View Code Tables for Dental Billing

Help Guide for NextGen® Enterprise PM 8

Set Up Practice Preferences for Dental Billing

Dental billing in NextGen® Enterprise PM requires specific settings in Practice Preferences. Two Charge Entry options must be enabled to display dental fields on the Charge Posting window, and one Claims option must be enabled to enable the three Qualifying Encounter check boxes on the General tab of the Service Items library. Access Practice Preferences. From the Preferences List, select Charge Entry. To display Tooth, Surface and Quadrant fields on the Charge Posting window, select the Display tooth, surface, quadrant check box. To allow multiple selections in the Surface field on the Charge Posting window, select the Allow multiple tooth surfaces check box. Practice Preferences From the Preferences List on the left, select Claims. To enable the three Qualifying Encounter check boxes on the General tab of the Service Items library, select the Enable Qualifying Encounter Billing check box. Practice Preferences To save changes and close the window, select OK. The dental fields display

Help Guide for NextGen® Enterprise PM 8

Enter Dental Charges

Open NextGen® Enterprise PM, and then select Charges. The Charge Posting window opens. Select the desired patient and encounter. Do one of the following: To add a charge, select New. To modify a charge, select the charge and then select Open. In the Svc Dates fields, enter the service date range for the charge. These fields default to the Billable Date, when you select it on the Encounter Maintenance window. Select Svc Item, and then enter the applicable dental service item. The Unit and Override fields default to the price from the SIM Library. The Extended field is calculated as (Quantity x Override = Extended) and displays the total price for the charge. Select Modifier, and then enter up to four modifiers for the charge. Select Quantity, and then enter the desired quantity. The Quantity field defaults to 1. The Unit and Override fields default to the price from the SIM Library. The Extended field displays the total price for the charge. (Quantity x Override = Extended) Select Tooth

Help Guide for NextGen® Enterprise PM 8

Service Items Library for Dental Billing

When setting up SIM codes for dental, set the Form field on the Service Item Library Maintenance window to ADA. Service Library Maintenance Set Up Payer-Specific Requirements Parent topic: Dental Billing

Help Guide for NextGen® Enterprise PM 8

Dental Billing

This section provides information on dental billing for Health Centers that perform dental services. Specific setup in File Maintenance is required so that dental charges can be entered on encounters and then billed to dental payers on either 1500, ADA or UB claim forms. The type of claim form generated is determined by the setup for each dental payer. The following claim formats are supported in NextGen® Enterprise PM: 1500: Electronic 837PPaper CMS 1500 Form (2012) ADA: Electronic 837D Paper ADA Form (2024) UB: Electronic 837IPaper UB04 Form (2004) Dental billing in NextGen® Enterprise PM involves the following setup in File Maintenance: Practice Preferences Code Tables CPT4 Codes SIM library Claim Edits library Claim Printing library Transaction Codes Payers Set Up Practice Preferences for Dental Billing View Code Tables for Dental Billing Service Items Library for Dental Billing Claim Edits for Dental Billing Claim Printing Library for ADA Claims Payers Master File for Dental Billi

File Maintenance Help for NextGen® Enterprise 8

Code Tables

NextGen® Enterprise PM uses enterprise-wide code tables. Code tables are lists of codes and their descriptions that are required for billing and reporting purposes, such as allergy severity, claim types, race category, and sexes. The data in these tables is set up when your server is staged. For example, the Claim Types code table lists the codes that are required for different payers, such as Medicare, Blue Cross Blue Shield, and Workers' Compensation. Code Table Descriptions You can know the functions of the code tables through their descriptions. Enable Facility Billing for Places of Service You can enable facility billing for a place of service using the Place of Service code table in the Code Tables section of File Maintenance. External Systems for Code Tables You can add external systems that interface with the NextGen Healthcare applications and associate them with a code table.

File Maintenance Help for NextGen® Enterprise 8

Open Code Tables

Open File Maintenance. Select Code Tables. The Code Tables List window opens. Select a code table from the Code Table list. The list updates to display the codes in the selected code table. To open a code in the code table, double-click it. Parent topic: Code Table Descriptions

View Code Tables for Dental Billing

Recommendations

Set Up Practice Preferences for Dental Billing

Enter Dental Charges

Service Items Library for Dental Billing

Dental Billing

Code Tables

Open Code Tables

Set Up Practice Preferences for Dental Billing

Enter Dental Charges

Service Items Library for Dental Billing

Dental Billing

Code Tables

Open Code Tables