CPT/HCPCS Code Updates

NextGen® Adaptive Content Engine Help Enterprise 8

Coded Results Mapping for the Improved Claim-Based Measures Reporting

In the Coded Results Mapping template, you can map specific template field values to specific coded values to ensure accurate quality measure reporting. This function provides a flexible and scalable solution that delivers real-time codification for NextGen® HQM supported measures, as well as for claims- and registry-based reporting. Coded Results Mapping has the following benefits. Improves the accuracy of quality measure reporting Simplifies the maintenance of customized templates with quality measure values Streamlines the updating of quality measures The Center for Medicare and Medicaid Services (CMS) measures must be configured at the provider level using the Provider CQM Maintenance system template. For information on using the Provider CQM Maintenance system template to define CMS measures, go to NextGen Healthcare Success Community and download the latest Provider CQM Maintenance System Template for NextGen® Adaptive Content Engine. The key feature of this mapping template is i

NextGen Behavioral Health Suite Help 5.5

Completing Care Guidelines by Coded Results Mapping

Currently, a stored procedure runs at night to update any coded results mapping. Therefore, you do not see the update to Care Guidelines until the next day. The job is set to automatically run every night. Therefore, you can run a job at the encounter level from the Update Encounter Coded Data template to update the Coded Results mapping table immediately with the new values entered for the current patient encounter. Configure Coded Results Mapping for Behavioral Health Protocol You can configure coded results mapping for the BH protocols. Update Encounter Coded Data You can run a job at the encounter level on the Update Encounter Coded Data template to update the coded results mapping table immediately with the new values entered for the current patient encounter. Parent topic: Care Guideline Configuration for BH Protocols

NextGen® Adaptive Content Engine Help Enterprise 8

Obtaining Test or Code Information for Codes Submitted to the Procedures Module

You can view the test or code information for codes submitted to Procedures module to satisfy a care guideline. When you want guidelines to update based on the codes submitted to the Procedures module, such as visit CPT® codes or billing codes, it is important to note that not all guidelines are updated from the Procedures module alone, and this functionality can vary depending on the NextGen® Enterprise EHR and NextGen® Adaptive Content Engine version and guideline. For instance, vaccines can be partially billed, so immunizations are never updated from the Procedures module. Additionally, it may not be appropriate for guidelines to update solely on billed codes as these are typically not sufficient evidence that a particular test is resulted, nor they are as easily canceled or removed if billed in error or are no longer applicable. In NextGen® Adaptive Content Engine 8.4.x and later, a separate section on the Data Sets Setup practice template enables you to specify codes for guideline

NextGen® Adaptive Content Engine Help Enterprise 8

CPT II Code Auto-Submission

The CPT Code Auto-Submission setting on the Practice Configuration template applies to practices that use CPT II procedure codes for claims-based measure reporting. Reporting measures can be set up and mapped on the Coded Results Mapping template. When documentation in the patient encounter meets the specific criteria set up on the Coded Results Mapping template, the CPT II code is automatically assigned. CPT Code Auto-Submission section The CPT II code automatic submission functionality consists of two options: Submit CPT II code without diagnosis code automatically assigns and sends the CPT II code to the Superbill without assigning a diagnosis code. Assign diagnosis code to CPT II on Finalize activates the CPT II Claims Based Measure Reporting panel on the Finalize template. This setting automatically assigns and sends the CPT II code to the Finalize template for provider to assign a diagnosis code before submitting to the Superbill. For more information on assigning diagnosis codes

NextGen® Adaptive Content Engine Help Enterprise 8

Update a Mapping

You can retain the original mapping values for the previously created patient records. Open the Coded Results Mapping template. Expand the Certification Custom Data Mapping panel. Select a mapping record in the grid. The data fields are filled with the data from the selected record and the Update button is enabled. Make the required changes to data fields. Note: If you clear a field that is required, the Update button is disabled until you make an entry in that field. Click Update. The system updates the selected mapping record with the changed data. Note: If you change any of the data in the fields and click Add, the system creates a new mapping and does not update the selected mapping record. Parent topic: Custom Data Mapping

NextGen® Adaptive Content Engine Help Enterprise 8

Coded Results Mapping

You can map specific template field values to specific coded values to ensure accurate quality measure reporting on the Coded Results Mapping template. Coded Results Mapping for the Improved Claim-Based Measures Reporting In the Coded Results Mapping template, you can map specific template field values to specific coded values to ensure accurate quality measure reporting. Coded Results Mapping You can map specific template field values to specific coded values to ensure accurate quality measure reporting on the Coded Results Mapping template. Reporting CPT II Procedure Codes Coded results mapping simplifies the process of submitting codes for claims-based reporting by enabling you to configure and submit procedure codes needed to satisfy reporting measures. Custom Data Mapping You can report the data fields for newly added measures that are not currently available in the system. You can enter variable data for reporting purposes at runtime. Mapping SNOMED Codes with LOINC Codes Parent

CPT/HCPCS Code Updates

Recommendations

Coded Results Mapping for the Improved Claim-Based Measures Reporting

Completing Care Guidelines by Coded Results Mapping

Obtaining Test or Code Information for Codes Submitted to the Procedures Module

CPT II Code Auto-Submission

Update a Mapping

Coded Results Mapping

Coded Results Mapping for the Improved Claim-Based Measures Reporting

Completing Care Guidelines by Coded Results Mapping

Obtaining Test or Code Information for Codes Submitted to the Procedures Module

CPT II Code Auto-Submission

Update a Mapping

Coded Results Mapping