Anesthesia Service Information Window

Field	Description
Type of Anesthesia	Select one of the following options to identify the method of anesthesia administered: <none> QS – Monitored Anesthesia Care (MAC) 8: G8 – MAC for complicated or invasive surg 9: G9 – MAC for severe cardio-pulmonary cond General Anesthesia Epidural Anesthesia Spinal Anesthesia Note: Selection of QS, G8, or G9 will populate the modifier in position 2 for the anesthesia charges. All other modifiers are for case documentation purposes.
Physical Status	The physical status modifier is a two-character code that indicates the general health of the patient. The first character is a P and the second character is a single digit from 1-6. This selection overwrites any manually entered physical status modifier for this patient. Choose one of the following options to populate the modifier in position 3 for the anesthesia charge: <none> 1: P1 - A normal healthy patient. 2: P2 - A patient with mild systemic disease. 3: P3 - A patient with severe systemic disease. 4: P4 - A patient with severe systemic disease that is a constant threat to life. 5: P5 - A moribund patient who is not expected to survive without the operation. 6: P6 - A declared brain-dead patient whose organs are being removed for donor purposes.
Medical Direction	The purpose of this field is to override the automatic calculation performed by the concurrency audit for medical direction. The best practice is to leave this field blank or select None. Encounter failure (marked in red) occurs if: The level of concurrency selected is different from what the audit would calculate. AND The Exempt from Concurrency check box is not selected. Encounter will pass the concurrency audit and override the automatic selection of medical direction calculated by the system, if you: Select the Exempt from Concurrency check box. AND Select one of the following options: Personally performed by Physician 1 case: Medical direction of 1 case Direction: Medical direction by a Physician Supervision: Medical supervision CRNA service without medical direction Medically necessary
Present at Induction	Select this check box to indicate that the MDA was present at the initial administration of the anesthesia and when the anesthesia began to take effect.
Exempt from Concurrency	Select this check box to do the following: Exclude the providers on this encounter from being included in the concurrency calculation. Display the message Manually exempt from Concurrency on the Concurrency Audit Report for the encounter.

Help Guide for NextGen® Enterprise PM 8

Enter Anesthesia Charges

To enter an anesthesia charge, do the following: Open NextGen® Enterprise PM. Select Charges. The Charge Posting window opens. Select the patient and the encounter. Select New. Select Surg Proc, and then enter the SIM code for the surgical billing. To enter anesthesia charges, select Anesthesia Library for the practice in Practice Preferences > Libraries, and clear Advanced Service Item Library Mode in Enterprise Preferences > Libraries and do the following: Enter the surgical procedure code in the Surg Proc field. Surg Proc description, Svc Item, Svc Item Description, CPT4, and Modifiers fields are automatically entered. Surg Proc is a required field. Select the service item for the encounter from the Svc Item list. It is a required field. Anesthesia codes mapped to the Surgical Procedure code are available for selection. Enter the Anesthesiologist or the directing MD who is engaged in the case in the MD Anesthesia field. Enter the time the anesthesia starts in the Start Time field. 1

Help Guide for NextGen® Enterprise PM 8

Anesthesia Service Information

The following table describes the fields to enter anesthesia service information. Field Description Type of Anesthesia You can select one of the following options to identify the method of anesthesia administered: <none> QS – Monitored Anesthesia Care (MAC) 8: G8 – MAC for complicated or invasive surg 9: G9 – MAC for severe cardio-pulmonary cond General Anesthesia Epidural Anesthesia Spinal Anesthesia Note: Selection of QS, G8, or G9 fills the modifier in position 2 for the anesthesia charges. All other modifiers are for case documentation purposes. Physical Status The physical status modifier is a two-character code that indicates the general health of the patient. The first character is a letter P, and the second character is a single digit from 1-6. This selection overwrites any manually entered physical status modifier for the patient. You can choose one of the following options to enter the modifier in position 3 for the anesthesia charge: <none> 1: P1 - A normal healthy patient 2

Help Guide for NextGen® Enterprise PM 8

Set Up Claim Modifiers for Anesthesia Billing

Use the following procedure to set up a claim modifier for Anesthesia SIM codes: Access the Add/Modify Claim Modifiers window. In the Modifier field, enter a two-character anesthesia modifier. This field is required and cannot be modified after the modifier is saved. For example: P1 - Normal healthy patient P2 - Patient with mild systemic disease P3 - Patient with severe systemic disease P4 - Patient with severe systemic disease that is a constant threat to life P5 - Patient who is not expected to survive without the procedure P6 - Declared brain-dead patient whose organs are being removed for donor purposes In the Effective Date field, enter a start date for the modifier. This field is required. Note: The date defaults to 01/01/1900 for modifiers that were created prior to version 5.9.3. In the Expiration Date field, enter an end date for the modifier. This field is required. Note: The date defaults to 01/01/2099 for modifiers that were created prior to version 5.9.3. In the Modifier

File Maintenance Help for NextGen® Enterprise 8

Set Up Claim Modifiers for Anesthesia Billing

Use the following procedure to set up a claim modifier for Anesthesia SIM codes: Access the Add/Modify Claim Modifiers window. In the Modifier field, enter a two-character anesthesia modifier. This field is required and cannot be modified after the modifier is saved. For example: P1 - Normal healthy patient P2 - Patient with mild systemic disease P3 - Patient with severe systemic disease P4 - Patient with severe systemic disease that is a constant threat to life P5 - Patient who is not expected to survive without the procedure P6 - Declared brain-dead patient whose organs are being removed for donor purposes In the Effective Date field, enter a start date for the modifier. This field is required. Note: The date defaults to 01/01/1900 for modifiers that were created prior to version 5.9.3. In the Expiration Date field, enter an end date for the modifier. This field is required. Note: The date defaults to 01/01/2099 for modifiers that were created prior to version 5.9.3. In the Modifier

NextGen® Orthopedic Suite Help 80.2.14.0

Adding Surgery Details

You can enter the surgery details on the Surgery Sched template. The following table describes the fields in the Surgery Information panel on the Surgery Sched template. Field Description Urgent/High Priority Order To indicate if the surgery needs to be performed on priority. Patient to call to Schedule To indicate if the patient needs to make a phone call to schedule the surgery. Is Patient a Minor To indicate if the patient is a minor. Is Guardian Present You can select Y if the patient has a guardian, and enter the name and phone number of the guardian. Surgeon Displays the name of the surgeon. You can also click this field and update the surgeon name. Co Surgeon You can select the co-surgeon from the list that opens when you click the field. Assistant You can click the field, and select the assistant from the list. You can add another assistant in the subsequent field. Duration You can select the duration from the list that opens when you click the field. Admit Type You can click t

Help Guide for NextGen® Enterprise PM 8

Daily Charges By Current User Report Columns

This report contains fields that can be identified as Protected Content in Enterprise Preferences. These fields identify a patient's sexual orientation and gender identity (SOGI). If any of these fields are identified as protected content fields, then you must have the appropriate security access rights to view the data in these fields. The following columns are available on the Charges By Current User report: Column Name Description Data Populates From Acc Occur Cd Accident Occurrence Code Encounter Maintenance Acc Occur St Accident Occurrence State Encounter Maintenance Acct Nbr Account Number Account Profile Add-On APG Add-On Amount Addr 1 Address 1 Patient Information Addr 2 Address 2 Patient Information Addtl Prov Additional Provider (Practice Note: Field name is from Practice Preferences > Charge Entry. Charge Posting Admitting Admitting Provider Encounter Maintenance Admitting DX Admitting Diagnosis Encounter Diagnosis Selection Admit Dt Admit Date Encounter Maintenance Admit Tm

Anesthesia Service Information Window

Recommendations

Enter Anesthesia Charges

Anesthesia Service Information

Set Up Claim Modifiers for Anesthesia Billing

Set Up Claim Modifiers for Anesthesia Billing

Adding Surgery Details

Daily Charges By Current User Report Columns

Enter Anesthesia Charges

Anesthesia Service Information

Set Up Claim Modifiers for Anesthesia Billing

Set Up Claim Modifiers for Anesthesia Billing

Adding Surgery Details

Daily Charges By Current User Report Columns