Set Up CPT4 Codes at the Provider Master Level

File Maintenance Help for NextGen® Enterprise 8

Assign a Provider Number at a Practice/Location/Provider/CPT4 Code Level

You can set up a range of CPT4 codes at the practice/location/provider level. This range allows you to have a different provider number for each CPT4 code. Set Up CPT4 Codes at the Provider Master Level Rules for Claim Population Parent topic: Providers Practice Tab

File Maintenance Help for NextGen® Enterprise 8

Attach a Taxonomy Code for the Provider at the Practice Level

To attach a taxonomy code for the provider at the practice level: From the Master Files list, select System or PM > Providers. Select the provider. Select the Practice tab. Select the Rendering provider at this practice check box. Select a service location from the Service Location field, and then double-click on the applicable payer listed under Group Information. If you select the default location and a specific payer, then the code applies for this payer at all locations. If you select a specific location and the default payer, then the row applies for all payers at that location. If you select a specific location and specific payer, then the code applies only to this payer at this location. The Modify Provider Practice Payer window displays. Select the taxonomy code from the Taxonomy Code field. If you want to set taxonomy codes for specific procedure ranges, select the CPT4 Provider Nbrs button. The Valid Provider Numbers for [Payer Name] window displays. Select the Open Menu butt

File Maintenance Help for NextGen® Enterprise 8

Attaching Taxonomy Codes to Groups

From the Master Files list, select Practice > Groups. Select the group. If you want to select a default taxonomy code for the group, select a code from the Taxonomy Code field. A taxonomy code added to the default location with a specific payer row applies only for that payer across all locations. The code overrides the taxonomy code at the top of the group screen for that payer. If you want to select a taxonomy code for the group at the location level: Select a service location. Then double-click a payer name in the Payer column. And then select the code from the Taxonomy Code field. A taxonomy code added to the default payer row at a specific location applies for all payers at that location. The code can also be payer-specific at a specific location. The most specific setting is always selected above the other settings. If you want to set taxonomy codes for specific procedure ranges, select the CPT4 Group Information button. The CPT4 Group Information for [Group Name] window displays

Help Guide for NextGen® Enterprise PM 8

Attach CPT4 Codes to Field Locator 51

In File Maintenance, select Master Files - System and then Payers. Select the payer from the Payers List window. The Add/Modify Payer Information window opens. Select the Practice Parameters tab and then UB tab. Select the Open Menu button at the bottom of the window and select New. The Field Loc 51 for a CPT4 Range window opens. Enter the CPT4 code you want to attach to the provider in the CPT4 field. If you want to enter a range of CPT4 codes, your entry in this field serves as the beginning of the range. This field is required. Note: Select the Question Mark icon to perform a CPT4 Code search. You can search by code or by description. To enter a range of CPT4 codes, enter a second CPT4 code in the Thru CPT4 field. Enter the provider number in the Field Locator 51 field. This field is required. Select OK. Parent topic: UB Claims

File Maintenance Help for NextGen® Enterprise 8

Attach Taxonomy Codes to DME Regional Carriers

You can attach taxonomy codes to DME Regional Carriers at the system and practice levels. If you need taxonomy codes for CPT4 codes for items such as prosthetics or orthotics, you can define the codes to be used at the CPT4 level. To attach a taxonomy code, perform the following steps: From the Master Files list, select System > DME Regions. Select the region. Select either the System or Practice tab. If you want to select a default taxonomy code for the carrier, select a code from the Taxonomy Code field. If you want to set taxonomy codes for specific procedure ranges, select the CPT4 Group Information button. The CPT4 Taxonomy Information for DME LIbrary window displays. Select the Open Menu button, and then select New. The Taxonomy Information for CPT4 Range window displays. The Taxonomy Information for CPT4 Range window enables you to enter a range of CPT4 numbers. In the CPT4 field, enter the CPT4 code at the beginning of the range you want to set up. Use the to display the CPT4 C

Help Guide for NextGen® Enterprise PM 8

Set Up CPT4 Codes for Roll-Up Billing

Verify that the appropriate CPT4 codes exist that are needed on UB claims in Field Locator 44 for the roll-up payer. The CPT4 codes are linked to SIM codes as the Alternate CPT4 in the SIM library. To set up a CPT4 code for roll-up billing, do the following: Access File Maintenance. Select System Master Files, then PM, and then CPT4 Codes. The CPT4 Code Search window opens. Do one of the following: To add a CPT4 code, select Open Menu and select New. To modify a CPT4 code, search for the code, then select the code from the list, and then select Open Menu and select Open. The Add/Modify CPT4 Code Information window opens. In the Code field, enter the CPT4 code. This field is required. In the Description field, enter a descriptive name for the code. This field is required. In the Type of Service field, select Medical Care. To save changes and close the window, select OK. Add CPT4 Code Information Parent topic: Setting Up Roll-Up Billing by CPT4 Code

Set Up CPT4 Codes at the Provider Master Level

Recommendations

Assign a Provider Number at a Practice/Location/Provider/CPT4 Code Level

Attach a Taxonomy Code for the Provider at the Practice Level

Attaching Taxonomy Codes to Groups

Attach CPT4 Codes to Field Locator 51

Attach Taxonomy Codes to DME Regional Carriers

Set Up CPT4 Codes for Roll-Up Billing

Assign a Provider Number at a Practice/Location/Provider/CPT4 Code Level

Attach a Taxonomy Code for the Provider at the Practice Level

Attaching Taxonomy Codes to Groups

Attach CPT4 Codes to Field Locator 51

Attach Taxonomy Codes to DME Regional Carriers

Set Up CPT4 Codes for Roll-Up Billing