Set Up Reason Codes

The Reason Code Setup tool allows a practice to define and reference the codes sent by the carrier that identify the reasons for any differences, or adjustments, between the original provider charge for a claim or service. This setup option is used for customers using the 835 Processing tool.

Launch the Reason Code Set setup window by selecting Reason Code Set from the Insurance Section under the Setup menu.

The current list of carrier reason code sets is displayed on the left side of the window and information about the selected code is shown on the right. From this window, new profiles may be added, or current ones edited and deleted (based on permissions.)

To create a new reason code set, click the Add Reason Code Set button complete the fields as appropriate. The set is composed of a number of individual codes that must be added separately.

To add a Reason Code Set:

1. Type a name for the set in the Reason Code Set field.

   

2. Type the reason code or number in the Reason Code field.
3. Type the description and information in the Default Description field.  This field contains the full narrative text associated with the code. There is a 255 character limit.
4. Type a shorter description with key words if desired in the Short Description field.  This description field is visible to users when selecting a code from the Reason Code set. There is a 100 character limit.
5. Click the Add button.
6. Repeat as needed to create the complete set of Reason Codes
7. Click the Save button.