Submit Evaluation and Management (E&M) Codes under the 2021 Coding Guidelines

You can submit a calculated or selected Evaluation and Management (E&M) code to the Superbill by using 2021 Coding Guidelines.

1. Open NextGen® Enterprise EHR.
2. Open a patient record.
3. Open the Finalize template, and expand the Evaluation and Management Coding panel.
4. To use a calculated E&M code, review and select the Medical Decision Making (MDM) level or enter the total time.

   The Medical Decision Making section displays the MDM level based on the calculated levels in the three tables in the Medical Decision - Making Elements panel.

   

5. To bypass or override the calculated code, select an E&M code in the code option section of the Evaluation and Management Coding panel.
   Note: You cannot select code 99201. The code expires effective January 1, 2021.

   You cannot calculate code 99211 Nurse Visit based on the MDM level or time. You must select the code manually.

   For codes 99205 and 99215, if the time exceeds the threshold of 74 minutes for a new patient or 54 minutes for an existing patient, you can add a prolonged time code to report the additional time.

6. Enter any additional visit codes.
7. To meet the visit code criteria for Quality Reporting, select a SNOMED® CT code.
8. Select the G2211 checkbox to bill on the new add-on code for the 99202, 99203, 99204, and 99205 codes.
   Note: You can select only the G2211 checkbox or Modifier(s) at a time.
9. To generate a note, referral, lab order, a requisition, or another document, select Generate Note, and then select an option.
10. Select Submit Code.
    The code appears in Submitted Code.

    The application creates the Master or Speciality Master document, or other documents based on your practice configuration for offline generation or the document configuration for a submitted code. For more information, go to NextGen Healthcare Success Community, and download the Practice Configuration Template User Guide for NextGen® Adaptive Content Engine.