Describe the consult
Free text or checklistEverything here is matched on this device to build a shortlist of diagnosis codes.
Matching runs on this device. Nothing you type is uploaded or saved.
Diagnosis codes (ICD-10)
0 of 12 usedOne primary diagnosis is required — it is the chief reason for the visit and becomes pointer A. Everything else is secondary (B–L).
Visit parameters
Drives the code menuSetting, patient status and time decide which base visit codes and modifiers are offered next.
CMS-1500 rules require the mother and the infant to be billed separately, so you'll get two PDFs — one with maternal codes, one with infant codes.
Procedure codes (CPT / HCPCS)
Three categories, three rulesBase codes are exclusive, add-ons need a base code, standalone services stack freely.
Base visit code
Choose exactly oneOnly one primary E/M or counseling code can be billed per patient, per day. Pick the level that matches your time or medical decision-making.
Add-on & prolonged codes
Choose a few — only with a base codeThese cannot stand alone. Add them when the visit runs past the time built into your base code.
Pick a base visit code before adding prolonged codes.
Standalone & special services
Choose as neededThese can be billed alongside or instead of an E/M code, depending on the payer.
Travel & mileage
Non-covered linePortal-to-portal travel is a patient-responsibility line — it carries no diagnosis pointer.
Modifiers, links & charges
Max 4 modifiers · max 4 links per lineModifiers stack when they describe different circumstances (25 + 33 + 95). Each line must point to at least one diagnosis to show medical necessity.
Lines total
$0.00
Auto-applied from your visit answers: 33. Adjust per line below.
Pick a procedure code above and the fee will split across your line items.
Locked rows keep their amount; the rest share what's left of the total.
Equipment or supplies sold during consult
Off by default. Nothing about equipment appears on the preview or PDF unless you turn this on and add an item.
Pick a primary diagnosis — every claim needs one.
No procedure codes selected yet.
You marked travel but there's no travel line item.
Two superbills will be produced — CMS-1500 rules require mother and infant to be billed separately.
Live Preview
CMS-1500Your Practice Name
Provider Name, IBCLC
NPI —
Practice address
Phone · Email
Mother
Diagnoses — A is primary
No diagnosis codes
Procedure / CPT-HCPCS
No codes selected
POS
12
Modifiers used
—
Your Practice Name
Provider Name, IBCLC
NPI —
Practice address
Phone · Email
Infant
Diagnoses — A is primary
No diagnosis codes
Procedure / CPT-HCPCS
No codes selected
POS
12
Modifiers used
—
Client fields stay blank & fillable — no PII ever leaves your device.