Enable Semi-Automatic Submission of CPT II Codes

NextGen® Adaptive Content Engine Help Enterprise 8

The Finalize Template Workflow

You can do the following on the Finalize template: Submit and review the plan of care, based on your role, on the Provider Sign Off panel. Document Evaluation and Management (E&M) codes on the Evaluation and Management Coding panel. Calculate the patient's medical-decision-making level and submit the E&M codes to the Superbill module. Review the patient's history and physical examination details on the E&M Level panel and identify factors in the calculation of the E&M code under the 95 or 97 Coding Guidelines. For more information on E&M coding, go to NextGen Healthcare Success Community, and download the latest E&M Coding User Guide forNextGen®Adaptive Content Engine. Patient's General Information on Finalize You can view the general details related to finalizing the workflow of the patient in the General panel. Patient's Assessments on Finalize You can view, add, or edit patient assessments in the Today's Assessment panel. E and M Level Summary You can view the summary of a patient's

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

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

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

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

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

Enable Semi-Automatic Submission of CPT II Codes

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The Finalize Template Workflow

Submitting CPT II Codes Semi-automatically with Diagnosis

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CPT II Code Auto-Submission