NextGen Knowledge Center

Assign Evaluation and Management Coding Criteria

You can assign Evaluation and Management coding criteria to a cardiology visit type.

The criteria for assigning the Evaluation and Management (EM) code to visit types, configured as per the 2021 E&M coding guidelines, are decision making and time range. As per 95 and 97 guidelines, the criteria for assigning the EM code to a visit type include level of history, level of exam, and decision making, or total visit time.

  1. Open NextGen® Enterprise EHR.
  2. In System \ Practice Template, open the Card Setup Visit Types template.
    The effective date configured in the Practice Configuration practice template appears in the 2021 Date field.
    Card Setup Visit Types

  3. In the EM CODING CRITERIA section, select the Visit Type.
  4. Select the level of history that indicates clinical problems or symptoms being addressed during the encounter.
    You can decide the level of history based on chief complaint, history of present illness, review of systems, past medical, family, and social history.
  5. In Level of Exam, select the level of physical examination performed on the patient.
  6. In a Decision Making, select the complexity involved in establishing a diagnosis and determining a management option.
    The decision making level selection depends on the number of diagnoses, amount of analyzed data, and risk of complications.
  7. Enter the time range in minutes.
  8. Select the EM Code to assign to the visit type.
    The CPT® code and EM level appear in the corresponding fields.
  9. To indicate that the E&M coding criteria are assigned as per the 2021 E&M coding guidelines, select Yes.
  10. Click Add.