Adding CPT Category II Codes to Encompass Practice Management Orders and Claims

Depending on your electronic health record and your settings in Encompass practice management, CPT Category II codes may automatically transmit from the exam to the order and then onto the claim.

CPT Category II codes are labeled PQRS in Encompass practice management.

Enabling CPT Category II Codes for Insurance Plans

CPT Category II codes are already enabled for Medicare and VSP plans. To allow CPT Category II codes to appear on orders and claims for other insurance plans, perform the following steps:

In Administration, under Company Setup, click Insurance and select Carrier and Plan Setup.
Search for the insurance plan.
Select the PQRS check box.
Click Save.

Adding CPT Category II Codes to Orders Manually

If you're using Encompass EHR, and the patient has an insurance plan with PQRS enabled, you can skip this topic. The CPT Category II codes should populate automatically.

If you aren’t using Encompass EHR, you’ll need to manually add CPT Category II codes to orders:

Within the Demographics page, open or create the exam.
In the Procedure Codes table, locate the PQRS row, and select the appropriate CPT Category II code.
Complete the rest of the order and click Save.

Adding CPT Category II Codes to Claims Manually

If you're using Encompass EHR, and the patient has an insurance plan with PQRS enabled, you can skip this topic. The CPT Category II codes should populate automatically.

If you aren’t using Encompass EHR and your front office staff didn’t add the CPT Category II codes to the exam, you’ll need to manually add CPT Category II codes to claims:

Search for the claim and select Edit Claim.
Scroll down to the 24. Services section.
Click + Add.
Enter the Date of Service in the next available row.
Enter the CPT Category II code in the Procedure Code field.
Enter a Diagnosis Pointer.
Click Save.