Select the Review of Systems Calculation Method

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Select Evaluation and Management Coding Guidelines

You can select the Evaluation and Management (E&M) coding guidelines to use for your practice on the Practice Configuration template. Open the Practice Configuration template. In the E&M Coding section, do one of the following: Select in the 2021 Coding Effective Date. Then, select either the 95 Coding Guidelines or 97 Coding Guidelines option to use for visit types unaffected by the 2021 Coding Guidelines or for encounters before the effective date. Select the 95 Coding Guidelines option, and then select the physical exam calculation method. Parent topic: Best Practices for Evaluation and Management Coding Calculations See also Physical Exam Calculation for 95 Coding Guidelines Physical Exam Calculation for 97 Guidelines

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Review of Systems Calculation for Evaluation and Management Coding

The ROS information factors into the calculations under the 95 or 97 coding guidelines. All ROS symptoms are shared fields from the Symptom Master template or Symptom Master2 template. These fields are shared with both the History of Present Illness and Review of Systems templates. By using a single shared table, you do not have to reenter symptoms on a Review of Systems template if they were documented on a History of Present Illness template. For example, if positive for fever has been entered on a History of Present Illness template, it has also been filled on the appropriate Review of Systems template and appears in the ROS data grid. You can copy the previous review of systems information to the current encounter, select ROS History. The Historical Information window opens, select Copy ROS & Close to copy previous review of systems information to the current encounter on the SOAP template. You can give the E&M coding credit for ROS to the symptom from a History of Present Illness

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Mark the Medical Decision Making Level as Not Required

If you are using the 95 or 97 Coding Guidelines, you can choose not to use the MDM level as one of the three components for the overall E&M level. You can mark the MDM level as not required on the Practice Configuration template. This option is not applicable to the 2021 Coding Guidelines. Open the Practice Configuration template. Go to the E&M Coding, Medical Decision Making section. Select the MDM not a required component checkbox.MDM not a required component checkbox in E&M, Medical Decision Making section Select Save and Close. Parent topic: Medical Decision Making

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Review and Configure the 95 Single-Organ System Complete Exam Thresholds

You can configure single-organ system thresholds for a complete exam under the 95 coding guidelines. Open the Practice Configuration template. In the E&M Coding section, select 95 Coding Guidelines. For the 95 PE Exam Calculation Method, select either the Detailed Numeric or Strict Numeric option. 95 Details in E&M Coding section Select the 95 Complete Exam link.The 95 Single System Complete Exam Thresholds section appears. 95 Single System Complete Exam Thresholds section Review the default number of documentation elements for each organ system. To change the coding thresholds, select to enter a new number for an item in the Organ Systems. Parent topic: Single-Organ System Exam Thresholds for 95 Coding Guidelines

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Review and Configure 95 Detailed Numeric Exam Coding Thresholds

You can configure coding thresholds for body areas and organ systems under the 95 coding guidelines detailed numeric method. Open the Practice Configuration template. In the E&M Coding section, select the 95 Coding Guidelines option. For the 95 PE Exam Calculation Method, select the Detailed Numeric option. 95 Details in E&M Coding section Select 95 Coding Thresholds.The 95 Detailed Exam Coding Thresholds section appears. 95 Detailed Exam Coding Thresholds Review the default number of documented elements. To change the coding thresholds, select to enter a new number for an item under Body Areas or Organ Systems. Parent topic: Detailed Numeric Exam Coding Thresholds for 95 Coding Guidelines

NextGen® Adaptive Content Engine Help Enterprise 8.3.1

Configure 95 Strict Numeric Exam Levels by Payer

When you select the Strict Numeric option for 95 Coding Guidelines, you can configure all exam levels for each payer on the 95 Exam Payer Configuration template. Note: Payer configurations on the 95 Exam Payer Configuration template supersede all other coding configurations. Open the Practice Configuration template. In the E&M Coding section, select the 95 Coding Guidelines option. For the 95 PE Exam Calculation Method, select the Strict Numeric option.The 95 Exam Payer Configuration link becomes active. Select 95 Exam Payer Configuration.The 95 Exam Payer Configuration template opens. 95 Exam Payer Configuration template To review the 95 Exam payer information, select the information icon. In the Payer(s) Available section, select a payer and then select the right arrow to move the payer to the Payer(s) Selected section. Enter the number for each Physical exam level in the fields for Body areas/organ systems. Note: The defaults are 1 as the lowest possible value and 12 as the highest

Select the Review of Systems Calculation Method

Recommendations

Select Evaluation and Management Coding Guidelines

Review of Systems Calculation for Evaluation and Management Coding

Mark the Medical Decision Making Level as Not Required

Review and Configure the 95 Single-Organ System Complete Exam Thresholds

Review and Configure 95 Detailed Numeric Exam Coding Thresholds

Configure 95 Strict Numeric Exam Levels by Payer

Select Evaluation and Management Coding Guidelines

Review of Systems Calculation for Evaluation and Management Coding

Mark the Medical Decision Making Level as Not Required

Review and Configure the 95 Single-Organ System Complete Exam Thresholds

Review and Configure 95 Detailed Numeric Exam Coding Thresholds

Configure 95 Strict Numeric Exam Levels by Payer