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Quantity versus Units
 Moderated by: Jeff Ward, Gary Tallman
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 Posted: Fri Jul 14th, 2017 07:31 pm
   
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Gary Tallman



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The Quantity and Units fields have been misunderstood as being one in the same but they actually operate quite differently.  Read below to learn the difference.

Units:
The Units field is a valid output for a medical claims and in fact is required.  There is a perception that changing the quantity value also changes the number of units. This is FALSE.  The units field stands alone.  The units field DOES NOT affect pricing.

Quantity:
The Quantity field is NOT a valid output for a medical claims and in fact is ignored.  There is a perception that changing the quantity value also changes the number of units. This is FALSE.  The quantity field stands alone.  The quantity field DOES affect pricing.

Example:
Procedure code xxx has a retail price of $25.00.   One unit is priced at $25.00.
  • Changing the units from 1 to 2 will have the effect of telling the insurance carrier the 2 unit price is $25.00. 
  • Changing the quantity from 1 to 2 will have the effect of telling the insurance company that 1 unit is $50.00
  • Changing both the units and quantity to 2 will have the desired effect of telling the insurance company that 2 units are $50.00
Both the units and quantity should be changed when the price per unit is a standard amount to be double or tripled for 2 or 3 units respectively.  In all other cases it's best to create a new procedure code with a correct price for multiple units.



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