Configure Service Item Library for CPT® II Claims-Based Reporting

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Configure Non-CMS Provider Measures

You can configure non-CMS Provider measures for CPT II codes. To enable a provider to document an exception and submit a CPT II code manually, you must assign a measure to a provider. Open NextGen® Enterprise EHR. Open the Provider CQM Maintenance template. Provider Measures (not CMS) Panel In the Provider Measures (not CMS) panel, select the Provider field. Select a provider in the list. Select the System field, and select Claims Based Measures. Note: The grid displays measures that have been set up in the Claims Based Reporting Setup panel on the Provider CQM Maintenance template that matches the System selection you have selected. Select the Measure # field, and select a measure in the list.The Measure short description field displays the description of the measure. Select Add.The Provider Measures (not CMS) configuration is added to the All Providers Measure grid. Update Non-CMS Provider Measures You can update the non-CMS Provider measures that are configured for the CPT II codes.

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Configuring Settings for CPT® II Claims Based Reporting

You can enable the CPT II reporting feature by configuring a set of prerequisites. You must complete the following common configurations to enable CPT II code claims-based reporting. Download the CPT code set. For more information about downloading the CPT code set, go to NextGen Healthcare Success Community, and download the CPT4 Utility Guide for NextGen® Enterprise. Configure each CPT II code in Service Item Library Maintenance to enable the submission of a $0 charge claim. Review the mapping or add additional measures on the Coded Results Mapping template. Configure and assign measures to providers on the Provider CQM Maintenance template. Configure CPT II codes for claims-based reporting in Service Item Library. After you complete the required configurations, you must complete the configurations specific to the CPT II code submission option (manual or automated) that your practice uses. See the corresponding section in this document for the remaining configuration steps for the CP

Help Guide for NextGen® Enterprise PM 8

Set Up the Service Item Library

Before you begin Each practice must designate which Service Items library to use by selecting it in Practice Preferences. Open File Maintenance and then select Libraries > Service Items. The Service Items List window opens. Select the open menu button to add or open an existing Service Item library. The Service Item Library Maintenance window opens. To set up the library, enter values in the fields and the tabs. Service Item Library Maintenance Field Descriptions You can set up your Service Item Library by setting up CPT4 codes for each practice, along with the prices and claims. Parent topic: Set Up CPT Codes in Service Items Library

Help Guide for NextGen® Enterprise PM 8

Set Up the Service Item Library

In Libraries, select Service Items. Double-click on the applicable Service Item Library or select open menu button, and then select New. The Service Item Library Maintenance window opens. Complete the fields to set up the library. Service Item Library Maintenance Field Descriptions You can set up your Service Item Library by setting up CPT4 codes for each practice, along with the prices and claims. Parent topic: Service Items Library

Help Guide for NextGen® Enterprise PM 8

Set Up CPT Codes in Service Items Library

Within the Service Items library, you can set up CPT4 codes for each practice, along with prices, and claim form designations. You can also group Service Items together under one main number or name. Libraries are available enterprise-wide, but each practice must designate which Service Items library to use by selecting it in the Libraries Practice Preferences. You can generate the Service Item Library Listing report from the Service Items library. For more information go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Set Up the Service Item Library You can set up CPT4 codes for each practice, along with prices and claim form designations in the service items library. Set Up Anesthesia SIMs Parent topic: Setting Up Claims

NextGen® Enterprise EHR Help

Add SIM Items to a SIM Library

After you have created a SIM library, you need to add service items and pricing information to the library. Select File Maintenance > Libraries > Service Items. From the Service Items List window, select the library to update.The Service Item Library Maintenance window opens. Select the open menu and select New.The three service item fields turn red. In the CPT4 Code field, enter a CPT4® code from your list of service items and then select Enter. The details for that CPT4® Code appears. In the General tab, do the following: In Eff Date, enter the effective date. In Exp. Date, enter the expiration date. In Non-Facility Price, enter the non-facility price in dollars. In Facility Price, enter the facility price in dollars. If you have more items to add, select Enter and repeat steps 4 to 6 for all service items you wish to add. Select OK when you are finished adding all your service items. The service items that you added display in the left panel. Parent topic: Using Advanced Service Ite

Configure Service Item Library for CPT® II Claims-Based Reporting

Recommendations

Configure Non-CMS Provider Measures

Configuring Settings for CPT® II Claims Based Reporting

Set Up the Service Item Library

Set Up the Service Item Library

Set Up CPT Codes in Service Items Library

Add SIM Items to a SIM Library

Configure Service Item Library for CPT® II Claims-Based Reporting

Configure Non-CMS Provider Measures

Configuring Settings for CPT® II Claims Based Reporting

Set Up the Service Item Library

Set Up the Service Item Library

Set Up CPT Codes in Service Items Library

Add SIM Items to a SIM Library