Document Wound Care Billing Information

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Finalize Template

You can use the Finalize template at the end of an encounter to review the encounter, record and calculate time-based and service-based Current Procedural Terminology (CPT) codes, and associate the appropriate diagnosis codes for billing. This template contains Assessments, Payer, Evaluation, Procedures, and Wound Care panels. Assessments Panel Payer Panel Evaluation Panel Procedures Panel Document Wound Care Billing Information Verify Coding and Submit to Superbill Parent topic: Physical Therapy

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Complete Billing for Procedure Items

Open NextGen® Enterprise EHR. In the Assessment panel on the PT Finalize template, select an assessment listed in the Encounter Diagnosis grid. To associate the diagnosis with a treatment, click the first available Dx code field in the row displaying the treatment.All Procedure rows displaying treatments that were performed automatically display the selected encounter diagnosis code under the Dx code field. This is done to eliminate the need to keep re-selecting the assessment and clicking in the Dx code field for the following treatment. Up to four diagnosis codes can be associated with a treatment procedure. If appropriate, click the treatment procedure’s first available Modifier field and select the modifier from the picklist.Up to three modifiers can be entered. To enter a modifier code that is not listed, select the top blank line and type the desired value. To suppress billing for a treatment procedure, select the corresponding Suppress billing checkbox. Click the links in the Pr

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

The Finalize Template Workflow

You can do the following on the Finalize template: Submit and review the plan of care, based on your role, on the Provider Sign Off panel. Document Evaluation and Management (E&M) codes on the Evaluation and Management Coding panel. Calculate the patient's medical-decision-making level and submit the E&M codes to the Superbill module. Review the patient's history and physical examination details on the E&M Level panel and identify factors in the calculation of the E&M code under the 95 or 97 Coding Guidelines. For more information on E&M coding, go to NextGen Healthcare Success Community, and download the E&M Coding User Guide for NextGen® Adaptive Content Engine. Patient's General Information on Finalize You can view the general details related to finalizing the workflow of the patient in the General panel. Patient's Assessments on Finalize You can view, add, or edit patient assessments in the Today's Assessment panel. Evaluation and Management Level Summary You can view the summary o

NextGen® Orthopedic Suite Help 80.2.14.0

Coding Procedures

You can view all procedures, diagnoses, and modifiers that need to be billed for the current encounter to finalize a visit. The coding grid on the Finalize Visit template displays the following items that need to be billed for the current encounter. Procedures Diagnoses Modifiers Orders for durable medical equipment (DME) that are dispensed by your practice The following details are displayed for each item in the coding grid. Visit type Billing status of the procedure Description of the procedure to be billed Primary diagnosis codes after it is been coded Modifiers Code being sent for billing Coding grid on the Finalize Visit template The billing status is displayed as Coded for the items that have a diagnosis code, and the billing status is blank for the items without a diagnosis code. After you submit the charges, the billing status is displayed as Submitted for all items in the coding grid. The following table describes the buttons that are used for modifying items in the coding gri

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Create a DME Order

Outside DME (Durable Medical Equipment) can be documented on the Pt Dme template. The Pt DME template can also be launched from the Outside DME Order link in the navigation bar. Open NextGen® Enterprise EHR. On the Objective tab, navigate to the Documents and Printing panel. Click the DME button to open the Pt DME template. Pt Dme Highlight an assessment in the grid located in the Encounter Diagnoses section to associate with the order. Note: An alert message appears if you attempt to enter a DME type without previously selecting an assessment. Select medical equipment by category of Assistive devices, Supplies, and Splints. Click the Assistive Devices field and select from the picklist.The service item CPT code and ICD code appear in their respective fields automatically. If appropriate, click the Side field and select from the picklist. Repeat step 4 until all items have been selected. Document the Prognosis by selecting one of the available options. Select one of the available optio

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Document Referrals for Durable Medical Equipment

You can document a referral to Durable Medical Equipment (DME) for a patient in the Referrals Order template. Open NextGen® Enterprise EHR. Open a patient's record, and then open an encounter. Open the Intake template, select the Family Practice specialty and Office Visit visit type, and then select My Plan.The My Plan window opens. Select the Referrals tab. The Referrals Order template opens. You can select the information icon to learn more about the Referrals Order template. On the Referrals tab, select the insurance provider. Enter the insurance policy number, and then select the referral type. In the To section, select DME. In Specialty/Therapy/DME, select a service item from the list. Options to Document Referrals Window To document related details, select the Additional Information link. Select No or Yes to indicate if authorization is required. In the Diagnosis section, select Description. If the patient encounter does not have a documented assessment, select Add Assessment or

Document Wound Care Billing Information

Recommendations

Finalize Template

Complete Billing for Procedure Items

The Finalize Template Workflow

Coding Procedures

Create a DME Order

Document Referrals for Durable Medical Equipment

Document Wound Care Billing Information

Finalize Template

Complete Billing for Procedure Items

The Finalize Template Workflow

Coding Procedures

Create a DME Order

Document Referrals for Durable Medical Equipment