Excluding Oxygen A0422 from the Base Rate

Exclude oxygen A0422 from the base rate

When billing a rolled payer, you can now exclude oxygen A0422 from rolling into the base rate.

When non-rolling is enabled for A0422 on a charge category, and you add that A0422 to a claim that is using that charge category and has a payer that is rolled, you will see an icon next to the charge. This icon gives you a visual indication that this charge is set to non-rolling.

Excluding oxygen from the base rate by charge category

Charges defined for a specific category are created/modified on the Charges page. Oxygen can be excluded from the base rate using charge categories or claim-by-claim.

The following steps outline how to change oxygen in a charge category to non-rolling.

  1. On the navigation bar, click Settings and then click the Charges tab.

  2. Click the View field and select the charge category.

  3. Click Edit.

  4. Scroll down the list until you find the "Other supplies & additional service" section. Then look at the HCPCS column and find A0422. On the A0422 line next to the "Price per unit" column, check the Non-rolling box to exclude A0422 from the rolling base charges.

  5. Scroll down to the bottom and click Save.

In cases where you want oxygen to be rolled into the base rate for a particular claim, and still want to use the charge category where oxygen is set to non-rolling, you can override the non-rolling setting for that claim:

  1. On the Claim page, click the Charges tab.

  2. Click the edit pencil.

  3. Scroll down until you find A0422 under the "Other supplies & additional services" heading.

  4. On the "Override charge amount" window, uncheck the Non-rolling box and then click Continue.

  5. Click the Save changes button.

Unrolling oxygen from the base rate claim-by-claim

If you do not want to set oxygen to non-rolling for an entire charge category, but you do want to unroll it for one particular claim, you can apply non-rolling to oxygen on a claim-by-claim bases.

  1. On the Claim page, click the Charges tab.

  2. Click the edit pencil.

  3. Find the A0422 charge and click the edit pencil next to the "Price per unit" number.

  4. On the "Override charge amount" box, check the Non-rolling box and then click Continue.

  5. Click Save changes.

    A visual indicator that represents non-rolling displays next to the charge A0422.

Note: You can also unroll oxygen from the base using charge categories.

Expected amounts and readable file

When oxygen is set to non-rolling it will have its own set of expected amounts that can be viewed by clicking the "Expected amounts" tab. You will also see a separate entry for oxygen in the readable file.