Enter Present on Admission Indicators for UB Claims

Help Guide for NextGen® Enterprise PM 8

Add Encounter-Level Diagnosis Codes

Access the Patient Chart for the desired patient. Select the Encounters tab, and then the General sub-tab. In the Encounters list on the left, select the desired encounter. In the ICD-CM section on the right, select the Open Record button. The Diagnoses Selection window appears. Note: Existing encounter-level diagnosis codes are listed in the Selected ICD-CM Codes section on the right. Select one of the following buttons: Diagnostic to search for ICD-CM diagnostic codes. This button is selected by default. Procedural to search for ICD-PCS procedural codes. In the pane on the left, select one of the following column headings to select a search method: Code to search by diagnosis code. This column is selected by default. Description to search by diagnosis description. A flashlight icon displays in the selected column heading. In the ICD-CM Codes field, enter all or part of the desired code or description. Codes that match the entered search criteria are displayed. Note: Select the Search

Help Guide for NextGen® Enterprise PM 8

Encounter-Level Diagnosis Codes

Diagnosis codes are typically entered during charge posting. Charge-level diagnosis codes then display in the ICD-CM section on the General sub-tab on the Encounters tab in the Patient Chart. After charge posting, you can add additional encounter-level diagnosis codes, if needed. You can also add encounter-level diagnosis codes prior to charge posting, so they default to each charge during charge posting. Note: Diagnosis codes added to an appointment from the Ins/Diag tab in the Add/Modify Appointment window automatically default to the ICD-CM section on the General sub-tab in the Patient Chart > Encounters tab when the appointment is checked-in and the encounter is created. Add Encounter-Level Diagnosis Codes You can add diagnosis codes at an encounter-level for a patient. Select an Admitting Diagnosis for UB Claims You can use the admitting diagnosis as an institutional claim to indicate the patient's primary diagnosis at the time of inpatient admission. Enter Present on Admission In

NextGen® Enterprise EHR Help

Select Diagnosis Data

Select Diagnosis from the Report Filter Settings List. Report Filter Select to display the Diagnosis Search window. Diagnosis Search Select the pertinent Library. To further narrow your search, select the Category. Select whether you wish to search by ICD or Dx Code. Enter a Diagnosis search criterion. Note: Make sure to use the proper ICD Code for your search. If your Practice is using the decimal ICD Code, make sure to enter the ".". Select Search. Select the desired Diagnoses. Select OK. The selected diagnoses display in the Diagnosis Search pane. Select whether to Include or Exclude the displayed diagnoses. Select whether to display patients who have had problems within specific date criteria, for example: Patients who have never had the problem before or after a specific date or between a specific date range. Patients who have ever had a problem before or after a specific date. Patients who have not had this problem since a specific date. To select a date range, check Who Have Eve

File Maintenance Help for NextGen® Enterprise 8

Set Up the Claim Rules by TOB Tab

The Claim Rules by TOB tab on the Institutional Billing Maintenance window allows the Type of Bill (TOB) to control whether specific fields are populated on claims for the selected payers. From the Institutional Billing Maintenance window, select the Claim Rules by TOB tab. In the Claim Rules by Type of Bill section, do one of the following: To add a new claim rule by TOB, select open menu button and select New. To modify an existing claim rule by TOB, select the row for the rule in the list, select the open menu button and select Open. The Claim Rules by Type of Bill Range window opens. In the Effective Date and Expiration Date fields, enter an effective date and an expiration date for the rule. These fields are required. Dates cannot overlap between rules for the same TOB range. If dates overlap, the following prompt displays when the OK button is selected: Effective/Expiration dates overlap with [Claim Rules by TOB Name]. In the Description field, enter a descriptive name for the ru

Help Guide for NextGen® Enterprise PM 8

UB/General Tab

All the fields on the UB > General sub-tab can be automatically populated. The information on this tab can be overridden, but it is not recommended, especially if you are an Enhanced UB user and you want to use the automated UB claims process. Regular UB users should not use the fields on this window, except to change the Source of Admission field. Regular UB users should continue to use the Billing & Collections tab on the Encounter Maintenance window to review or change the values that display on the UB claim form. Encounter Maintenance Field Description Type of Bill This field is divided into three positions. The values for each position are described separately. First Position After the UB claim is billed, this position is populated automatically with the value that is in the Type of Facility field located on Modify Payer Information > Practice > UB sub-tab. If this field does not contain a value, this position is populated from the Type of Facility field in Practice Preferences >

File Maintenance Help for NextGen® Enterprise 8

IB Library with Claim Rules by TOB Report

The Institutional Billing Library with Claim Rules by TOB report includes information from the Institutional Billing library in File Maintenance. Information on the report pulls from the Institutional Billing Maintenance window > Claim Rules by TOB tab. The report includes the following information: Column Description Data Populates From Lib Name Library Name Institutional Billing Library Name field Desc Description Claim Rules By Type of Bill Range window > Description field Eff Dt Effective Date Claim Rules By Type of Bill Range window > Effective Date field Exp Dt Expiration Date Claim Rules By Type of Bill Range window > Expiration Date field Tob From Type of Bill From Claim Rules By Type of Bill Range window > TOB From field Tob To Type of Bill To Claim Rules By Type of Bill Range window > TOB To field Adm Diag Admitting Diagnosis Claim Rules By Type of Bill Range window > Populate Admitting Diagnosis check box Y or N Patient Reason Visit Patient Reason for Visit Claim Rules By Ty

Enter Present on Admission Indicators for UB Claims

Recommendations

Add Encounter-Level Diagnosis Codes

Encounter-Level Diagnosis Codes

Select Diagnosis Data

Set Up the Claim Rules by TOB Tab

UB/General Tab

IB Library with Claim Rules by TOB Report

Add Encounter-Level Diagnosis Codes

Encounter-Level Diagnosis Codes

Select Diagnosis Data

Set Up the Claim Rules by TOB Tab

UB/General Tab

IB Library with Claim Rules by TOB Report