CPT II Code Auto-Submission

NextGen® Adaptive Content Engine Help Enterprise 8

Submitting CPT II Codes Automatically without Diagnosis

You can to configure additional options to automatically submit the CPT II codes to Superbill. In addition to the CPT II configuration in the “Common Configuration for CPT II Claims Based Reporting” section, you also need to configure the following areas to automatically submit the CPT II codes without the diagnosis option: Claim Edit Library Practice Configuration When configured to automatically submit the CPT II codes, the codes are automatically assigned and submitted to Superbill for a patient documentation that meets the criteria mapped for a measure on the Coded Results Mapping template. The claim edits activated during the configuration select all claims without a diagnosis. The diagnosis can be added later in NextGen® Enterprise PM. You need to report measure exceptions on the Exceptions/Measures template for the CPT II code auto-submission functionality to work. Enable Automatic Submission of CPT II Codes You can automatically submit CPT II codes to the Superbill and Procedur

NextGen® Adaptive Content Engine Help Enterprise 8

Submitting CPT II Codes Semi-automatically with Diagnosis

You can to configure additional options to semi-automatically submit the CPT II codes to Superbill. In addition to the configuration in the “Common Configuration for CPT II Claims Based Reporting” section, you must enable the automatic functionality in the Practice Configuration template. When configured for semi-automatic submission of CPT II codes and patient documentation meets the criteria that is mapped for a measure on the Coded Results Mapping template, the CPT II code is automatically assigned and submitted to the CPT Claims Based Measure Reporting panel on the Finalize template. A provider assigns a diagnosis code to the CPT II code on the Finalize template. You need to report measure exceptions on the Exceptions/Measures template for the CPT II code semi-automatic submission functionality to work. Enable Semi-Automatic Submission of CPT II Codes You can send the configured CPT II codes to CPT II Claims Based Measure Reporting on the Finalize template. Parent topic: Submitting

NextGen® Adaptive Content Engine Help Enterprise 8

Submitting CPT II Codes Automatically

You can select the automating submission method after completing the configuration steps. The CPT II code automatic submission functionality facilitates claim-based quality measure reporting by automatically assigning and submitting CPT II codes. Selected HEDIS measures are mapped to the CPT II code system on the Coded Results Mapping template. Practices can configure additional measures. When the CPT II code automation functionality is enabled, documentation that meets the criteria setup on the Coded Results Mapping template automatically assigns a CPT II code when the template that contains the configured field is saved. You can either send the CPT II code directly to the Superbill without assigning a diagnosis, or you can send it to the Finalize template where a provider assigns the diagnosis before submitting to the Superbill. Note: You must report any measure excluded from claims-based reporting on the Exception/Measures template. The auto-submission methods are: Automatic: activa

NextGen® Adaptive Content Engine Help Enterprise 8

Reporting CPT II Claims Based Measure on Finalize

You can activate the claims-based reporting on the Finalize template. Practices who use CPT II procedure codes for claims-based measure reporting can use the CPT II Claims Based Measure Reporting panel on the Finalize template to submit CPT II codes. To activate the CPT II Claims Based Measure Reporting panel, you must enable the Assign diagnosis code to CPT II on Finalize option in the Practice Configuration template. When a patient encounter documentation is saved, and it meets the CPT II code criteria configured on the Coded Results Mapping template, the CPT II code is automatically sent to the Finalize template. You can view the CPT II codes that are assigned during the patient encounter in the CPT II Claims Based Measure Reporting panel. You can then submit the CPT II codes to the Superbill directly on the Finalize template. The information icon above the Today’s CPT II Codes grid provides instructions on how to use the Finalize template to assign diagnosis codes to the CPT II cod

NextGen® Adaptive Content Engine Help Enterprise 8

Reporting CPT II Procedure Codes

Quality Program measures for the Merit-Based Incentive Payment System (MIPS) are reported using CPT II codes for both registry- and claims-based reporting. The system is delivered with a defined set of measures and code mappings, including HEDIS measures, so that you can immediately submit the specific CPT codes. In addition, you can add measures and code mappings, as needed to meet new reporting requirements. Beginning with 5.9.2020.1, NextGen® Adaptive Content Engine contains the following mapped CPT II codes for auto-submission: 0500F, 0501F, 0502F, 0503F, 1111F, 1123F, 1124F, 1125F, 1126F, 1157F, 1158F, 1159F, 1170F, 3044F, 3046F, 3048F, 3049F, 3050F, 3051F, 3052F, 3060F, 3061F, 3062F, 3074F, 3075F, 3077F, 3078F, 3079F, and 3080F. CAUTION: The information recorded in this document is accurate as of this release. You must confirm the valid codes each release per year as they may be updated. Coded results mapping provides the following configurable options to facilitate claim-based r

NextGen® Adaptive Content Engine Help Enterprise 8

Assign Diagnosis to CPT II Codes on Finalize

You can submit the CPT II codes to Superbill from the Finalize template. Open NextGen® Enterprise EHR. Open the Finalize template. In the CPT II Claims Based Measure Reporting panel, select a CPT II code in the Today’s CPT II Codes grid. The CPT II Description field is filled with the selected code. To add a diagnosis to the Today's Assessment grid, do the following: Select the Add Common Assessment link. Select a diagnosis. Select Save & Close. In the Today's Assessment grid, select a diagnosis code to assign to the CPT II code. You can select up to four diagnosis codes per CPT II code. If you try to add more than four codes, an alert appears indicating that only four codes can be associated with a CPT code. Note: To clear the diagnosis entered in error, select Clear. Select Submit to Superbill. The CPT II code is displayed in the Today's Submitted Charges grid. Note: If you select Submit to Superbill without assigning a diagnosis code, an alert appears stating that a diagnosis code i

CPT II Code Auto-Submission

Recommendations

Submitting CPT II Codes Automatically without Diagnosis

Submitting CPT II Codes Semi-automatically with Diagnosis

Submitting CPT II Codes Automatically

Reporting CPT II Claims Based Measure on Finalize

Reporting CPT II Procedure Codes

Assign Diagnosis to CPT II Codes on Finalize

CPT II Code Auto-Submission

Submitting CPT II Codes Automatically without Diagnosis

Submitting CPT II Codes Semi-automatically with Diagnosis

Submitting CPT II Codes Automatically

Reporting CPT II Claims Based Measure on Finalize

Reporting CPT II Procedure Codes

Assign Diagnosis to CPT II Codes on Finalize