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We have insurance carriers set up with procedure code sets 2 or 3, and have added those codes into the alternate codes in the procedure code. But when we bill the claim is using code set 1.

For example - we have a carrier set up as code set 2.
we have Procedure code 93975, has code set 2 as 93976.
When we enter the transaction for this carrier we entered 93975, when we create the claim it has 93975. not 93976.

Is there something else we need to do for this to work?

Hmm, are you sending the claims electronically using Revenue Management or are these printed on paper? If Revenue Management, which iGuide are you using? If Paper, which Claim Report template are you printing with?

we are using revenue management - iguide for transactions is 837 P MS19 5010 Claims.

It happens with paper and electronic - paper we are using CMS - 1500 Primary 02/12 w/ form

Sounds like you have it all setup correct. So when you print the claim out or send it electronically, it has procedure code 93975 on it instead on 93976.

yes

Is this a primary or secondary insurance and is this a primary or secondary claim?

primary insurance and claim

Hi never got a reply to the last post when I answered your question as to whether it was primary or secondary. Do you have any ideas why this is not working or how to fix it?

Sounds like you have it all setup correct. Someone will probably need to work one-on-one with you. What clearinghouse are you guys using?

MD on line / Ability is the clearinghouse. Shouldn't the claim be created correctly before we send it to the clearinghouse, in claims management?