Anesthesia Charges

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

Field Descriptions for Entering a Charge

Use the following table to complete the fields for each charge entered on the encounter. Field Description Svc Dates Defaults to the Billable Date found on the Encounter Maintenance window. The From and To dates can be modified, by entering the date (MM/DD/YYYY) or by selecting the date from the Calendar button. Note: The encounter Billable Date and the charge Service Date are typically the same. Svc Item You can do one of the following: Enter or select the SIM code from the list. Enter or select the SIM description from the list. You can leave this field blank and press the Tab key to move to the SIM description field on the right. Note: The Service Item code is not sent on claims. CPT4 Shows the CPT4 code linked to the selected SIM code. This field cannot be modified. Note: The CPT4 code is sent on claims. Modifiers 1 - 4 In the Modifier fields to the right of CPT4, you can enter up to four 2-digit modifiers for the charge, if needed. Quantity Defaults to 1 and can be modified, if ne

File Maintenance Help for NextGen® Enterprise 8

Set Up SIM Options for Anesthesia Billing

The SIM Options tab on the Anesthesia Library Payer Maintenance window allows override parameters to be defined for specific payers and SIM code ranges. Override options include; exempt from concurrency, minutes per unit, time units, price, and contractual adjustments. On the Anesthesia Library Payer Maintenance window, select the SIM Options tab. Select Open Menu and select New. The SIM Range window opens. In the SIM and Thru SIM fields, enter the range of SIM codes, and then select OK. Select (highlight) the SIM range and use the following table to define SIM Options parameters for the selected SIM range and Valid Payers. To save changes and close the window, select OK. Field Description Exempt from Concurrency Select this check box to exclude the selected SIM range from being counted against max concurrency (not a concurrent case) for the selected payers. During the Anesthesia Concurrency Audit process in NextGen® Enterprise PM, the SIM is ignored during calculation of concurrent ch

Help Guide for NextGen® Enterprise PM 8

Set Up SIM Options for Anesthesia Billing

The SIM Options tab on the Anesthesia Library Payer Maintenance window allows override parameters to be defined for specific payers and SIM code ranges. Override options include; exempt from concurrency, minutes per unit, time units, price, and contractual adjustments. On the Anesthesia Library Payer Maintenance window, select the SIM Options tab. Select Open Menu and select New. The SIM Range window opens. In the SIM and Thru SIM fields, enter the range of SIM codes, and then select OK. Select (highlight) the SIM range and use the following table to define SIM Options parameters for the selected SIM range and Valid Payers. To save changes and close the window, select OK. Field Description Exempt from Concurrency Select this check box to exclude the selected SIM range from being counted against max concurrency (not a concurrent case) for the selected payers. During the Anesthesia Concurrency Audit process in NextGen® Enterprise PM, the SIM is ignored during calculation of concurrent ch

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

Set Up Concurrency Rules for Anesthesia Billing

The Concurrency Rules tab on the Anesthesia Library Payer Maintenance window enables you to define parameters related to concurrency audit rules, charge split percentages, unit price, contractual adjustments, rounding method, and minutes per unit. For both split and non-split charges, the total charge amount is determined by multiplying the unit price by the total anesthesia units. Base Units + Time Units + Modifier Units = Total Anesthesia Units Total Anesthesia Units x Unit Price = Total Charge Amount For split charges, the extended price is split across the two resulting charge lines based on the percentages in the Medical Director and CRNA. After the charges are split, units are only used for reporting purposes. Note: The total charge calculation is the same for split billing and non-split billing. In File Maintenance, select Libraries, and then select Anesthesia. The Anesthesia Library Payer Maintenance window opens. Select Concurrency Rules. Enter the Concurrency Rules parameters

Anesthesia Charges

Recommendations

Enter Anesthesia Charges

Field Descriptions for Entering a Charge

Set Up SIM Options for Anesthesia Billing

Set Up SIM Options for Anesthesia Billing

Enter Anesthesia Charges

Set Up Concurrency Rules for Anesthesia Billing

Enter Anesthesia Charges

Field Descriptions for Entering a Charge

Set Up SIM Options for Anesthesia Billing

Set Up SIM Options for Anesthesia Billing

Enter Anesthesia Charges

Set Up Concurrency Rules for Anesthesia Billing