Page Description

Use this page to create or modify the settings for CPT rules. Using these rules, Copia will replace an order choice’s CPT codes with one or more new CPT codes.

Copia evaluates these rules when it generates outbound billing messages. If more than one rule qualifies for a specific order choice/billing host combination, Copia considers the rules in alphabetic order of the description. This allows you to prioritize different rules defined for the same order choice.

For more help, click one of the following links:

• Accessing this Page
• Defining CPT Rules
• Example: Replacing CPT Codes Based on Order Choice

Accessing this Page

• Click the Add CPT Rule button in the CPT Rules section of the DFT Events administration page.
• Click the Description of an existing CPT rule in the CPT Rules section of the DFT Events administration page.

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1. Use the CPT Rules section of the page to view, add, or edit the CPT rules for the selected host.
2. Select the Active checkbox to have the page display active CPT rules.
3. Enter a name for the rule in the Description field. This field is required.
4. The Current order choice is in list section lists the order choices for which this rule will apply. To add order choices, enter one or more characters in the Order Choice field, and then click the Search button to select the order choice in the Order Choice Search page. See the Order Choice Search topic. To remove an order choice from the list, click the X button in the Remove column that corresponds to the order choice.

This will most commonly be used in conjunction with the Order contains all order choices including current order choice option (see below), in order to specify which CPT code to assign to an order choice when several order choices must be combined into one CPT code.

Select either the Select Order Choices or All Order Choices Except... options to have the ability to select order choices with or without exceptions.

5. The Order contains all order choices including current order choice section lists all of the order choices that must be on an order to trigger the CPT rule. Note that Copia considers the order choice(s) you enter in the Current order choice is in list section to be on this list. To add order choices, enter one or more characters in the Order Choice field, and then click the Search button to select the order choice in the Order Choice Search page. See the Order Choice Search topic. To remove an order choice from the list, click the X button in the Remove column that corresponds to the order choice.

This option may be used in conjunction with the Current order choice is in list option (see above), in order to specify which CPT code to assign to an order choice when several order choices must be combined into one CPT code.

6. The Testing host is in list section lists where the testing must take place in order for this rule to be enforced. To add testing hosts, click the Add button to select the order choice in the Host Selection page. See the Host Search topic. To remove a host from the list, click the X button in the Remove column that corresponds to the host.
7. The Replace order choice CPT codes with these codes section lists the CPT codes that you want to use when this rule is triggered to replace the CPT codes originally defined in the Order Choices administration page for the selected order choice(s). If you do not select any CPT codes in this section, Copia will remove all CPT codes defined for the order choice(s) if this rule is triggered.
8. Click Cancel to return to the Interface Configuration administration page without modifying the CPT rule settings, if desired.

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You may use CPT calculation rules to write one rule for CBC when CBC/Diff are both on the order, and another rule for Diff when CBC/Diff are both on the order. This allows you to change the CBC CPT code to the CPT code used when CBC/Diff are combined, while changing the Diff code to empty.

1. In this example, the CPT code when combining CBC and Diff order choices on an order is 123.
2. You need to create two rules:
1. Create a rule for the CBC, as follows:
• Add CBC to the "Current order choice is in list" section.
• Add CBC and Diff to the "Order contains all order choices including current order choice" field.
• Set the "Replace order choice CPT codes with these codes" to use 123.
2. Create a rule for the Diff, as follows:
• Add Diff to the "Current order choice is in list" section.
• Add CBC and Diff to the "Order contains all order choices including current order choice" field.
• Clear the "Replace order choice CPT codes with these codes" field.
3. With these rules in place, when Copia is evaluating an order that contains both a CBC and a Diff, it will replace the CPT code for a CBC with 123, and it will set the CPT code for Diff to an empty value.

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