Appendix A: Alternate Type of Service Codes

File Maintenance Help for NextGen® Enterprise 8

Alternate Type of Service Codes

You can use alternate type of service codes in the place of standard type of service codes for each payer by creating a library of alternate type of service codes, and then attaching the library to the payer. State Payer If the Standard Code is... Then the Alternate Code is... CT, AR, NY, PA, MD, OR, WI, SC All Types of Service codes Blank WA Medicare All Types of Service codes Blank SC Medicaid All Types of Service codes Blank PA Blue Cross Blue Shield All Types of Service codes Blank MD Blue Cross Blue Shield All Types of Service codes Blank TX WorkComp All Types of Service codes Blank WA Medicaid and WorkComp All Types of Service codes 3 AL Medicare when there is no Secondary or Tertiary Payer All Types of Service codes Blank Note: The table outlines the alternate type of service codes for paper claims. The alternate type of service codes for electronic claims are not mentioned here. Parent topic: Appendix A: Alternate Type of Service Codes

File Maintenance Help for NextGen® Enterprise 8

Type of Service Code Table

The standard Type of Service codes are part of the application's Type of Service code table. You can access these standard codes from the Code Table list in File Maintenance. Parent topic: Appendix A: Alternate Type of Service Codes

File Maintenance Help for NextGen® Enterprise 8

Types of Service Library

The Types of Service library enables you to enter Alternate Type of Service codes that meet specific payer requirements. Alternate Type of Service codes can also be set up for specific CPT4 codes or CPT4 code ranges. In addition, Alternate Type of Service Codes can be specific, based on payer requirements, for the claim media type: either paper or electronic. After a Type of Service Library has been set up, it can be attached to a payer at the Payer Master level. When you view or print paper claims, any Alternate Type of Service codes that are set up and attached to the payer print in box 24c on the 1500 form. Set Up an Alternate Type of Service Codes Library Attach an Alternate Type of Service Library to a Payer

File Maintenance Help for NextGen® Enterprise 8

Set Up an Alternate Type of Service Codes Library

From the File Maintenance window, select Libraries > Type of Service. Select open menu button , and then select New. Enter the name of the new library in the Service Name field. Select open menu button , and then select New. The Add Type of Service Alternate window opens. In the Type of Service list, select the applicable standard Type of Service. The Code field is automatically populated with the standard code and the field is disabled and cannot be changed. Enter the applicable Alternate Type of Service code for: paper claims in the Alt Paper field. electronic claims in the Alt Electronic field. Note: When entering alternate type of service codes for paper or electronic claim types, you must fill in both of these fields. For example, if a payer requires an alternate type of service code for paper claims, but they want the standard type of service code for electronic claims, then you must enter the alternate code in the ALT Paper field and the standard code in the ALT Electronic field

File Maintenance Help for NextGen® Enterprise 8

Attach an Alternate Type of Service Library to a Payer

From the File Maintenance window, select Master Files - System > Payers. Double-click on the applicable payer. The Add/Modify Payer Information window opens. Select the Practice tab > Libraries tab. Select the applicable Alternate Type of Service Library from the Type of Service Library field. Select OK. Parent topic: Types of Service Library

File Maintenance Help for NextGen® Enterprise 8

Set Up an Alternate CPT4 Code

Open a Service Item library. From the Search list on the left, select a service item and then select the Payer tab. Select the applicable main payer from the drop-down list. Enter the Alternate Payer Alternate CPT4 code in the Alt Payer CPT4 column. Note: If there is an alternate payer attached to a main payer in the Payer Master and there are Alternate Payer Alternate CPT4 codes that need to be used on the alternate payer claim, then enter the Alternate Payer Alternate CPT4 code in the Alt Payer CPT4 field for the selected service item and payer that the alternate payer is attached to. Only when the location and service items on the encounter match the location and services set up on the Alternate Payer tab of the Add/Modify Payer Information window for the main payer will Alternate Payer Alternate CPT4 codes populate to the alternate payer claim. Parent topic: Alternate CPT4 Code

Appendix A: Alternate Type of Service Codes

Recommendations

Alternate Type of Service Codes

Type of Service Code Table

Types of Service Library

Set Up an Alternate Type of Service Codes Library

Attach an Alternate Type of Service Library to a Payer

Set Up an Alternate CPT4 Code

Alternate Type of Service Codes

Type of Service Code Table

Types of Service Library

Set Up an Alternate Type of Service Codes Library

Attach an Alternate Type of Service Library to a Payer

Set Up an Alternate CPT4 Code