Bundling CCI Edits

Help Guide for NextGen® Enterprise PM 8

CCI Bundling Anesthesia Edits

Principles of Medicare coding for anesthesia services involving administration of anesthesia are reported by the use of the anesthesia five-digit CPT procedure codes (00100-01860). These codes specify Anesthesia for followed by a general area of surgical intervention. When the following CPT codes are reported with an anesthesia code, it is assumed that these services are being reported as part of the anesthesia service and so will not be paid in addition to the anesthesia code. Because it is recognized that many of these procedures may occur on the same date of surgery but are not performed in the course of and as part of the anesthesia provision for the day, these codes will be separately paid only if the -59 modifier is appended to the code, indicating that the service rendered was independent of the anesthesia service. CPT codes describing services that, when performed as part of the anesthesia service, would be considered included in the anesthesia code include the following partia

Help Guide for NextGen® Enterprise PM 8

CCI Bundling Lab Edits

The CPT Manual assigns CPT codes to organ or disease oriented panels consisting of a group of specified tests. If all tests of a CPT defined panel are performed, the provider may bill the panel code or the individual component test codes. The panel codes may be used when the tests are ordered as that panel or if the individual component tests of a panel are ordered separately. For example, if the individually ordered tests are cholesterol (CPT code 82465), triglycerides (CPT code 84478), and HDL cholesterol (CPT code 83718), the service could be billed as a lipid panel (CPT code 80061). The service could not be billed with CPT code 80061 (Lipid Panel) with CPT code 82465 (cholesterol) as the Lipid Panel would include the individual test. An encounter with CPT 80061 and 82465 CPT codes will show on the Claim Production Status report with the following claim edit. Parent topic: Set Up CCI Edits

Help Guide for NextGen® Enterprise PM 8

Set Up CCI Edits

In File Maintenance, select Libraries > Claim Edits > Claim Edits Libraries. Select the applicable claim edit library. The Claim Edit Library Maintenance window appears. Check the appropriate CCI bundling edits as needed. You can set the CCI bundling edits with a severity level based on business practices. Select System > Payers, and then select the applicable payer. The Modify Payer Information window appears. Select the Practice tab, and then the Libraries tab on the bottom of the window. Attach the claim edit library to the payer by selecting a library in the Claim Edit Library field. Select OK. Bundling CCI Edits CCI Bundling Anesthesia Edits CCI Bundling Lab Edits Parent topic: CCI Edits

NextGen® Enterprise EHR Help

View Hillrom™ HeartCentrix® Exercise ECG Reports

After ordering a Cardiac Science Exercise ECG report, you can view it. Open the Integrated Equipment Module From the IEM grid, select a Cardiac Science Exercise ECG Report record with a Test Status of Confirmed, UnconfirmedOnly, or Reconfirmed. Select View Report. The HeartCentrix® Exercise ECG report opens. Note: If the patient has multiple race entries, then for Cardiac Science multiple race entries, the race is interpreted as Other. If the system finds a suitable match from information supplied in the Patient Information window, it populates the Race field. Otherwise, the field defaults to "Unknown." Select the HeartCentrix Main toolbar items as needed (functions are dependent on user permissions and view mode). After making any changes, select Confirm to save changes and return to the IEM. For more information on how to use HeartCentrix® functionalities, refer to the appropriate HeartCentrix® user manual. Parent topic: Hillrom HeartCentrix Devices

NextGen® Enterprise EHR Help

Midmark ECGs

This section describes how to record, view, and compare ECG data from the Midmark software that interfaces with supported Midmark ECG equipment. Note: When you perform a test and generate a report, a report PDF can be also generated and attached to the patient's encounter on the Encounter History tab. For more information on working with report PDFs, see the Equipment Report PDFs section. Create Midmark ECG Reports How to create Midmark ECG reports in the Integrated Equipment Module. View Midmark ECG Reports How to view Midmark ECG reports in the Integrated Equipment Module. Compare Midmark ECG Reports How to compare Midmark ECG reports in the Integrated Equipment Module. Parent topic: Midmark Equipment

Help Guide for NextGen® Enterprise PM 8

CCI Edits

The Centers for Medicare and Medicaid Services (CMS) developed the National Correct Coding Initiative (CCI) to promote national correct coding methodologies and to control improper coding that leads to inappropriate payment in Part B claims. The coding policies developed are based on coding conventions defined in the American Medical Association's CPT Manual, national and local policies and edits, coding guidelines developed by national societies, analysis of standard medical and surgical practice and review of current coding practice. The National Correct Coding Policy Manual and edits have been developed for application to services billed by a single provider for a single patient on the same date of service. The purpose of the Correct Coding Initiative (CCI) edits is to ensure that uniform payment policies and procedures are followed by all carriers. When services are accurately coded and reported by physicians proper payment can be guaranteed. Note: You must be licensed for CCI edit

Bundling CCI Edits

Recommendations

CCI Bundling Anesthesia Edits

CCI Bundling Lab Edits

Set Up CCI Edits

View Hillrom™ HeartCentrix® Exercise ECG Reports

Midmark ECGs

CCI Edits

CCI Bundling Anesthesia Edits

CCI Bundling Lab Edits

Set Up CCI Edits

View Hillrom™ HeartCentrix® Exercise ECG Reports

Midmark ECGs

CCI Edits