ANSI X12-compliant Country Codes

Help Guide for NextGen® Enterprise PM 8

Set Up an ANSI X12-compliant Country Code

To set up an ANSI X12-compliant country code: From File Maintenance application, select Master Lists. Select Countries in the Master List field. Select the applicable list. The Modify Country Information window opens. Select the External tab. Select the open menu button and select New to create a new External ID or select Open to modify an existing one. The Add/Modify External Interface window opens. Enter the applicable country code in the External ID field. Select ANSI_X12_Code_Table in the External System field. Select OK. Your entry is listed on the External tab. An example of the code that appears on the claim in the electronic 837 file's N4 segments for Mexico is: N4*Puerto Vallarta**46800*MX~ Parent topic: Master Lists

Help Guide for NextGen® Enterprise PM 8

ANSI X12-compliant Country Codes

You can override the country description in the Countries master list with an ANSI X12-compliant code from the External tab of the master list. A new option in the External System field, ANSI_X12_Code_Table, was added for claims purposes to be used to translate a country code to an ANSI X12-compliant code. This function enables you to use the required format for a foreign country to send on claims for non-US patients. When a country code has an External ID entered with the ANSI_X12_Code_Table External System selected, then during billing that country code is translated into the code rather than the first three letters of the description from the master list. That code will then be the code that appears on the claim in the electronic 837 file's N4 segments. Note: When using the ANSI X12-compliant code, you must disable the Populate foreign country code in the subscriber loop check box, which was previously used to populate Canadian and Mexican countries. This check box is located in the

Help Guide for NextGen® Enterprise PM 8

Set Up an ANSI X12-compliant Country Code

To set up an ANSI X12-compliant country code: From File Maintenance application, select Master Lists. Select Countries in the Master List field. Select the applicable list. The Modify Country Information window opens. Select the External tab. Select the open menu button and select New to create a new External ID or select Open to modify an existing one. The Add/Modify External Interface window opens. Enter the applicable country code in the External ID field. Select ANSI_X12_Code_Table in the External System field. Select OK. Your entry is listed on the External tab. An example of the code that appears on the claim in the electronic 837 file's N4 segments for Mexico is: N4*Puerto Vallarta**46800*MX~ Parent topic: Master Lists

File Maintenance Help for NextGen® Enterprise 8

Disable Admitting Diagnosis on UB Claims

If you do not normally send Admitting Diagnosis information on electronic 837I claims, and you find that Admitting Diagnosis is populating your ANSI X12 5010 claims, then you may need to disable a legacy ANSI X12 4010 option in the Submitter Profile Library. Open File Maintenance. Select Libraries, and then Submitter Profiles. The Submitter Profiles List window opens. From the list, double-click to open the library used for 837I claims. The Submitter Profile window opens. In the ANSI X12 Version field, select Version 4010 (default). The following prompt appears: There are currently [n] pending electronic claims for this submitter profile flagged for processing as well as [n] electronic claims which are not flagged for processing. If you change this submitter profile's ANSI X12 version then the pending claims flagged for processing will be archived and the encounters associated with them flagged for re-bill. Would you like to save this change to the submitter profile? Select No. Select

File Maintenance Help for NextGen® Enterprise

Claims-2 Tab

For additional details about the settings on this tab, see the latest Claims Guide for NextGen® Enterprise PM. Claims-2 The options in the Claims-2 section work for all electronic claims regardless of COB. Field Description Enable NDC coding for electronic claims If you select this check box and the NDC information has been added to a SIM, then the 2410 LIN and CTP segments are created in the electronic claim file. Populate 2410 CTP segment Select this option to populate the 2410 CTP segment. Populate 2400 PS1 purchase service segment Select this check box to populate the Purchase Service Amount in the 2400 loop/PS1 segment for electronic claims. Populate foreign country code in subscriber loop Select this check box to populate Patient and Subscriber loops with a two-character country code in electronic claims. Currently, this setting only supports Canada and Mexico as valid foreign countries. Populate PCP in 2310A loop (professional only) Select this check box to create the 2310A PCP

Help Guide for NextGen® Enterprise PM 8

Claims-2 Tab

For additional details about the settings on this tab, see the latest Claims Guide for NextGen® Enterprise PM. Claims-2 The options in the Claims-2 section work for all electronic claims regardless of COB. Field Description Enable NDC coding for electronic claims If you select this check box and the NDC information has been added to a SIM, then the 2410 LIN and CTP segments are created in the electronic claim file. Populate 2410 CTP segment Select this option to populate the 2410 CTP segment. Populate 2400 PS1 purchase service segment Select this check box to populate the Purchase Service Amount in the 2400 loop/PS1 segment for electronic claims. Populate foreign country code in subscriber loop Select this check box to populate Patient and Subscriber loops with a two-character country code in electronic claims. Currently, this setting only supports Canada and Mexico as valid foreign countries. Populate PCP in 2310A loop (professional only) Select this check box to create the 2310A PCP

ANSI X12-compliant Country Codes

Recommendations

Set Up an ANSI X12-compliant Country Code

ANSI X12-compliant Country Codes

Set Up an ANSI X12-compliant Country Code

Disable Admitting Diagnosis on UB Claims

Claims-2 Tab

Claims-2 Tab

ANSI X12-compliant Country Codes

Set Up an ANSI X12-compliant Country Code

ANSI X12-compliant Country Codes

Set Up an ANSI X12-compliant Country Code

Disable Admitting Diagnosis on UB Claims

Claims-2 Tab

Claims-2 Tab