Provider CQM Maintenance System Template

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

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Provider CQM Maintenance

The Provider CQM Maintenance system template is used to set up the CMS and non-CMS measures at the provider level. You can also configure Quality Program measures for claims-based reporting. This maintenance template can be dynamically updated to relieve users of constant template editing and hard-coding of the measures. Open the Provider CQM Maintenance System Template You can access the template in multiple ways to capture the provider CQM maintenance details. Panels in the Provider CQM Maintenance System Template The Provider CQM Maintenance system template includes different panels which you can use to indicate exceptions, configure measures, import and update exceptions for each measure and so on. Parent topic: Provider CQM Maintenance System Template

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Panels in the Provider CQM Maintenance System Template

To configure various measures, the Provider CQM Maintenance provides the following panels: Panel Description Provider CMS Measures This panel provides the ability to pick and indicate exceptions for the measures. Provider Measures (not CMS) This panel is used to configure non-CMS measures to providers. Claims Base Reporting Setup Your system is delivered with a pre-defined set of Quality Program measures. Copy Provider Measures You can copy measures configured for one provider to another provider. Exception Maintenance You can do the following: Import a spreadsheet with measure details. Update the exclusion data such as the Exception Class, Exception Type, Exception, Effective Date, and Expiration Date for each measure. Remove a record from the grid. Parent topic: Provider CQM Maintenance

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

Manage Clinical Quality Measures

This guide provides instructions to configure Quality Reporting, Quality Program, Centers for Medicare & Medicaid Services (CMS) and provider non-CMS measures in the Provider CQM Maintenance template. Parent topic: Provider CQM Maintenance System Template

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Provider CMS Measures

This panel provides the ability to pick and indicate exceptions for the measures. Open the Provider CQM Maintenance system template. Click the Provider field and select a name from the list. The default option in the System field is CMS. Click the Measure number field and select a value from the list. The Measure short description field automatically fills the information based on the selected measure. In the Default exception class field, click and select an option from the list. Click the Default exception description and select an option from the list. Click Add/Update. The record appears in the grid and displays confirmation text. Provider CMS Measures To delete a measure, select the desired row on the grid and click Remove. Parent topic: Provider CQM Maintenance System Template

Provider CQM Maintenance System Template

Recommendations

Configuring Settings for CPT® II Claims Based Reporting

Provider CQM Maintenance

Panels in the Provider CQM Maintenance System Template

Configure Non-CMS Provider Measures

Manage Clinical Quality Measures

Provider CMS Measures

Provider CQM Maintenance System Template

Configuring Settings for CPT® II Claims Based Reporting

Provider CQM Maintenance

Panels in the Provider CQM Maintenance System Template

Configure Non-CMS Provider Measures

Manage Clinical Quality Measures

Provider CMS Measures