Denial Group Codes Dictionary

Denial Group Codes identify the financially responsible party or the general category of payment adjustment. A Group Code must always be used in conjunction with a Claim Adjustment Reason Code (CARC) and Denial Reason Codes when adjustments are posted in the Financial Management module. Denial Group and Reason Codes are required to be included for all adjustments referenced on electronic claims. The dictionary will be pre-loaded with the current industry standard codes.

Examples

• Contractual obligations
• Corrections and reversals
• Patient responsibility
• Payor initiated adjustments

The Denial Group Code is a Shared (Enterprise) dictionary. Items entered or modified in this dictionary will result in the item being added or modified in all of the Business Entities in the database.

To add a new denial group code

1. Click New Item from the Actions sectionActions section in the upper right of the dictionary. Complete the following fields.

   

2. Name: Enter a description of the item to be entered. This is a mandatory field and must be unique.
3. Quick Code: Enter a short name for the item. Quick Codes can be up to 15 alphanumeric characters,are mandatory and must be unique. If the Auto generate quick codes Preference has been enabled, this filed will populate when the Name field has been completed and you tab off of the field.
4. Generate quick code: If the Preference to Auto generate quick code has been set this field will be displayed when new items are added to the dictionary. If a quick code has not been set or if you would like to override the code that has been entered in the field, click this button to have the system generate a quick code.
5. Click one of the following buttons:
   • Save and DoneSave and Done

     Click to save your changes and return to the Items screen.

   • Save and NewSave and New

     Click to save your changes and clear the fields on the dialog, so you can add another new Item to the dictionary.

   • CancelCancel

     Click to discard your changes and return to the Items screen.

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