Service Line(s)

A Service Line is listed on a claim for each procedure or item that is to be reported to the Payer(s) for claim adjudication. Each claim must contain at least one Service Line.

The main view of the Service Line(s) tab contains the basic information for the line as it relates to NY Medicaid. Additional information and adjudication details from Other Payers are available on subsequent pages. As a default, 5 Service Lines are displayed on the main page, however you may add as many as needed, up to a maximum of 50, simply by clicking Add More Service Lines. You may remove any single Service Line by clicking the Remove icon on that line. In addition, the total of all the submitted charges for the Service Lines is listed below all the Service Lines that have been entered.

Ln (Line): This is a system generated value to uniquely identify the Service Line on the claim. The counter will start with 1 and increment with each new Service Line entered. A minimum of 1 Service Line is required on all claims.

Line Item Ctl#: This field can be used to enter a line number that corresponds with your records if it is different than the line number given. This field is not required.

Svc Dates: For a procedure/service rendered on a single date, enter this date in the From Date. However, if the procedure/service transpired over a period of time, enter the start and end dates in the From and To fields respectively. The date(s) may not be greater than the current date. The format is: MM/DD/YYYY and may either be entered in the field or selected from the calendar available by pressing the button to the right of the field. At a minimum, a From Date is required for all Service Lines.

Proc & Mod  (Procedure Codes & Modifiers): The Health Care Financing Administration Common Procedural Coding System identifier for the product/service. This code value is required for all claims. Optionally, up to 4 modifiers identifying special circumstances related to the performance of the service may be entered for each code. Note: If entered, the Modifier must be a 2 character code.

Chrg Amount: The submitted charge amount for this procedure/service must be entered. Note: Zero (0) is a valid charge amount.

Svc Count: The number of units or minutes in which the procedure/service is to be billed. A drop down is available to indicate the unit of measure for the Service Unit. A default value of 'Unit' will be selected but may be changed.

Place of Svc: Enter or select the code for the facility/location where services on the current line were performed, if the facility/location differs from the Place of Service listed on the Professional Claim Information tab.

DX (Diagnosis) Pointers: If Diagnosis Codes were entered on the Diagnosis tab, you may list the top four (4) diagnosis code labels in order of priority here. Diagnosis Codes are referenced by their label number and therefore acceptable values are 1 through 12 inclusive.

Emgcy: You must select 'Yes' or 'No' to indicate whether or not the services provided were emergency related.

More: Click the more button to enter additional details about the service line.

Del.: If you want to delete a service line that has been entered, click here.

Total Claim Charges: At the bottom of the table of Service Lines, all charges for all Service Lines on the claim will be summed and displayed, once the Service Line Information is saved.

For each Service Line, you may view/enter additional details by clicking the More icon. However you may only view these additional details once all required elements have been entered. Navigating off this summary page, either by clicking the More icon or moving to another tab, will trigger validation of the data entered on this page. Validation is done one line at a time, so if there are errors on multiple lines you will have to fix each line before seeing the next set of errors. If a Service Line must be removed for any reason, clicking the Delete icon will remove the line and re-sequence the remaining Service Lines.