Box 24e. - DIAGNOSIS POINTER

Per Medicare, CH 26 of the billing manual:

Enter the diagnosis code letter as shown in item 21 to relate the date of service and the procedures performed to the primary diagnosis. Enter only one reference number/letter per line item. When multiple services are performed, enter the primary reference number/letter for each service.

When using form version 02/12, the reference to supply in 24E will be a letter from A-L. Otherwise, the instructions above apply.

If a situation arises where two or more diagnoses are required for a procedure code (e.g., pap smears), the provider shall reference only one of the diagnoses in item 21.

Note - If you want the CPT code to point to only one of the diagnoses in item 21, you must point EACH CPT code itself. (If no pointers are entered on the CPT code itself, ECL will automatically point to the first 4 ICD codes on the cond screen). If they want ALL services to point to the same ICD code, i.e. the first one, they can go to the printed claims options tab and check the 13th box down... 'Always override 24E...' and in the 'Always override with box' below enter A. All CPT codes will have an A in 24E.
(If you don't point codes, might as well NOT enter more than four).

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(**Work-around TIP** - If the diag pointers are 1234 in PrtCap, go into the config and make sure the 'Max services per claim' is set to zero. Pointers will then be ABCD. This has been fixed on 3/4/14 and above).

To determine what prints in this box:

This box will contain a digit for each ICD9/ICD10 (A - L) on the condition screen unless changed in the printed claim options for the payor.

To override this box: Go into the patients file, go to the guarantors screen, click the paper clip button next to the guarantor, click edit. Go to the policy and coverage tab, click the paper clip button next to the payor, click edit. Go to the printed claim options tab, 12th box down 'Print 1st ICD instead of "1,2,3,4' in box 24E of the 08/05 form'. If checked, only the primary ICD9/ICD12 will print for each service and this is invalid for the 2/12 CMS 1500 form.

Note - Plus/advanced will print the ICD code assigned to the service in the ledger. If this box is checked and any ICD is blank, it comes from patient/ledger/services... the ICD code assigned to the service (you do not even need ICD codes on the condition screen). Standard prints ONLY the primary ICD code on the condition screen.

OR...

On the printed claim options tab there is a check box 'Always override box 24E of the 08/05 form (with text entered below)'. Put a check in this box and then enter the information that you want to put in the box 'Always override box 24E of the 08/05 form with' at the bottom. Do NOT leave blank, or 24E will be blank.
This is where the information is pulled from.

(See 24a for service line comments)