wed a ei 28 LEX cre ltda ota acaecida 29 1 Decision Diagnosis Management Options rana rar rr 30 Decisi n Amount COMpILEXIty Of Dala eege SE EE 31 1 Risk Screen Presenting Probleme 31 1 Risk Screen Diagnostic Procedure S Ordered cece cece eeeeeeeeeeeeeeeeeeeeeeenenenes 31 1 Risk Screen Management Option s Selected ococccccccccccccccccnccnccncr narrar 31 1 Teaching PiySictan Deg EE 32 EN Lee EE ER ENOCE Oe EE 34 ENVISIESUMINan eS co EE 36 MISIESUMIMarnes AFI tus tiled vies e 37 l REtrevind S aved ReDO EE 37 Reports ana PROTA Oise acacia 39 Generating Audit Summary Repnorte E 39 Encounter Detail REDONE esente taras 41 Issues and Recommendations Report 43 Intelicode User s Manual Version 8 Report PHANG OPONE ia aida 46 Fee Schedu
29. OU FOR THE DEFECTIVE COPY OF THE PRODUCT IN NO EVENT WILL TSI BE LIABLE TO YOU FOR ANY CONSEQUENTIAL INCIDENTAL OR SPECIAL DAMAGES INCLUDING ANY LOST PROFITS OR LOST SAVINGS EVEN IF TSI OR ANY OF ITS REPRESENTATIVES HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES OR FOR ANY CLAIM BY ANY THIRD PARTY Sales Contact us for information about the latest products and services Phone 1 800 786 4231 Fax 1 260 837 9090 World Wide Web www intelicode com Email sales intelicode com Office hours 9am to 5pm Eastern Daylight Time Technical Support Your annual license includes unlimited technical support You may contact us via phone fax email or web Please have the following information to help better serve your needs e Locate your product serial number This is found under the Help About I ntelicode menu 73 Intelicode User s Manual Version 8 74 Determine your operating system version All of the pertinent information about your computer can be found by choosing Help About I ntelicode then choosing System Information Find the version of INTELICODE in the by choosing Help About I ntelicode Having these pieces of information available will help our support person better diagnose any problem you may be experiencing Troubleshooting Common Problems e Problem I don t get a code and have History Exam and MDM What s wrong Possible Cause Make sure that you choose the appropriate Sub Category i e
30. across the country Call technical support at 1 800 786 4231 15 A Walk Through Step One This topic will show you a walk through of INTELICODE as we go through an audit screen by screen Once you have opened your Intelicode program and logged in as a user you will see a blank patient screen Please note that the field names followed by an asterisk are required fields Patient Screen To begin an audit in the Patient I D field you must enter a number by which you can identify the patient i e medical record number account number etc The Patient ID we have entered for our audit is 167 as seen in the example image below The Last Name and First Name fields should then be completed with the patient s name Completion of the Last and First Name fields is not required to complete an audit Any names entered in the name fields will appear on reports exactly as they are entered here The patient Last Name and First Name we entered for our audit is Bebee Beth as seen in the example image below The D O B Date of Birth field is only required for those services that are age driven such as preventive health services If date of birth is entered enter in MM DD YYYY format The patient D O B we entered for our audit is 07 27 1952 as seen in the example image below Choose the Patient Status to indicate if the patient is new or established The Patient Status we entered for our audit is established as seen in the example image
31. ai vw M Sample L Documents and Settings ohn Jackson ocal SettingsApplication Data CHMUDNTGlhbbbresentatoplntelcode dataolfCez ee ts LAMEBATS A bb Presentations ntelicode data offices E im ts Create New Office CAMCBAT SU be Presentation lntelcode data offices Create New Office ts LAMEBA TSU bB Presentations ntelicode data yothicesy young ts v Family Practice C Documents and Settings John Jackson Local Settings 4pplication Data New Office LAMEBATS A bo Presentation ntelicode data yotfices W ew Office tsi Sample Office CANMCBAT Sbb Presentation ntelicode Modified Data Offices ample O e Create New Office Rename Office Remove Office Browse for Office Choose Create New Office for a new database give it a name etc and OK choose OF to go into the selected Office Choose Remove to remove an Office from your list Choose Browse for Office to find it again Any time you change an Office you will be prompted to log into it Welcome to Intelicode Please sign in User Name SI nile Password Getting Help There are various ways to get Help on INTELICODE 14 Getting Started Troubleshooting Click Here to see the most common problems Join our INTELICODE Auditing Coding Forum This email forum is a wonderful resource for all of your coding and auditing questions You can post questions and answers to the list which is comprised of experts in the field from all specialties
32. ale 81141945 Bebee Betty 167 Female Perf 1952 EA Male Finkleman Henry Ja Male 3971929 ferlimagtorn Wilma 4096 Female 8301952 Holywell Holly Abd Female 67571968 Babble Durcilla A oe Female ard sal en Pes Millford billie B236 Female garr 1933 race hd te r Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELI CODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved Provider Maintenance To add a new Provider choose Add New Provider from the Attending Provider drop down list on the Patient screen or choosing Provider Maintenance from the Utilities menu The only required fields are ID Number Last Name and First Name If you wish to run reports based on Specialty then you should assign a Specialty to the Provider The Default Exam Type will allow you to have the same Exam template loaded each time you audit that provider Default Fee Schedule works the same way 58 Maintenance Provider Maintenance Provider Maintenance ID Number Last Hame First Name Specialty Sub Speciallty _ Welmore MD Marcus FAMILY PRACTICE Y Default Exam Type Default Fee Schedule General Multi 5 ystem Exar ER Se MD Lotta Body Areas Organ G ystems 95 CARDIOLOGY Farthington MD Lawrencio Neurological Exam 97 NEUROLOGY Fanwood MD Elwood Ear Hose and Throat Exam 97 OTOLOGY LARAN Feelgood MD Dona Body 4reas Organ Systems 95 INTERNAL MEDICII M
33. alone itis imperative to accurately documentthe most specific diagnosis inthe assessment impression section of the note Next Ly Step Six Finish Congratulations You have completed your first audit using Intelicode Save your work Now you need to Upon selecting the Finish button the Save Confirmation screen will appear Here you select how you wish to handle your information When select Save and Print the encounter audit will be saved in the database and an Encounter Detail Report will be printed When you select Save and Don t Print the encounter audit will be saved in the database and no reports will be printed When you select Clear All Screens and Don t Save all data entered for this encounter will be lost and nothing will be printed The user will be returned to a blank Patient Screen upon selecting this option This feature allows the user to audit an encounter without saving the information to the database When you select Cancel the Save Print Clear functions are cancelled and the user is returned to the End screen with all data entered in tact Keep in mind that your data for this 25 Intelicode User s Manual Version 8 encounter has not yet been saved If you should exit out of the program at this point your data for this encounter will be lost Save your data before exiting the program Save Confirmation Save and Don t Print Clear All Screens and Don t Save Cancel Next Ly Step Seven
34. and Negative 1 Notes History Unobtainable from any source Audit Date 04 30 08 B z U ae patient encounter should include assessment clinical impression or diagnosis Assesment iAy The assessment should be clearly documented for each encounter Since each note must stand alone itis imperative to accurately documentthe most specific diagnosis in the assessment impression section of the note Next GA Step Three Examination Screen Select the Exam Type 1997 General Multi System Cardiovascular 1995 Exam etc to display the desired examination elements For the 1997 exams once the exam elements are displayed down the left side of the screen select the documented examination elements by clicking on the appropriate body areas organ system check boxes Once the check boxes have been selected the corresponding examination elements will appear on the right side of the screen Select the desired individual examination elements by clicking on the element listed on the right side of the screen click on the actual words Once the element has been 19 Intelicode User s Manual Version 8 selected the font will change to red To unselect an element simply click it again and the font will return to blue For the 1995 examinations once the desired 1995 examination is selected in the Exam Type field the examination body areas organ systems elements will appear on the right side of the screen To select a body ar
35. below Choose the patient s Gender The patient Gender we entered for our audit is female as seen in the example image below Select the Attending Provider physician performing the visit for the encounter being audited If the attending provider is not listed select Add New Provider to add the provider to the database The Attending Provider we entered for our audit is Welmore MD Marcus 1 as seen in the example image below Enter the Visit Date the date of service by entering the date in MM DD YYYY format or by clicking on the drop down arrow and selecting the appropriate date from the calendar displays The Visit Date we entered for our audit is 7 10 2007 as seen in the example image below Enter Requesting Provider physician requesting the service as necessary in relation to the services being provided If the requesting provider is not listed select Add New Requester to add the provider to the database We did not enter a Requesting Provider for our audit since the service type was Office or Other Outpatient Select the appropriate Service Type i e office visit consult etc for the encounter being audited Next select the appropriate service Sub Type i e initial visit office consultations initial hospital care etc Note if Service Type Consultations is selected the Consult 17 Intelicode User s Manual Version 8 Verification questions must be answered to continue with the audit The Service Type we entered fo
36. d paste or meet g j those sentences into your Notes section Insert Text Send Macros to another Office EditMacro Print Mote Macro List 35 Intelicode User s Manual Version 8 1 Visit Summaries Visit Summaries The visit summaries screen displays the audited encounters for each office department You may sort by using only one filter or multiple filters at the same time The information displayed on this screen can be sorted in multiple ways to make your reports as specific as you desire The following will describe the various filtering items on the Visit Summaries screen Visit Date Audit Date This sort will determine if the encounters displayed will be sorted by visit date or audit date The Visit Date is the date of service of the audited encounter The Audit Date is the actual date the audit was performed Intelicode automatically stores the date each audit is performed The date fields located directly below the Visit Date Audit Date toggle button correspond with which ever type of date is selected For example If Visit Date is selected the date boxes display 2 27 2005 2 27 2007 the encounters displayed will be only those encounters with visit dates service dates ranging from 2 27 2005 through 2 27 2007 The same applies to Audit Date when this is selected the date ranges displayed in the date fields will control the encounters displayed by their actual date of audit Status This is patient status New or Es
37. d yes No cones wheres We Current Medications Operations and hospitalizations W Quality 4 Context Severity Iw Modifying factors Prior illnesses injuries Allergies Dietary status E Age appropriate Immunizations Iw Duration IT Associated signs amp symptoms AG Review Of Systems ROS Extended Health status or cause of death of parents siblings and children 4 Constitutional Symptoms Musculoskeletal Diseases related to Chief Complaint HPI or ROS Eyes 4 Integumentary skin breast Hereditary or high risk diseases Ears Nose Mouth Throat Neurological Cardiovascular Psychiatric SOCIAL Respiratory Endocrine Living Arrangements Use of drugs alcohol or tobacco Gastrointestinal Hematologic Lymphatic Marital Status Extent of Education Genitourinary l Allergic Immunologic Sexual History IT Current Employment All Others Reviewed and Negative 7 Occupational History Other Note Macros Notes Audit Date 01 02 07 Diagnosis of Nodular Lymphoma Abdomen was not necessary on this visit as it was not addressed in the history or exam Medical necessity of MDM did not substantiate a level 3 visit 1 Exam Screen Click an area on the image areas where the d cursor appears Le History below for more information and to preview the various screens The Exam screen will display the exam elements relevant to the type of exam selected The
38. d will become active Our previous version required fees to determine whether a visit was Over or Under coded The software based this on the difference in fees between the Audited and the Billed code Now Intelicode looks at the Service Category Type of visit to determine the Variance between the Reviewer Audited and the Provider Billed code Creating a new Office Department The first screen you will see upon entering the Intelicode program will be the Choose Create Change Office Department screen The first time you use your software there will be two items in the list box Sample Office and Master Office The sample office is simply to provide users with an example of how to set up their own offices Intelicode Pro and P A T H users will need to create a new office s to store your audit data in Simply click on the Create new Office button and two fields will appear The first field is the office name Choose a name for the office that will indicate to you what audit information you plan to store in this office i e Internal Medicine ENT Office Long Beach Office etc The second field will be the Data Name and Location field The Intelicode program will default to storing your audit data on the hard drive C 1ProgramFileslIntelicodel Applications Datal Offices of your computer If you wish to have your data stored elsewhere e g a network drive contact your Information Services IS departmen
39. ded the names of your macros will appear in the macros list on the left side of the Note Macro Maintenance screen Select the name of the macro you wish to insert into the encounter you are auditing the contents of that macro will appear in the block on the right side of the screen Click the Insert Text button and the macro will then be inserted into the Notes white text field field at the bottom of the screen on the Patient History and End screens If you know the Note Macro you wish to use is already created simply click the Note Macros button to get to the Note Macros Maintenance screen then select the macro name you wish to insert and click the Insert Text button and the macro will be inserted Note Macro Maintenance Note Macro Maintenance Macro Type f Issues C Recommendations fe A Choose the macrots you want to insert This is the text that will be inserted into the note Field when you into the note Field click Insert Text Add New Macro Allergy Sticker Blank 1 Allergy Sticker Blank A Assessment I Assessment A Bundled Service I Chief Complaint I Chief Complaint A Clear Reference to Testing I Clear Reference to Testing A Consult Requirements 1 Consult Requirements A Consultation vs Referral 1 Counseling I Note Macros consist of a list of Words which are linked to typically used text or sentences enabling you to simply click on the word or words an
40. e etc Then click OK and choose your Print Destination i e Printer Word PDF etc See more on Report Printing Options 44 Reports and Printing Report Printing Options Selecta report from the fist below m Please select a print option All Providers By Provider f Print to Printer C Send to Excel Y f Print Preview C Send to POF C Send to ord C Email Report Audit Summary with Ox and Proc Audit Summary with Ds and Proc Not Billed CPT Totals Issues amp Recommendations Provider Accuracy Report 3 7 Provider Met Fee Totals l ummary Comments Provider Summary This is a sample Issues and Recommendations report generated by Intelicode 45 Intelicode User s Manual Version 8 Sample Office 123 Anywhere Lane Midwest IN 46723 Audit Date Auditor Provider Number of Reports Audited Comments Records accurately coded Records over coded Records under coded Records wrong category farc Issues amp Recommendations Report 260 555 1212 260 555 1215 af 24 2007 Auditor A 100 Miller John 9999 5 2 HL 2 40 00 1 20 00 1 20 00 Documentation and Coding Issues 1 Ensountet s Reflect s This seni ceuras not listed as abilled serviceon the HCFA 15000r superbill This represents a potential revenue loss to the practice Recommendations If more than 50 of the face to face for unit floor time visit is spent counseling the code may be determined based on the entire time ofthe vis
41. e eee es 13 p Patient LISTING vesciocuosicia nacida 61 Patient Maintenance 69 PRIMING RE 57 Printing from Visit Summaries 57 Provider LISting cccceeeeeeeeee eee eees 62 Provider Maintenance ccccceeeeeeeees 70 R RegisterinQ oocccccccccccncnnncncncnr rr 7 Report Options cccceeeeeeeeee seen eens 57 Reports EE 5 Requester Listing 63 Requester Maintenance ococccccccccccnncos 75 Ke 71 Resident Uietmg 64 Retrieve Saved Reports cccceeee eee es 66 REVICWED cocacola ri rn EIER SN ee EE 9 Risk Diagnostic Procedures 65 36 Risk Management Options 65 37 Risk Presenting Problems 36 RUNNING RECH VE 3 S EE 85 Sond RE 3 Sena ge 3 Service Category cccccccccccceeeeeeeeeeeuaes 9 17 Intelicode User s Manual Version 8 SEVICE TYDE der piano 9 Specialty Maintenance 72 Start TE ee 7 System Requirements 0ccceeeeeeeeeees 7 T RR Lelleg bdo 37 Technical SUPPOMIT coccion 85 TFOUDICSNOOUNG EE 87 U Unreo iteraci n 7 USC 9 User LISTING EE 65 User Maintenance 73 78 Utilities Menu 69 V ENEE 9 Verificato iii 9 VISIO Dale nia ads 9 NIESEN 41 Visit Summaries Archive 42 W Walk d e e L le BEE 17 ENEE GE Geer 15 REENEN E 1 Whats NEW 26 555 ee EE i 5
42. e screen When the mouse is positioned over a specific statement the actual corresponding quotation from the Documentation Guidelines will appear in the blue green help box across the bottom of the page as an additional reference 1 Risk Screen Presenting Problem s Click an area on the image areas where the d cursor appears Le History below for more information and to preview the various screens The Presenting Problem tab of the three Risk screens Is used to indicate the level of risk associated with the presenting problem documented for the encounter being audited To select the desired level of Presenting Problem Risk click on the risk elements or statements Selected risk elements will be highlighted in Red The highest corresponding level of Presenting Problem Risk e g minimal low moderate high will appear to the left of the selected elements To unselect any element simply click that element again it will turn blue again 1 Risk Screen Diagnostic Procedure s Ordered Click an area on the image areas where the d cursor appears Le History below for more information and to preview the various screens The Diagnostic Procedures tab of the three Risk screens is used to indicate the level of risk associated with the review or ordering of diagnostic procedures or services documented if applicable for the encounter being audited To select the desired level of Diagnostic Procedures Risk click on the risk elements or
43. ea organ system simply click on that body area organ system click on the actual words Once a body area organ system is selected the font will turn red To unselect a body area organ system simply click it again and the font will return to blue We chose the 1997 General Multi System Examination and then selected Constitutional Within Constitutional we selected Measurement of any three vital signs and General appearance of the patient We also selected Respiratory Auscultation of lungs and Cardiovascular Auscultation of heart with notation of abnormal sounds and murmurs Finally we chose Skin with the individual element being Inspection of skin an subcutaneous tissue We selected a total of examination elements As we select the various examination elements on this screen Intelicode is calculating the level of Examination The level of Examination is displayed at the top of the screen The Examination elements we have entered for our audit haven produced a Expanded 97 Examination as seen in the example image below Patient 167 Betty Bebee Sample Office File Utilities Preferences Wisits OFFice Department Documentation Guidelines Intelicurve Exam Type E Elements Saeed Elements of Examination General Multi System Exam 97 Constitutionals Measurement of any three vital signs Constitutiona
44. ed by the Note Macros utilized The Macros available for this field are those previously added to the Note Macros Maintenance screen The informational fields located at the bottom of the screen will provide totals specific to the sorts performed There are two sets of numbers for each heading No for number and for dollars Total Visits Reflects the total number of visits associated with the displayed information and the total dollar amount of the visits associated with the information displayed Under Coded Billed Reflects the total number of visits and percentage that were Under Coded Billed and the total dollar amount of those Under Coded Billed services Over Coded Billed Reflects the total number of visits and percentage that were Over Coded Billed and the total dollar amount of those Over Coded Billed services 36 Navigation Non Compliant Teaching P A T H only Reflects only those services the number and percentage that are non Compliant teaching service or those services that did not meet the teaching physician guidelines below Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved 1 Visit Summaries Archive When you edit a visit Intelicode keeps the original in its unaltered format The edited visit is saved in Visit Summaries You can not go back and edit an original once
45. ements for our audit Presenting Problem Acute uncomplicated illness or injury Diagnostic Procedure s Ordered We chose nothing on this screen Management Option s Selected Over the counter drugs amp Elastic bandages Intelicode will calculate the level of Medical Decision Making MDM by compiling the information from all of the Decision screens The level of overall MDM will be displayed at the top of the screen as shown in the example image below The Decision elements we have entered for our audit produce a Straightforward MDM 21 Intelicode User s Manual Version 8 Patient 167 Betty Bebee Sample Office File Utilities Preferences Wisits OFFice Department Documentation Guidelines Intelicurve Diagnosis M anagement Options Amount Complexity of Data 22 Amount Complexity of Data Limited 2 Review and or order of clinical lab tests CPT codes in the 80000 series F Review and or order of tests in CPT radiology section nuclear medicine and all imaging except echocardiography and cardiac cath CPT codes in the 70000 series PLT Ltt eee iv Review and or order of tests in CPT medicine section EEG EKG echocardiography cardiac cath non invasive vascular studies pulmonary function studies CPT codes in the 90000 series Discussion of tests with performing physician Independent review of image tracing or specimen Decision to obtain old records and or obtain history from someone
46. enance screen and call it First Year Resident Then we go into the Provider Maintenance screen and select our provider and select First Year Resident in the Specialty drop down box Click Save Open the Visit Summaries screen and in the Specialty drop down box select First Year Resident This will show all of the Providers that have the First Year Resident Specialty therefor showing all of the First Year Residents Please call us if you have a unique filtering criteria and need some assistance 69 Contacting Corporate Headquarters We are committed to providing not only the number one auditing software but the customer service and support to go along with it Address Technology Solutions Inc P O Box 758 Waterloo Indiana 46793 USA Telephone 260 837 8200 800 786 4231 Fax 260 837 9090 World Wide Web www intelicode com Office Hours Monday to Friday 9 am to 5 pm Eastern Standard Time End user License Agreement for INTELICODE IMPORTANT READ CAREFULLY This End User License Agreement Agreement is a legal contract between you either an individual or a single business entity and Technology Solutions Inc d b a TSI for the software product identified above which includes computer software and as applicable associated media printed materials and online or electronic documentation hereinafter the Software Application BY CLICKING THE ACCEPTED ICON BELOW OR BY INSTALLING COPYING OR OTHERWISE USING THE
47. eport from list Please select a print option C Print to Printer C Send to Excel f Print Preview C Send to POF C Send to word C Email Report Fee Schedule Report Printer Setup Copyright 1998 2006 Technology Solutions Inc All rights reserved 48 Note Macro Listing Reports and Printing INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved Modifier Listing To print a listing of Modifiers choose Modifier Codes Maintenance from the Utilities menu then click Print List Of Modifiers and choose your Printing Options See more on Report Printing Options Report Printing Options Selecta report from list Please select a print option C Print to Printer Ce Print Preview C Send to Word C Send to Excel i Send to POF O Email Report Choose a sort column Ze Code C Description Printer Setup Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved Maintenance To print a list of your Note Macros click Print Note Macro List in Note Macro See more on Report Printing Options 49 Intelicode User s Manual Version 8 Report Printing Options Select a report from list Please select a print option Print to Printer Ce Print Preview C Send to Word C Send to Excel C Send to POF C Email Report Choose a sort column Ze Type C Name Print
48. er Setup l Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved Patient Listing To print a list of your Patients click Print List of Patients in Patient Maintenance See more on Report Printing Options 50 Reports and Printing Report Printing Options Select a report from list Please select a print option Print to Printer Ce Print Preview C Send to Word C Send to Excel C Send to POF C Email Report Choose a sort column Ce ID C Name Printer Setup l Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved Provider Listing To print a list of Providers click Print List of Providers in Provider Maintenance See more on Report Printing Options 51 Intelicode User s Manual Version 8 Report Printing Options Selecta report from list Please select a print option Print to Printer Ce Print Preview C Send to Word C Send to Excel C Send to POF C Email Report Choose a sort column Ge ID Name C Specialty Printer Setup l Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved Requester Listing To print a list of Requesting Providers click Print
49. ert a macro that is a Recommendation Intelicode keeps track of that too To generate the report follow these simple steps Step One choose Visit Summaries from the Visits menu Step Two Choose the criteria you wish to report by i e Status Service Category Sub Category Provider etc Select as many as you deem necessary to achieve the results you are looking for This will filter the information to suit your needs Patient 156 Suzie Singleton Sample Office e Ea Ex File Utilities Preferences Visite OrFice Department Documentation Guidelines Help Patient History Exam Decision End D ate Range Du Visit Audit Status Service Lategor 5 ubLategory Prowider Provider EM 2 22622005 Tol 2 26 2007 eil vil si E User El Specialty Requester War Macro d Bal visitDt Audit Dt stat Service Type Sub Category l Provider Reviewer E amp M TP Provider E amp M EE EE 9 20 2005 1720 2006 SNS or Other Dutp Initial Visit Feelgood MD De 2122005 11202006 Office or Other Qutpe Follow Up Welnore MO Me 41 2005 1202006 Office or Other Outpe Initial visit Feelgood MD De 34132005 1 20 2006 Office or Other Outp Follow Up Carrington MO Li 9292005 1720 2006 Consultations Office Consultatic Carrington MD Li 10 20 2005 1 20 2006 Critical Care Services First Hour Carrington MO Li EEE 1 29 2006 1 20 2006 Est Preventive Medicine Periodic Comprek Welmore MD Me 33336 33215 57854
50. esults you are looking for This will filter the information to suit your needs In our example we chose Dr Carrington from the Provider list intelicode Pro Sample Officeel File Utilities Preferences Visite OFFice Department Documentation Guidelines Help Date Range By Visit Audit Status Service Category SubCategory Provider Provider E amp M A 24 2006 To 32 ARO sl si Carrington MD Le si User Specialty Requester War Macro EaD Leg Loan Sa Sevis Typo L tze Provider Bess Eew TP Pode ais bi ji 1 156 WIS 2006 12 4 2006 Est Office o Other Qutp Follow Up Carrington MD Li 99213 99213 fog 10202006 129 2007 New Hospital Inpatient Se Initial Hospital Ca Carrington MD Li 99223 99223 134 11242006 12 10 2006 Est Office or Other Outp Follow Up Carrington MD Li 99213 99213 135 Br222006 10 19 2006 New Consultations Office Consultatic Carrington MD Li 99243 99244 15982 A Ter2007 3272007 Eet Nursing Facility Servi Subsequent Mure Carrington MD Li 399309 399310 18945 91172006 332007 Est Preventive Medicine Periodic Compret Carrington MD Li 99395 99395 Total Visits Accurately Coded Under Coded Billed Over Coded Billed Financial Error Wrong Category wc Non Compliant TP Edit visit H E 4 6667 D 00 Fa 2 3133 1052 Be 0 0 0 0 00 5 7 6565 00 0 00 60 00 Print Reports EEG with report found in medical records however there was no charge submitted and it was not s
51. ew to Intelicode you are in for a Surprise If you have been using Intelicode you already know how valuable this tool has become You will no doubt find its many new features a compliment to its ease of use and its powerful reporting Intelicode is ideal for auditing or reviewing services for HCFA CMS compliance Many are using this as a monitoring tool Simply stated they are using Intelicode to monitor and validate charges prior to submission Others find this program to be ideally suited for training purposes Countless professionals rely on Intelicode for consistency reliability and credibility for their encounter reviews education appeals and expert witness testimony We are pleased that you have chosen Intelicode We invite you to call us any time with questions comments or suggestions on how we can continue to deliver a superior product TSI Makers of INTELICODE products Basic features of INTELI CODE e Easy to use Intelicode has a familiar look and feel to the paper audit forms you are used to Excellent reporting A variety of reports that improve your productivity that save you time Produces a running tally Intelicode starts calculating from the very beginning Adheres to both HCFA 95 and 97 Guidelines CMS has instructed payors to use whichever set of guidelines is most favorable to the provider Intelicode makes this easy You can use both 95 and 97 exams and Intelicode will save the hi
52. ghest level if you prefer Visit archive Intelicode archives or stores visits that have been edited Flexible reporting ntelicode gives you the flexibility to create reports that fit your needs giving you the information you want while being able to save them into the format of your choice or even email them Enhanced features of I NTELI CODE Pro and P A T H Stand alone or network Intelicode runs locally yet allows you to network data If you need to be mobile simply copy the data to your local drive and go e Supports multiple offices i e databases If you have multiple sites departments or clients Intelicode allows you to maintain as many as you wish e Copy and Send Data Copy and Send Patients Providers Diagnosis Codes Note Macros etc from office to office What s New In Version 8 Although the overall look and feel of Intelicode hasn t changed there is much about the program that has been improved Many of the changes are those that you have been asking for but others effect the inner workings and really won t be outwardly noticeable Their net affect will leave you pleasantly pleased with the new Intelicode Some of the changes are Intelicurve This is an Intelicode add on that allows you to quickly generate a bell curve graph for provider billing information It runs either as a stand along application or as an integrated bell curve solution in I ntelicode Numerous Bug
53. her copyrighted material subject to the provisions of this Agreement Submissions Should you decide to transmit to TSI by any means or by any media any materials or other information including without limitation ideas concepts or techniques for new or improved services and products associated with the Software Application whether as information feedback data questions comments suggestions or the like you agree such submissions are unrestricted and shall be deemed non confidential and you automatically grant TSI and its assigns a non exclusive royalty free worldwide perpetual irrevocable license with the right to sublicense to use copy transmit distribute create derivative works of display and perform the same DISCLAIMER OF WARRANTY THIS SOFTWARE AND THE ACCOMPANYING FILES ARE PROVIDED AS IS TSI DOES NOT AND CANNOT WARRANT THE PERFORMANCE OR RESULTS YOU MAY OBTAIN BY USING THE SOFTWARE OR SUCH FILES TSI MAKES NO WARRANTIES EXPRESS OR IMPLIED AS TO MERCHANTABILITY OR FITNESS FOR ANY PARTICULAR PURPOSE Good data processing procedure dictates that any program be thoroughly tested with non critical data before relying on it The user must assume the entire risk of using the Software Application ANY LIABILITY OF TSI FOR A DEFECTIVE COPY OF THE SOFTWARE APPLICATION WILL BE LIMITED EXCLUSIVELY TO REPLACEMENT OF YOUR COPY OF THE SOFTWARE APPLICATION WITH ANOTHER COPY OR REFUND OF THE INITIAL LICENSE FEE TSI RECEIVED FROM Y
54. icode is calculating the level of History The level of History is displayed at the top of the screen The history elements we entered for our audit produced a Expanded History as seen in the example image below Patient 16 Betty Bebee Sample Office File Utilities Preferences Wisits OFFice Department Documentation Guidelines Intelicurve History Of Present iliness HP Etan ES Past Family And Social History PFSH Mo of Chronic PAST Diseases Reviewed Bale ee Current Medications Operations and hospitalizations Chief Complaint Documented Ye el No jw Location Timing Iw Quality Iw Context Severity Modifying factors Prior illnesses injquries Allergies Dietary status Age appropriate immunizations jw Duration Associated signs amp symptoms FAMILY Extended _ Health status or cause of death of parents siblings and children Musculoskeletal Diseases related to Chief Complaint HPI or ROS Integumentary skin breast Hereditary or high risk diseases a Iw Ears Nose Mouth Throat Neurological os es Cardiovascular Psychiatric SOCIAL Respiratory Endocrine Living Anangements Use of drugs alcohol or tobacco BR IT e Gastrointestinal Hematologic Lymphatic Marital Status Extent of Education Iw i E E Allergic Immunologic Sexual History Current Employment Occupational History 1 Other Genitourinary All Others Reviewed
55. ients for any additional encounters audited This should be changed as appropriate for the encounter being audited Patient Gender The gender of the patient should be indicated here Attending Provider This is the provider who rendered service for the encounter being audited Providers can be added all at one time or individually as they are encountered during audits To add Attending Providers click on the drop down arrow in the Attending Provider field Next click on the Add New Provider option The Provider Maintenance screen will appear for completion You may also access the Provider Maintenance screen by clicking on the Utilities drop down menu and select Provider Maintenance The Provider Maintenance screen will appear for completion Visit Date Enter the date of service for the encounter being audited This can be done by clicking on the Month Day or Year with your mouse cursor and changing the value You can also click the drop down arrow to the right of the date which will display a calendar control You can scroll back and forward by year You can also display an entire list of months by clicking on the current month see below January 007 12 3 4 5 6 7 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 17872007 Requesting Provider This is the provider who sent the patient to the attending provider or the requester of service for the encounter being audited Requesting Providers ca
56. igned initlaled Print Grid Step Three 41 42 Intelicode User s Manual Version 8 select a visit and click the Print Selected button and choose your Print Options Click OK Report Printing Options Selecta report from list Please select a print option Print to Printer Ce Print Preview C Send toward C Send to Excel C Send to POF C Email Report Printer Setup l Reports and Printing Sample Office Encounter Detail Report 260 555 1212 123 Anywhere Lane 260 555 1215 Midwest IM 46723 Pi ID 156 Pt Name Singleton Suzie Sex F DOB 211411945 Ver Dr 31306 Aude Dt 12 406 Provider Carrington WD Lotta 3 Requester Reweuer Fach 99213 Senice Categon Office or Other Outpatient Stats Established Pmruder Fa hi 99713 Sub Category Follow Up Rewewer Auditor Bl 200 Mo Difference 0 00 Yanance Face to Face Minutes Counselmg Minutes Fee Sche duh Sample Powder Dx 1 401 9 Hypertension Unspecified Revever Dx 1 401 9 Hypertension Unspecified Pouder Dx 2 477 9 Cardiac Oyerhuthmia Unspeci ed Rewevuer Ds 2 477 9 Cardiac Oyerhuthmia Unspecified Prowder Poor 1 Mod Rewewer Poci SON See odoyen cones Mod Hi story Chronic Disease s Reviewed Chief Complaint Documented Expanded History History Of Present hess HPI Brief Quality Sewenty Rewew Of Systems ROS Extended Corsttitonal yrptors Cardiovascular Respiratory Past F amp Social History PFSH Pertinent PAST Current Medications FAMILY SOCIAL Examination
57. iller John Body 4reas Organ Systems 95 Selman Norman General Multi System Exam 97 GENERAL PRACTIL Wellington MD Beaumont General Multi System Exam 97 INTERNAL MEDICII Welmore MD Marcus General Multi System Exam 97 FAMILY PRACTICE Y e r Y Y e L vw Bx required fields Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved Resident Maintenance P A T H only To add a new Resident choose Add New Resident from the Attending Resident drop down list on the Teaching screen or choosing Resident Maintenance from the Utilities menu The required fields are ID Number Last Name and First Name 59 Intelicode User s Manual Version 8 Teaching Physician Guidelines for Evaluation and Management Ser Attending Resident Johnson Mary Add New Resident Johnson Mary s the teaching physician documented his her physical presence during the key portion he service with agreement or revision of the assessment olan of care s the teaching physician documented his own evaluation of the patient with review of tl idenk lt nante and anreement nr revicion of Fhe acceccment nolan of rare Attending Resident Maintenance Aftending Resident Maintenance ID Number Last Hame First Hame 2424 ohngon M ary Print List of Residents Archive Resident TE ghrai A on j Mackey Pat
58. ing Options selecta report from the disibelow Please select a print option All Providers By Provider Print to Printer C Send to Excel Audit Summary e Print Preview C Send to PDF Audit Summary Mo C Send toward Email Report Audit Summam with Os and Proc Audit Summary with Ox and Proc No VS EE Billed CPT Totals Pee Issues amp Recommendations Yes C No Print Graph Provider Accuracy Report Provider Wet Fee Totals Provider Summary Summary Comments Printer Setup 123 Anywhere Lane 260 555 1215 Midwest IN 46723 Provider Miller John 9999 Audit Dt Range 11112007 To 3 24 2007 Visit Dt Stat Service Category Service Sub i Reviewer Mod DC IT Provider Mod Var Miller John 9999 65432 8 2506 Est Problem With Documentation No Service Documented Provider Dx 4 CHEST PAIN NEC 786 59 Reviewer Dx 1 No documentation found in chart called hospital and they were unable to find it If this were an audit by a third party payor this could be interpreted as fraudulent billing 134 22207 Est Office or Other Outpatient Follow Up Focused 95 99211 Provider Dx 1 241 0 NONTOX UNINODULAR GOITER Reviewer Dx 1 HYPERTENSION NOS 401 9 Provider Proc 1 25000 INCISION OF TENDON SHEATH Modifier Reviewer Proc 1 Modifier This should have been coded as a nurse visit rather than a physician visit The patient was seen by the nurse for a BJP check Diagnosis should have been the reason patient was seen by the nurse Hyperte
59. ion of the note Required Field Next gt Step Two History Screen Begin by indicating the presence of a Chief Complaint by clicking the appropriate Yes or No box in the Chief Complaint Documented field To enter the documented History of Present IIIness HPI elements for the encounter you are auditing simply click the check boxes next to the appropriate history elements We entered Yes in the Chief Complaint Documented field and checked off Location Quality Duration Context and Modifying Factors for our audit as seen in the example image below Also notice the level of HPI displayed in red font in the upper right corner of the HPI section We entered 5 elements giving us an Extended HPI To enter the documented Review of Systems ROS elements for the encounter you are auditing simply click the check boxes next to the appropriate ROS elements We checked off Constitutional Symptoms and Integumentary for our audit as seen in the example image 18 A Walk Through below Also notice the level of ROS displayed in the upper right corner of the ROS section We entered 2 ROS elements giving us an Extended ROS To enter the documented Past Family and Social History PFSH elements for the encounter you are auditing simply click the check boxes next to the appropriate PFSH elements We have not checked off any PFSH elements therefore we do not have a PFSH level As we add the various history elements to this screen Intel
60. ist e Possible Cause The Critical Care Codes are further down in the fee schedule list Just keep scrolling down and you will find them 76 Index A A Tour of Intelicode ccce cece ees 31 Adobe eg EE 7 Advanced tips and rrcke 81 Archiving Data vis cicsctaxsacenvedwerersneeadiee ss 77 B Basic features 3 Sege 9 C Changing Offices Departments ccc eens 13 81111910 Inte PPMPC70 7Oo0U0 OO OCA ne riirii 13 Choose ChooseiCreateiChange 13 e TEET E E E E E T 3 Copying and Sending From Office to Office Eegen 77 Corporate Headquarters 0eeeees SE Create New Office 13 Custom Audit Summary Reports 45 D Decision Amount Complexity of Data 36 Decision Diagnosis Managment Options35 E Editing or Changing an Office Name 17 Sin ee nt EE 49 ENO Reg 37 End user License Agreement 83 EXam Sr esaii edoa erian erea 34 F OE PEE 15 Fee Schedule Report 58 File TU necia 43 G Getting Help 15 GUIA CINES ornato 3 H FISCO ireo a 9 33 l Na errira 7 Issues and Recommendations Report 53 L eS WING enrii srie era E a E En 9 M Oe 9 Modifier Codes Maintenance 65 74 Modifier Uietmg oo 59 Multiple Offices Departments Sites 78 N Note Macro Listing 60 N te Macros sossarnas hinnan 3 39 O Olula Poo lt P E E ETET 10 13 Office Department 77 Offices Departments menu 13 Opening Drolects ccc cece ee e
61. it Documentation must be stated as 20 30 minute visit spent counselinethepatient an patient regarding Sor spetit themajorityot thetaminute visit counseling the To reduce potential monetary loss ta the practice or facility all charges should be reviewed prior to charge entry by qualified individuals ta ensure complete charge capture and coding compliance Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Report Printing Options Reserved When printing various reports whether it be a list of Providers or an Audit Summary Report you will be presented with this dialogue Report Printing Options gives you choices about what report to print how you choose to have the data listed i e sorted by ID or Specialty etc and how you want to print the report Most of these choices are self explanatory but a couple of items should be clarified 46 Reports and Printing In the latest version of Intelicode we have changed the report options We have separated the reports into two sections All Providers and By Provider Each tab contains its own individual Audit Summaries Both tabs contain some of the same reports including Issues amp Recommendations Audit by Patient Provider Net Fee Totals etc The Print Graph option is only available on select report types When the check box is enabled if it is selected I ntelicode wil
62. ities menu is where you go to choose the various maintenance forms In this latest version of Intelicode Enter Codes by Description and Require Consult Verification have been moved to the Preferences Menu Preferences Visits Office Departrn Patient Maintenance E L Provider Maintenance KR Resident Maintenance 1 9100 Speciality Sub Speciality Maintenance Cu User Maintenance TL Fee Schedule Maintenance Modifier Codes Maintenance Mote Macro Maintenance Requester Maintenance Office Department Mame Maintenance Sol Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved Patient Maintenance You can enter patient information on the Patient Screen or you can enter it here You can get to Patient Maintenance by clicking on the Patient ID button or choosing Patient Maintenance from the Utilities Menu 57 Intelicode User s Manual Version 8 Patient Maintenance Patient Maintenance Patient ID Last Name First Name fi 34 Finestein Fred Gender e Date of Birth Print List of Patients Save Send Patent Tel To Other Office Department or File Delete Patient Copy Patients From Other Office Department or File Close Last Name First Name Patient ID Gender DUR Public Johr 123 Male 175 1963 Finestein Fred ER Male 6307 1959 Sizzle Cindy 135 Female 322197 Singleton Suzie 156 Fem
63. iting or Changing an Office Name 65 Intelicode User s Manual Version 8 There are a number of reasons why you might want to change the name of an office database Maybe you wish to archive your data from a particular year much like you would with files in your office In our example we have decided to rename Spine Clinic to Spine Clinic 06 Choose Create Change Office Department Choose Create Change Office Department _ Olfice Department ___ Location Name v Master Office CAMCBT STW vbB Presentation ntelicode D ata Offices aster Office tel Sample Office LAMEBATS PAP WbB Presentation sntelicode Moditied Data0 fices S ample O Department of Surgery C Program Files IntelicodeD latas Ofhices Department of Surgery ts v Gastro C Program Files ntelicode D ata Offices astro ts Spine Clinic LA Program FilesSIntelicode D ataO fices S pine Clinic tel Office Name and Location Office or Group Name Spine Clinic 06 E Data Name and Location C Program FilesSIntelicode D atas Dech Spine Clinic Give the new office or group a name Select Browse if you want to choose a different location to store the data Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved Creating Multiple Offices Departments Sites There are many reas
64. l General appearance of patient oystem Body Area Respiratory Assessment of respiratory effort Respiratory Percussion of chest Respiratory Palpitation of chest Head and Face Respiratory Auscultation of lungs Cardiovascular Palpation of heart Cardiovascular Auscultation of heart with notation of abnormal sounds and murmurs Ears Nose Mouth Throat Cardiovascular Examination of carotid arteries Cardiovascular Examination of abdominal aorta Neck Cardiovascular Examination of femoral arteries Respiratory Cardiovascular Examination of pedal pulses Cardiovascular Examination of extremities for edema andor varicosities Skin Inspection of skin and subcutaneous tissue Chest Breast skin Palpation of skin and subcutaneous tissue Constitutional Eyes Cardiovascular Gastrointestinal abdomen Genitourinary MAA A A MA Lymphatic T Musculoskeletal Joints B ones h uscles IF Extremitiez Ir Neurologic d Psychiatric 20 A Walk Through Step Four Decision Screen The decision screen is divided into three tabs Diagnosis Management Options Amount Complexity of Data and Risk Each tab displays the information respective to the tab name Intelicode will calculate the level of each tab as the information is entered The Diagnosis Management Options tab displays the Number of Diagnosis or Management Options section
65. l place a graph of the current data at the end of the report The graphs can help you and providers identify trouble areas quickly and give a different format for returning data after an audit Report Printing Options Selecta report from the list below Please select 4 print option All Providers Du Provider Print to Printer C Send to Excel Audit Summary Send to POF Audit Summary Oe Proc f Send to Word f Email Report Audit Summary Pt Name Audit Summary Dey ProccPt Hame y Audit Summary Ho Audit Summar Dvdbrochho s x SR Issues amp Recommendations Billed CPT Totals Provider Nei Fee Totals Provider Summary Provider Accuracy Report Provider Bell Curve Provider National Bell Curve Summary Comments te A ee A eal la epa LE SE AL ee P de H EE EEN Dk eg A TA mean 5 elec Ting a repart wi Il dig ol oy more INTO rmaton Ip th W indow a i an To Email Report you will need to have Microsoft Outlook installed on your computer This will create an email message and will include your report as an Adobe Acrobat PDF file There is no need to save it as one first 47 Intelicode User s Manual Version 8 ES Email Report Email To CL Subject Message Send Cancel Fee Schedule Report To print a Fee Schedule Report choose Fee Schedule Maintenance from the Utilities menu select a Fee Schedule then click Print Schedule See more on Report Printing Options Report Printing Options Selecta r
66. le Repo aus A a 48 MOE die e VE EEN 49 Note Macro E dn e DEE 49 Patient EE ebe 50 Provider LISTING EE 51 REQUESTS LIS tidad O ds 52 Residents ri ri O dal 53 User LISINO EE 54 RECIEVING Saved ReDO RS marias a E a bees a Seve tae a a 55 EN ae EE 57 Biet MICA WEE 57 Patient MaltenanCO ade sida das 57 Provider Maintenant EE 58 Resident Maintenance PA TH only c ooooccocccccccccccccnccnnnnnc nor rar 59 Specialty NEE rta 60 User Maintenance EE 61 Modifier Codes MaintenanCe EEN 62 Requesting Provider Mamntenance cnc rra 63 Managing Your E EE 65 ALCAIVING Data EEN 65 Copying and Sending From Office to Office Pro and P A T H Only ccccee cece cess eeeees 65 Eqiting Or Changing an Omice nn 65 Creating Multiple Offices Departments SIteS cece ccc e cece e cece ee arar rr 66 Advanced MIS dobla 69 eieiei DEE 69 CONTACT ME 71 Corporate Headquarters ta 71 End user License Agreement for INTEUCODER rn rr rr 71 A Ehe EE EE EE E 73 Reefer ele ee 73 Re ell ele e n e HE 75 COMMON REODICING ns A is 75 LOCK EE 77 Welcome to INTELI CODE O When Compliance Counts and Reputation Matters Thank You for choosing INTELICODE We appreciate the fact that you have placed your trust in us Rest assured you are in good company Since the early days of our first product in 1998 Intelicode has evolved into the number one software for auditing validating and teaching Evaluation and Management services E amp M If you are n
67. licode Mote Password is optional 1 You must add yourself as a new user before using intelicode Give yourself an ID Number something like your initials and a 3 or 4 digit number i e SE1000 You can give yourself a password if you choose then click Save and Close User Maintenance User Marnfenance ID Number Last Name First Hame 00 2 Smith f ohn Password aca Print List of Users Send User s To Other OfficeDepartment or File elete Selected User Copy Users From Other Officer Department or File First Name Last Hame Administrator Smith on ri 12 Getting Started You will select your name from the list of Users and log in User Name Administrator OOO Password Smith John 00 Changing Offices Departments To change from one Office to another you would choose the Choose Create Change Offices Departments option from the Offices Departments menu If you wish to create a new Office choose Create New Office or simply double click the office or select it and choose OK 13 Intelicode User s Manual Version 8 Choose Create Chanpe Office Department Choose Create Change Office Department a Office Department Location ame v Master Office CANMICBT SU yb6 Presentation ntelicodesD ata Offices master Office ts Or Bones CANMCBS TSU bBSPresentation ntelicode datayotfices Or Bones tel v Dr Heart CANMCBAT SU bo Presentation ntelicodeWdataotfices 0r Heart t
68. llams 006 C Program FilessIntelicodeD atas Offices Dr Willams 2006 a Office Name and Location Office or Group Name D Willams 20077 Browse Data Name and Location C Program FilessIntelicodesDatasOificesi Dir williams Give the new office or group a name Select Browse if you want to choose a different location to store the data Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved 67 Advanced Tips Shortcuts This topic is for any tips tricks or shortcuts you may want to familiarize yourself with Hopefully you will find useful ways to accomplish tasks that can help increase productivity with our product Please feel free to contact us at 800 786 4231 and we will be happy to do a walk through to show you helpful tips Y Y Y Y Quickly calculate a level of service If you simply want to calculate a level of service you only need a Patient ID Status Gender and Service Type When you get to the End simply click Finish then Clear All Screens and Don t Save Keeping your offices updated with Note Macros etc Each time you enter a new Note Macro Provider or other item that you wish to have included in your other offices simply select the new item or items in this case Diagnosis Code and click the Send to Other Office button choose your other office or offices and hit OK A
69. modifiers that need to be added can be done with the boxes on the right side of each Procedure Code 24 Patient 16 Betty Bebee Sample Office File Utilities Preferences Visite OFFice Department Visit Information Patient Name i Betty Bebee Patient ID Provider Welmore MD Marcus 1 Requester Service Type Status Office or Other Dutpatiert Sub Category User Time Comparison FacetoFace ProviderERM 99214 Min Reviewer E amp M 99213 Fee Schedule Sample Min Overbilled H on Yariance Note Macros E M Codes 99203 Counseling h Audit Date 04 30 06 Assessment The assessment is not clearly stated for this encounter Documentation Guidelines states The documentation for each patient encounter should include assessment clinical impression or diagnosis Documentation Guidelines Established Auditor A 100 Reviewer A Walk Through Intelicurye Help Age 55y Sex F Wat Date 04 30 2008 History Level Expanded Problem Focused Exam Level H Expanded On Decision Level Straightforward Dx Codes Procedures Diagnosis Sequencing Issues r Provider SS Dx 1 692 9 DERMATITIS MOS Dx 2 Dx 4 Dx 3 Agree i jw 692 9 DERMATITIS NOS Assessment Ri The assessment should be clearly documented for each encounter Since each note must stand
70. n be added all at one time or individually as they are encountered during audits To add Attending Providers click on the drop down arrow in the Requesting Provider field Next click on the Add New Requester option The Requesting Provider Maintenance screen will appear for completion You may also access the Requesting Provider Maintenance screen by clicking on the Utilities drop down menu and select Requester Maintenance The Requesting Provider Maintenance screen will appear for completion User Reviewer A User Reviewer is required for any visit The User Reviewer is the individual performing the audit Each individual performing audits should be assigned an individual User ID to maintain the most accurate audit data To set up a User Reviewer 27 Intelicode User s Manual Version 8 click on the drop down arrow in the User Reviewer field Select the Add New User Reviewer option and the User Maintenance screen will appear for completion Note When you set yourself up as a user a password is not required To save without a password simply leave the Password field blank and click Save A pop up box will appear to ask you if you are sure you want the user saved without a password Click yes if you want to save without a password Service Type Subcategory Select the appropriate service type for the encounter being audited based on the documentation Once the service type is selected the Subcategory field will be
71. nosis code s when desired The diagnosis codes are pre loaded by Intelicode The display of the pre loaded diagnosis codes can be changed to display the code first or the description first 33 Intelicode User s Manual Version 8 F Patente 167 Betiy Bebee Sample Office File Utilities Preferences visits OFFice Department Documentation Guidelines Help Patient _ History _ E Exam Decision End Finish r Visit information Patient Name Betty Bebee Patient ID 67 Age 54y Sex F YisitDate 12 10 2006 Provider Welmore MD Marcus 1 Requester History Level Expanded Prot Problem Focused Service Type Cite Ollas Dutpatient Status Established Exam Level Sub Category Follow Up User Audio A 100 Decision Level Straightforward r Time Comparison El M Codes Dx Codes Procedures Face bo Face Provider E amp M 99213 Min Reviewer E amp M 99212 DC A EL nseli sl Dx 1 H iti i Counseling Fee Schedule Sample 632 3 Contact Dermatitis Cause Unspecif Ss ES Dx 2 NODULAR LYMPHOMA ABDOM 202 03 Min Overbilled 20 Wariance 1 EN NI Dus REES Medical Necessity Audit Date 01 02 07 Dx 4 Reviewer l f Agree Does the presenting problem decision making documented support the level of service C Yes No Dui jw 692 3 Contact Dermatitis Cause Unspecih d Dx 2
72. nsion 12 306 Est Office or Other Outpatient Follow Up Detailed Expanded 97 Moderate 99214 Provider Dx 1 414 9 Chronic Ischemic Heart Disease Unspecifie Reviewer Dx 1 414 9 Chronic Ischemic Heart Disease Unspecified Provider Dx 2 250 00 Diabetes Mellitus Type II Controlled Reviewer Dx 2 250 00 Diabetes Mellitus Type II Controlled Provider Dx 3 Reviewer Dx 3 272 4 HYPERLIPIDEMIA NECINOS Provider Proc 1 Modifier Reviewer Proc 1 93000 ELECTROCARDIOGRAM COMPLETE Modifier Missed Charges D EKG This service was not listed as a billed service on the HCFA 1500 or superbill This represents a potential revenue loss to the practice Missed Charges R To reduce potential monetary loss to the practice or Facility all charges should be reviewed prior to charge entry by qualified individuals to ensure complete charge capture and coding compliance 2 2106 Est Office or Other Outpatient Follow Up Moderate 99215 N 99213 2 Provider Dx 1 MALIG NEO ASCEND COLON 153 6 Reviewer Dx 1 MALIG NEO ASCEND COLON 153 6 Provider Dx 2 MALIG NEO RENAL PELVIS 189 1 Reviewer Dx 2 MALIG NEO RENAL PELVIS 189 1 Provider Proc 1 43750 Place gastrostomy tube Modifier Reviewer Proc 1 43750 Place gastrostomy tube Modifier Provider Proc 2 35201 Repair blood vessel lesion Modifier Reviewer Proc 2 35201 Repair blood vessel lesion Modifier You did an excellent job documenting the time counseling however you Forgot to charge for it Counseling R IF more than
73. of the Documentation Guidelines both 1995 and 1997 Each statement is preceded by a blank box with a drop down arrow Choose the appropriate statement s for the encounter being audited Click the drop down arrow next to the desired statement s and select the number of applicable diagnoses We entered 1 Self limited or minor problem as seen in the example image below The Amount Complexity of Data tab displays the Amount and Complexity of Data Options section of the Documentation Guidelines both 1995 and 1997 Each statement is preceded by a check box To choose the appropriate statement s for the encounter being audited simply click on the check box to select it To unselect a statement s simply click on the check box again and the check will disappear We did not enter any information on this tab for our audit The Risk tab is further divided into three tabs representing the three columns of the Risk table Presenting Problem Diagnostic Procedure s Ordered and Management Option s Selected Each tab lists the elements as they appear on the Risk Table from the Documentation Guidelines both 1995 and 1997 To select elements from each tab simply click on the risk statement itself click on the actual words The font for selected elements will turn red To unselect any element click it a second time and it will return to blue Intelicode will calculate the highest level of risk from all three of the Risk tabs We chose the following el
74. of your choosing e Problem My totals don t seem to be correct In other words the Total Overbilled Underbilled numbers don t seem to match the Variances and dollar differences Possible Cause There are a couple of things that will effect your totals Sometimes we will see instances where a fee has been entered incorrectly for one of the codes being compared For example The Reviewer code is a 99203 and the Provider code is a 99205 This will show a variance of 2 which will be added to the Overcoded totals However if the fee was entered incorrectly for either one of these the dollar difference could show a negative amount thus adding that to the Underbilled totals This would have a cancelling out effect e Example Sometimes fees are not entered for a particular set of codes In the example above lets assume that the Provider code was a Preventative code fees were never entered into the fee schedule for Preventative codes The 99203 would have a fee assigned to it let s say 80 and the provider billed a 99396 which had no fee assigned to it This would show a negative difference which would be added to the Underbilled totals If the reviewer assigned a positive variance because this typically has a fee of 95 75 Intelicode User s Manual Version 8 to indicate that the provider had overbilled then that would create conflicting totals e Problem cannot find the Critical Care Codes 99291x99292x1 etc in the fee schedule l
75. ons for creating and maintaining multiple Offices We need to look at our Intelicode data in much the same way as we would a file cabinet Good filing practices make finding and managing information easier In addition to breaking up data into smaller manageable pieces databases lose performance as they grow in size particularly with Access databases For this reason we create multiple databases We might create one for each Clinic Site Department i e Department of Medicine Surgery etc or by client We might also create a new Office for each year quarter or month depending on how much data You have a great deal of flexibility The second field will be the Data 66 Managing Your Data Name and Location field The Intelicode program will default to storing your audit data on the hard drive C ProgramFiles ntelicode Applications Data Offices of your computer If you wish to have your data stored elsewhere e g a network drive contact your Information Services 1S department for assistance in determining where data storage Should be located Choose Create Change Office Department Choose Create Change Office Department EA Office Departrient Location ame Master Office CAMCEST SIb PresentationsIntelicodes D atas Dech Master Office tsi Sample Office CAMCBST SU bB Presentation ntelicode Modified ata 0 ffices S ample O i Dr williams 2005 LA Program Files SIntelicode D ataO fices Dr Willams 2005 ts Dr Wi
76. priate letter of your CD ROM drive for D Follow the instructions on the screen Our latest files are found at www intelicode com solo or www intelicode com pro or www intelicode com path Choose the Solo Install exe or Pro Install exe or Path Install exe and Save it to your computer These contain our installation package By default INTELICODE is installed in C Program Files I ntelicode Applications Your data will be stored by default in C Program Files I ntelicode Applications Data Offices Of course you can choose to have your data stored in a directory of your choosing or across a network Feel free to contact us for help in setting up your data or for network installation Activating INTELICODE Intelicode User s Manual Version 8 Once installation is complete you will see an INTELI CODE con on your desktop To start INTELICODE e Double click the INTELI CODE icon OR e From the Start menu select All Programs then click on INTELI CODE When you start INTELICODE you will notice the following activation screen To activate your copy of Intelicode select Phone Activation Select the Launch Program button to activate your 30 day trial period of INTELICODE You will get a message box that tells you how many days are left in the evaluation of the software Intelicode Activation INTELICOD frtelligent Coding Software Intelicode PA T H 7 0 0 Choose Launch Program if you are evalua
77. quick way of getting into your program Intelicode highlights the last Office Department that you were in It also highlights the last user When you start the program and assuming you wish to go into the previous office you can simply click Enter on your keyboard If your user has no password again click Enter and it will open up your office Save multiple Encounters into one report You can combine multiple encounters into one report by selecting multiple encounters by selecting and holding your CTRL key while selecting each encounter Then you choose Print Selected and save to PDF Give the report a name that will correspond the Encounters i e Office Name Provider Date range This will combine all encounters into one report Choose the columns you wish to display in Visit Summaries You can right click in the Visit Summaries grid and choose See video Advanced Report Filtering If you want to filter certain items in a report there are a few solutions First you can use the note macros to filter out certain criteria For example if you had added a legibility issue to several encounters Then in the visit summaries screen you can select legibility in the note macros drop down box to see all the encounters that had a legibility problem Second you can sort by custom specialties if you want For example lets say you wanted to see all the First Year Residents To do this we need to add a new specialty in the Specialty Maint
78. r our audit is Office or Other Outpatient and the service subtype we entered was Initial Visit as seen in the example image below Intelicode P A T H Sample Office BHA File Utilities Preferences Wisits Office Department Documentation Guidelines Intelicurve Help Last Name First Name DOP IT SE Type fi EF Bebee Betty lower 952 Office or Other Outpatient Hospital Observation Services Hospital Inpatient Services Consultations Emergency Department Services C New Established C Male Female Pediatric Critical Care Patient Transport L A Critical Care Services Inpatient Pediatric Critical Care Inpatient Neonatal Critical Care Patient Status Gender Attending Provider gt isit Date Welmore MD Marcus H d 73072008 D Initial Visit Se Li Follow Up Requesting Provider User Reviewer Z L Auto sal El l Consult Verification Teaching Physician Visit udit Date 04 30 08 Ts Gs E jsAscessment th The assessment is not clearly stated for this encounter Documentation Guidelines states The documentation for each patient encounter should include assessment clinical impression or diagnosis wissessment Ri The assessment should be clearly documented for each encounter Since each note must stand alone itis Imperative to accurately document the most specific diagnosis in the assessment impression sect
79. registration of your license to the Software Application or in connection with the Support Services TSI may use such information for its business purposes including for product Support and development You may permanently transfer all of your rights under this Agreement provided that you retain no copies you transfer all of the Software Application including all component parts the media and printed materials any upgrades and your registration and the recipient expressly agrees to the terms of this Agreement Without prejudice to any other rights TSI may terminate this Agreement if you fail to comply with the terms and conditions of this Agreement In such event you must destroy all copies of the Software Application and all of its component parts and TSI may suspend or deactivate your use of the Software Application with or without notice GOVERNING LAW This Agreement shall be governed by the laws of the State of Indiana PROPRIETARY RIGHTS Copyright All title and copyrights in and to the Software Application including without limitation any images photographs animations video audio music text and applets incorporated into the Software Application any accompanying media and printed materials and any copies of the Software Product are owned by TSI The Software Application is 72 Contacting protected by copyright laws and international treaty provisions Therefore you must treat the Software Application like any ot
80. ricia Oats Steve Robertson Grant Stemle John required field Specialty Maintenance If you choose to enter and maintain your own Specialties choose Specialties Maintenance from the Utilities menu 60 Maintenance Specialty Sub Specialty Maintenance Specialty Sub Specialiy Maintenance Specialty H Hame fi GENERAL PRACTICE Print List of Codes Save Send Code 2 To Other Office Department or File Delete Code Copy Codes From Other OfficeDepartment or File Close Name GENERAL PRACTICE GENERAL SURGERY ALLERGY IMMUNOLOGY OTOLOGY LARYN RHINO ANESTHESIOLOGY CARDIOLOGY DERMATOLOGY FAMILY PRACTICE GASTROENTEROLOGY INTERNAL MEDICINE ck 0 0 00M E CH Fi hs Copyright O 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved User Maintenance Intelicode requires you to be logged in as a user When setting yourself up as a user you need to assign a User ID which can be any number of your choosing We also suggest having a password 61 Intelicode User s Manual Version 8 User Maintenance required fields User Maintenance ID Number Last Name First Name 200 12 Auditor Password g Archive User Print List of Users T ae Delete User Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI
81. ro Type field displaying three types Issue Recommendation or Other As each new macro is created the name of that macro will appear in the list box on the left side of the Macro Maintenance screen followed by a letter identifying the type of macro i e I R or blank for Other An Issue would be what you consider an issue to be addressed corrected or otherwise identified to the auditor and or provider A Recommendation would be the auditor s recommendation of how to address a particular issue or problem with documentation diagnosis and or CPT coding related to the 34 Navigation encounter s being audited individual or entire grouping of encounters or providers An easy way to utilize this feature would be to give an Issue macro and its respective Recommendation macro the same names i e Issue macro named Legibility 1 and the corresponding Recommendation macro would also be named Legibility R If your desired new macro is not an Issue or a Recommendation e g a note to the auditor or additional information macros like Additional Diagnoses or Additional CPT Codes etc the type would be Other In the Macro Contents field enter the information you wish to appear for this macro exactly as you wish it to appear including all of the appropriate grammar and punctuation necessary When finished click the OK button Once your macros have been successfully ad
82. s for service types which are age driven is a D O B necessary Patient Status Each patient will automatically be flagged as a new patient the first time you first enter them into the software Change the patient status accordingly Gender Choose Male or Female User This is a required field A User Reviewer must be selected for each visit Note When you set yourself up as auser remember a password is not required Visit Date This is the date of service for the encounter being audited The Visit date automatically defaults to today s date Change the date accordingly You may enter the date manually by entering the date in MM DD YYYY format or you may click the drop down button and select the date from the display calendars Note The Visit date will stay the same as the previous visit Always change this accordingly Service Category Select the type of service that you feel is appropriate based on the documentation This may differ from what the provider billed Intelicode User s Manual Version 8 9 Service Subcategory Make sure you include the appropriate subcategory i e A Consultation could be an Office Consult or Inpatient Consult as this will be a determining factor of the overall code Note If the Service Type consultation is selected the consult Verification questions must be answered to continue with the audit Once the required information is entered the Navigation buttons Patient History Exam Decision En
83. st Name Specialty Sub Specialty la E mith f ohn e Print List of Et List of Requesting Provide Providers Archive Provider Send Reqesting Provider s To Other Office Regesting Provider z To Other Office E ee ee Copy Requesting Providers From Other Office EE Smith a required fields Copyright 1998 2006 Technology Solutions Inc All rights reserved INTELICODE is a registered trademark of Technology Solutions Inc TSI All Rights Reserved 64 Managing Your Data Archiving Data Performance slows as your database grows Because of this fact we have designed Intelicode so that it will support multiple databases We highly recommend that you formulate a plan for how you want your data organized To make this point think of a file cabinet Most of us store our documents in individual file folders rather than lumping them all into a single drawer Intelicode enables you to manage your databases in the same manner For example if you have multiple sites you would want to create an Office Department for each one If you have multiple departments e Department of Medicine Pediatrics Family Practice Surgery etc you would want to create and Office Department for each of those Each Offices Department will hold Providers Users Patients Note Macros Visits etc However you can copy everything except Visits from one Office Department to another or several at the same time This is also useful if
84. t for assistance in determining where data storage should be located 10 Getting Started Choose Create Change Office Department Choose Create Change Office Department sample Office C MCBSTSIvb6 Presentationsintelicode Modified Data Offices S ample O E El Office Name and Location Office or Group Name New Office is Data Name and Location CAM CBATSIMvbE4PresentationsIntelicade Modified d D Give the new office or group a name Select Browse if you want to Cancel choose a different location to store the data Once this is completed a pop up screen will appear that will allow you to enter specific information about this office or department such as the address telephone etc information entered on this screen will appear in the upper corners of your reports Office Department Name Office Department Name Name New Office Phone Address City St Zip Information entered here will be printed on the report headers When finished click Save The newly added office will now appear in the Choose Create Change Office Department screen under the Office Department name field 11 Intelicode User s Manual Version 8 on the left side of the screen Click on the newly added office to highlight blue the name and then click OK to enter the office Once you create your new office and you go into it for the first time it will prompt you to add yourself as a new user Inte
85. tablished Service Category Sub Category this field will allow you to sort by the service type from the Patient Screen Once the service type Office or other outpatient Hospital inpatient services etc is selected the Sub Category field will be populated with the corresponding service sub types from Patient Screen i e initial follow up Provider this field will allow you to sort the encounters displayed by the provider selected The providers available for this field are those you have previously added to your Provider fields on the Patient screen CPT Code will allow you to sort the encounters displayed by CPT Code The CPT Code that will be referenced for this sort will be the Provider CPT for the audited encounters User will allow you to sort displayed encounters by the user or auditor who performed the audits Specialty this field will allow you to sort the encounters displayed by the specialty of the providers who performed the encounters visits Requester this field will allow you to sort encounters displayed by the Requesting Provider The Requesters available for this field are those you have previously added to your Requester field on the Patient screen Var This field will allow you to sort the encounters displayed by the Variance between the provider code and auditor code This information is taken from the Var field on the End screen Macro this field will allow you to sort the encounters display
86. te ___ fwelmore MD Marcus 1 IER 0 2006 Initial isi Provider es eviewer emm hooo Consult Verification Note Macros Notes Audit Date 01 02 07 Patient Status __ Gender C New Ze Established Diagnosis of Nodular Lymphoma 4bdomen was not necessary on this visit as it was not addressed in the history or exam Medical necessity of MOM did not substantiate a level 3 visit Required Field 1 History Screen Click an area on the image areas where the d cursor appears Le History below for more information and to preview the various screens 28 Navigation Here you select the various History elements documented for the encounter being audited Intelicode keeps track of the counting When the mouse is positioned over a particular History element examples of applicable history elements that may be found in medical records will be displayed in the blue green help box across the bottom of the page as an additional reference When all applicable history elements have been entered proceed to the next Exam screen Fi Patiente 167 Betty Bebee Sample Office J File Utilities Preferences Visits Office Departiment Documentation Guidelines Help Patient History Exam Decision End r History Of Present Illness HPI SE Extended Fast Family And Social History PFSH fa No of Chronic T Diseases Reviewed Chief Complaint Documente
87. ting Intelicade or have not registed yet IF you have purchased a license you can activate by choosing Phone Activation La eae Phone Activation To activate INTELICODE over the phone you will need the System ID from the box below Please call us at 1 800 786 4231 with the System ID You will then receive an Serial Number that needs to be entered into the Serial Number box After the Serial Number has been entered you will receive a message that the program has activated successfully or failed Getting Started Intelicode Phone Activation INTELICOD1 Intelligent Coding Saftware Intelicode PATH 270 0 System ID 561779259138 Seral Ho To activate your license please contact us at 1 500 766 4251 Basic steps to use INTELICODE The following simple steps will outline the overall flow as well as the necessary information to perform an audit using Intelicode First we will define the minimal information required to start the process 1 Patient ID This is the medical record number or whatever number that is used to identify the patient Last Name First Name This is the last name and first name of the patient whose encounter is being audited Note The patient name is not required to perform an audit D O B Date of Birth This is the date of birth of the patient Enter the D O B in MM DD YYYY format Note The patient D O B is not required to perform an audit Only when auditing service
88. tion entered on the previous screens The Time section far left side of screen may be utilized for those situations where time is documented for an encounter Both the Face to face time and the Counseling times must be entered for this function to calculate properly Click on the drop down arrows to select the appropriate time for each field We did not use time for our audit The Comparison section displays the Reviewer E amp M audited code and the Provider E M code billed by provider It also displays the Fee Schedule if any used and the total difference in dollars and the level of variance from the audited code To select the Provider E M simply scroll down the list of E M Codes provided and click on the code billed by the provider being audited Intelicode will then do a comparison between the Reviewer and the Provider E M to produce if any difference in the dollar amounts billed and the variance level We chose the provider code 99204 for our audit There was not a fee 23 Intelicode User s Manual Version 8 difference and the variance shows that the encounter was billed in the wrong category as seen in the example image below The Diagnosis Codes section lets the reviewer select the diagnosis used by the provider and also select diagnosis codes the reviewer feels were supported by the documentation to provide a complete picture of the encounter being audited The diagnosis codes come pre loaded by Intelicode or

Intelicode User`s Manual Version 8

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