Correcting Dx Codes on a Claim

If you get the rejection from the Clearinghouse or Insurance that the Diagnosis code needs to be corrected, these are the steps you will take to correct the encounter.

First, you will want to go into the Claim for the Date of Service that you are wanting to edit the Dx codes for. This can be done inside the Patient Demographics -> Claims tab or in the Billing tab -> Claims -> Search Patient. Click on the Blue hyperlink Claim number:

Once inside the claim, you will be editing the encounter to add the additional line. Click on the Encounter on the upper right hand side:

On the next screen, click on the Blue hyperlink encounter number:

Once inside the encounter, you will Re-Open the claim using the blue button on the lower right:Now that the claim is open, edit the line in the encounter by clicking on the Edit Pencil next to the CPT Code:

In the pop-up, you will see the information about that CPT code and the drop down areas where you can Edit the Dx code:

When you click on the Arrow next to the Dx code that you are needing to change, you will get a pop-up with the list of the Dx codes in HENO. You will search the one you want and add it to the line:

It will update the Dx code on that line for the claim and click Apply Changes:

Once everything looks correct, you will change the status at the top of the encounter to Approve and Apply Changes:

This claim will now be in your Send Claims bucket to be submitted to the insurance again.

If you have any additional questions, please email support@heno.io