The Line Item Default Percentage tool lets you define default pricing at the line item level. If a contract has a specified default percentage, you can use this tool to apply the default percentage to procedure codes that are not repriced by another reimbursement tool.
This tool applies a default percentage to line items that have not been repriced by another reimbursement tool, that is, a line item whose resources have not been consumed. If a line item has not been repriced, this tool reprices it to the specified percentage times the charge on the claim for that line item.
- If you select the Apply to zero table amounts check box, in addition to applying the specified default percentage to line items that have not been repriced by another tool, the Line Item Default Percentage tool also reprices any line item whose units have been consumed where the reimbursement value equals zero.
- Line items that have been repriced and have a non-zero reimbursement value are ignored by this reimbursement tool in all cases.
Field Descriptions
The following table describes the fields on the Line Item Default Percentage reimbursement tool.
|
Field |
Description |
|
Apply to zero table amounts |
Selecting this check box reprices any line item whose units have been consumed where the reimbursement value equals zero. |
|
Default |
Sets the percent of the billed charge at which the line item is reimbursed. For example, if you enter 75, all line items that have not been repriced by another tool are repriced at 75% of the billed charge. |