Canada - Procedures and Lab Fees
For Canada users, the Procedure Edit window has a Canada tab.
Procedure Type Code
By default, none is selected. Change the type code if you need it to go out on a Claim.
Lab fees are treated just like ordinary Procedures except
for a few key differences. Lab fees cannot be attached to appointments directly. Instead they are attached to procedures, which then can be attached to Appointments.
- For procedure codes that are lab fees (99xxx), go to the Procedure Code Edit window and check the "Is Lab Fee" box.
- In the Chart module, treatment plan the regular non-lab procedure.
- On the non-lab procedure's Procedure Info, Canada tab, enter the lab fees (up to two can be entered). If the carrier supports version 04 E-claims, both fees are sent. If the carrier supports version 02 e-claims, then only one lab fee is sent.
- Click OK.
For each lab fee entered, one lab procedure with code 99111 is automatically created (beginning with "^^" to visually indicate it is attached). The lab procedures show in the Chart module and the Account module directly below the procedure it is attached to.
- Lab procedures cannot be attached to claims.
- When sending e-claims, any lab fees attached to a procedure will be sent on the same line as the procedure.
- To remove a lab fee, edit the procedure and clear out the lab fee amount on the Canada tab.
- Lab fees can also be detached from procedures by right-clicking in the Chart module progress notes and choosing "Detach Lab Fee".
If the lab fee is not a 99111 code, then the lab fees can be manually entered into the Chart and attached to a non-lab procedure by highlighting both procedures and selecting "Attach Lab Fee". In this case, it will not show in the Procedure Code Edit window.
Version 16.3 and greater: When the insurance plan is a 'Category Percentage' plan, the percentage will be applied to the total of the procedure and attached lab fees. Example: 50% coverage. Procedure fee is $100. Lab fee is $10. Estimate = (100 + 10) * 50% = $55
Version 16.2 and earlier: When the insurance plan is a 'Category Percentage' plan, the percentage is applied to the procedure only.
Example: 50% coverage. Procedure fee is $100. Lab fee is $10. Estimate = (100) * 50% = $50