1. The Charge Table
At the first level of the table, you’ll see a list of procedure codes along with key details that you can review or adjust (such as Dx Pointers, Units, and Modifiers).
ID: Displays the procedure name and its CPT code.
Dx Pointers: Links the charge to one or more diagnosis codes (ex: A, B, C).
Units: Number of billable units for the service.
Modifiers: Codes that provide extra billing details (ex: GP, KX).
Fee: The cost per unit of the procedure.
Total: The full charge for that line (calculated as Fee × Units).
Insurance Balance: Portion of the total charge currently assigned to the insurance.
Patient Balance: Portion of the total charge currently assigned to the patient.
More actions: Options for making adjustments or viewing additional details.
1.1 DX pointers
Dx Pointers link a charge to the diagnosis codes that justify why the service was provided. Insurance companies use these connections to determine medical necessity and decide if the claim should be paid.
In the charge table, you’ll see the Dx Pointer field showing letters (A, B, C, D). These letters correspond to the diagnosis codes listed on the claim.
A, B, C, D: Each letter refers to a diagnosis code included in the patient’s visit.
Multiple Pointers: A charge can point to more than one diagnosis if more than one condition justifies the treatment.
Claim Accuracy: Making sure the correct Dx Pointers are applied is essential for reducing denials and ensuring faster reimbursement.
✅ Tip: Always verify that your Dx Pointers align with the provider’s documentation and the insurer’s requirements.
1.2 Units
Units In the charge table, the units field tells you how many instances of the service apply for that line item.
Adjusting units – You may see transactions like Units Added or Units Removed when units are changed on a specific claim.
Claim accuracy – Keeping unit counts correct ensures charges reflect the provider’s documentation and payer requirements.
✅ Tip: Avoid updating the units directly on the claim screen. It's recommended to amend the clinical note and the units will automatically update on the claim.
1.3 Modifiers
Modifiers are codes that provide additional information about a service or procedure without changing its definition.
In the charge table, you’ll see modifiers listed next to the CPT code.
Why they matter: Modifiers explain circumstances that affect billing, such as multiple providers, a reduced service, or a special condition.
Examples
GP: Tells the payer that the service was delivered under a physical therapy plan of care.
Medicare and many commercial insurers require it for all PT services.
It helps differentiate PT services from OT (GO) and Speech (GN).
KX: Used when therapy services exceed the annual therapy threshold (the old “therapy cap”) but are still medically necessary.
By adding KX, the provider attests that documentation supports the need for continued care.
If not applied correctly, claims above the threshold may be denied.
Claim impact: Using the correct modifiers helps prevent claim denials and ensures proper reimbursement.
✅ Tip: Always confirm modifiers match payer guidelines, as incorrect usage can delay payments.
2. Charge Overview Drawer
Clicking on a charge "More options" > "Overview" opens a drawer with a breakdown of all the transactions of this charge.
Charges: Billed amount
Adjustments: Any discounts, write-offs, or insurance adjustments applied
Payments: Payments received from insurance or patient
Total Balance: Remaining responsibility
3. Transaction Details Drawer
By clicking on a specific transaction (ex: Transfer to Patient, Insurance Write-Off, Patient Payment) opens a detail drawer with more information:
4. Common Transaction Types
Each line in the transaction table represents an action taken on a charge. Here are the most common types you’ll encounter:
Balance Added – The initial amount posted to the charge.
Transfer to Patient – Responsibility shifted to the from insurance to patient.
Transfer to Insurance – Responsibility shifted to from patient to insurance.
Patient Discount – A discount applied directly to reduce the patient’s balance.
Patient Write-Off – An amount forgiven from the patient’s responsibility.
Insurance Write-Off – An amount that that can't be collected from the insurance company (per insurance rules or uncollectable).
Insurance Payment – Payment received from the insurance company.
Patient Payment – Payment received from the patient.
Units Added / Units Removed – Adjustments made to the number of billed units.
Transfer to Secondary – Responsibility moved to a secondary insurance plan.
4.1 Transaction Tags
In some cases, you may also see a tag attached to a transaction type. These tags help you understand why a specific transaction occurred.
You can spot any of these tags in the transaction table marked as a red amount. This means that the transaction was undone. Clicking on this transaction will open a drawer with more details.
✅ Tip: Tags help you understand the “story” of a charge. If you see a reversal or refund, check the previous transaction to confirm what was undone.