> ## Documentation Index
> Fetch the complete documentation index at: https://help.elationhealth.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Charge DX

> Report on the diagnosis codes attached to each Elation Billing charge line.

One row per diagnosis code per Elation Billing charge line, ordered by `sequence_number`. This is the Elation Billing counterpart to `bill_item_dx` on the Elation EHR side.

There is no `id` column. Elation Billing holds no single key for these rows, so a row is identified by its charge, diagnosis code, and sequence together - all three parts are needed, because neither charge and sequence nor charge and code is unique on its own.

This table's columns and relationships are shown in the [Hosted Database schema](/articles/hdb/schema).

<Note>
  `dx` holds the ICD-10 code with the decimal point removed: `I10`, `E785` for E78.5, `Z0000` for Z00.00. This matches the format used by `bill_item_dx.dx`, so it does not join directly to `icd10.code` without reinstating the decimal point.
</Note>

<Note>
  `sequence_number` sets the order the diagnosis codes appear in on the claim and starts at 1, though a small number of rows carry 0. `is_deleted` rolls up the parent charge, so the diagnosis lines of a deleted charge are flagged deleted too.
</Note>

**For reporting on but not limited to:**

* Which diagnoses were billed, and how often
* The primary diagnosis on each charge line
* Diagnosis mix by practice or by CPT code
* Charge lines carrying more diagnosis codes than expected
* Reconciling billed diagnoses against the Elation EHR bill

## Diagnosis codes on each charge line

<CodeGroup>
  ```sql sql theme={null}
  select
      c.id as charge_id
    , pt.full_name
    , c.cpt
    , c.from_date
    , cd.sequence_number
    , cd.dx
  from charge_dx cd
    inner join charge c on c.id = cd.charge_id
    left join patient pt on pt.id = c.patient_id
  where not cd.is_deleted
  order by c.id, cd.sequence_number;
  ```
</CodeGroup>

## Most frequently billed diagnosis codes

<CodeGroup>
  ```sql sql theme={null}
  select
      cd.dx
    , count(*) as charge_line_count
    , count(distinct cd.charge_id) as charge_count
  from charge_dx cd
  where not cd.is_deleted
    and cd.dx is not null
  group by cd.dx
  order by charge_line_count desc;
  ```
</CodeGroup>

## Primary diagnosis by practice

<CodeGroup>
  ```sql sql theme={null}
  select
      p.name as practice_name
    , cd.dx
    , count(*) as charge_line_count
  from charge_dx cd
    left join practice p on p.id = cd.practice_id
  where not cd.is_deleted
    and cd.sequence_number = 1
  group by p.name, cd.dx
  order by p.name, charge_line_count desc;
  ```
</CodeGroup>

## Charge lines carrying several diagnosis codes

<CodeGroup>
  ```sql sql theme={null}
  select
      c.id as charge_id
    , pt.full_name
    , c.cpt
    , count(*) as diagnosis_count
    , listagg(cd.dx, ', ') within group (order by cd.sequence_number) as diagnoses
  from charge_dx cd
    inner join charge c on c.id = cd.charge_id
    left join patient pt on pt.id = c.patient_id
  where not cd.is_deleted
  group by c.id, pt.full_name, c.cpt
  having count(*) > 3
  order by diagnosis_count desc;
  ```
</CodeGroup>

*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \<your\_question>*