You can document a patient's nebulization values on the Nebulizer Treatment - Procedure template.
You can edit or remove a nebulization treatment entry from the Nebulizer grid.
- Open NextGen® Enterprise EHR.
- Open a patient's record, and then open an encounter.
- On Top Toolbar, select Templates
.
The Select Template window opens.
- Open the SOAP template, and expand the Nebulizer panel.
- In the Nebulizer panel, select Add.
The
Nebulizer Treatment - Procedure template opens.
- In the Pre-Treatment panel, select the Description field and select an indication from the Proc Nebulizer category on the diagnosis search window.
Note: You must record a diagnosis in the Description field to successfully bill the nebulizer treatments. NextGen® Enterprise EHR fills the Code fields automatically.
- Enter the values for Pre-Treatment Peak Flow in the three measured fields.
- In the Physical Exam section, do one of the following:
- Select the Normal check box for Inspection, Auscultation, and Effort, and the Absent check box for Cough.
- Enter details in the Side, Location, and Findings fields.
Note: You can select the Respiratory link to enter additional details on theRespiratory - Physical Exam template.
- Save and close the template.