Configure 95 Strict Numeric Exam Levels by Payer

NextGen® Adaptive Content Engine Help Enterprise 8

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

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 Click 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, click to enter a new number for an item under Organ Systems. Parent topic: Single-organ System Exam Thresholds for 95 Coding Guidelines

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Review and Configure 95 Detailed Numeric Exam Coding Thresholds

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 Click 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, click 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

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Select E&M Coding Guidelines

Open the Practice Configuration template. In the E&M Coding section, do one of the following: Click 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. For more information, refer to Physical Exam Calculation for 95 Coding Guidelines section. Select the 97 Coding Guidelines option (default). For more information, refer to Physical Exam Calculation for 97 Guidelines section. Parent topic: Best Practices for E&M Coding Calculations

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Select the ROS Calculation Method

Open the Practice Configuration template, and scroll down to the E&M Coding, ROS Calculation Method section. For guidance on the ROS calculation method, click the information icon. Select one of the following calculation methods: HPI and ROS credit is given when symptoms are entered on HPI templates Note: The ROS coding credit is not given when symptoms have been entered on the dynamic HPI templates. ROS is assigned when symptoms are documented on ROS templates Click Save and Close. Parent topic: Review of Systems (ROS) Calculation for E&M Coding

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Mark the MDM 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 and then scroll to the E&M Coding, Medical Decision Making section. Select the MDM not a required component check box. MDM not a required component check box in E&M, Medical Decision Making section Click Save and Close. Parent topic: Medical Decision Making

NextGen® Adaptive Content Engine Help Enterprise 8

Update a Payer Exam Configuration

In the Configured Payer(s) grid, select a payer Change the numbers in the Body areas/organ systems fields. Click Update. The level from and level to fields in the Configured Payer(s) grid display the new values. Parent topic: Configure 95 Strict Numeric Exam Levels by Payer

Configure 95 Strict Numeric Exam Levels by Payer

Recommendations

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

Review and Configure 95 Detailed Numeric Exam Coding Thresholds

Select E&M Coding Guidelines

Select the ROS Calculation Method

Mark the MDM Level as Not Required

Update a Payer Exam Configuration

Configure 95 Strict Numeric Exam Levels by Payer

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

Review and Configure 95 Detailed Numeric Exam Coding Thresholds

Select E&M Coding Guidelines

Select the ROS Calculation Method

Mark the MDM Level as Not Required

Update a Payer Exam Configuration