Evaluation and Management Coding

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Assign Evaluation and Management Coding Criteria

You can assign Evaluation and Management coding criteria to a cardiology visit type. The criteria for assigning the Evaluation and Management (EM) code to visit types, configured as per the 2021 E&M coding guidelines, are decision making and time range. As per 95 and 97 guidelines, the criteria for assigning the EM code to a visit type include level of history, level of exam, and decision making, or total visit time. Open NextGen® Enterprise EHR. In System \ Practice Template, open the Card Setup Visit Types template. The effective date configured in the Practice Configuration practice template appears in the 2021 Date field. Card Setup Visit Types In the EM CODING CRITERIA section, select the Visit Type. Select the level of history that indicates clinical problems or symptoms being addressed during the encounter. You can decide the level of history based on chief complaint, history of present illness, review of systems, past medical, family, and social history. In Level of Exam, selec

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Evaluation and Management Coding

NextGen® Adaptive Content Engine uses Evaluation and Management (E&M) coding guidelines from the Centers for Medicare and Medicaid Services (CMS) for the documentation and billing of E&M services because these protocols are the most stringent. CMS provides three sets of guidelines to calculate E&M codes: 1995 (95) Coding Guidelines 1997 (97) Coding Guidelines 2021 Coding Guidelines (effective January 1, 2021) The Cardiology template set does not use these calculation methods described. For information on E&M coding for the Cardiology specialty, go to NextGen Healthcare Success Community, and download the latest Cardiology User Guide for NextGen® Adaptive Content Engine. The 95 and 97 Coding Guidelines calculate E&M codes based on one of the following: Documented history and physical exam elements and the selected Medical Decision Making (MDM) level Total visit time if more than 50 percent of the time was spent counseling or coordinating care You can use either the 95 or 97 Coding Guide

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Applying 2021 Coding Guidelines on the Cardiology Finalize Template

If your practice has entered a 2021 Coding Guidelines Effective Date for Cardiology on the Ngkbm Config template or the Practice Configuration template, the following conditions apply to encounters on or after the effective date: The 2021 Coding Guidelines apply only to new patient visits or to return office visits. For these visit types, the EM 2021 Guidelines template calculates codes 99202-99205 for a new patient and 99211-99215 for an established patient. Note: Code 99201 expires effective January 01, 2021 and does not appear for a new patient. The 2021 E&M Coding Guidelines override any criteria your practice may have entered for new patient and return office visit types on the CARD Setup Visit Type template. If you select a non-custom visit type, the Cardiology Finalize template calculates E&M codes based on the 95 or the 97 Coding Guidelines selected on the Ngkbm Config template or on the Practice Configuration template. If your practice has set up custom visit types and entered

NextGen® Adaptive Content Engine Help Enterprise 8

Evaluation and Management Coding Under 2021 Coding Guidelines

After you install the update package for NextGen® Adaptive Content Engine, you can perform Evaluation and Management (E&M) coding under 2021 Coding Guidelines for the FTS Finalize, Ophthalmology Finalize, and Cardiology Finalize templates. For information on installing the package, go to NextGen Healthcare Success Community and download the latest 2021 E&M Coding Updates Installation Guide for NextGen® Adaptive Content Engine. The 2021 Coding Guidelines calculate E&M codes based on one of the following: Medical Decision Making (MDM) level selected Total time spent on patient care and documentation for the visit, which includes the face-to-face time with the patient and other time personally spent by the physician and/or other qualified healthcare professionals on the day of the encounter You can include counseling time in the total time, but the 2021 Coding Guidelines do not require that over 50 percent of the total time be spent in counseling or coordinating care. The 2021 Coding Guid

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Overview of Evaluation and Management Coding

You can calculate and submit the E&M code. You can submit and calculate the Evaluation and Management (E&M) code from the Finalize template using the 95, 97, 2021 Guideline, or 2023 Coding Guidelines update based on the Practice Configuration template settings. The available E&M codes vary by specialty and visit type. If you do not want to charge a patient encounter, you can select the No Charge Visit check box in the Evaluation and Management Coding panel to submit a no-charge code. The No Charge Visit procedure group check box is configured by default. The No Charge Visit check box is enabled only if the no charge SIM code is configured to the No Charge Visit procedure group using the Manage Procedure Group and Codes template. For more information, go to NextGen Healthcare Success Community, and download the latest Manage Procedure Groups and Codes Practice Template forNextGen®Adaptive Content Engine. The 95 and 97 Coding Guidelines use the following E&M code calculation criteria: Hi

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Submit E&M Codes per the 2021 Coding Guidelines

You can submit a calculated or selected Evaluation and Management (E&M) code to the Superbill using the 2021 Coding Guidelines. Before you begin The date of the encounter must be on or after the effective start date entered for the 2021 Coding Guidelines on the Practice Configuration template. The visit type must be one of the visit types impacted by the 2021 guidelines. For more information on the 2021 Coding Guidelines, go to NextGen Healthcare Success Community, and download the E&M Coding User Guide forNextGen®Adaptive Content Engine. Also, you must select an assessment in the Today’s Assessment panel to be able to submit an Evaluation and Management (E&M) code. For guidance on how to use the 2021 E&M Coding Guidelines based on Medical Decision Making (MDM) level and time, you can use the information Info Icon icon. For guidance on the level of complexity and risks involved in MDM, you can use the View MDM Guidelines link. From an encounter, select the Templates Template Icon icon.

Evaluation and Management Coding

Recommendations

Assign Evaluation and Management Coding Criteria

Evaluation and Management Coding

Applying 2021 Coding Guidelines on the Cardiology Finalize Template

Evaluation and Management Coding Under 2021 Coding Guidelines

Overview of Evaluation and Management Coding

Submit E&M Codes per the 2021 Coding Guidelines

Assign Evaluation and Management Coding Criteria

Evaluation and Management Coding

Applying 2021 Coding Guidelines on the Cardiology Finalize Template

Evaluation and Management Coding Under 2021 Coding Guidelines

Overview of Evaluation and Management Coding

Submit E&M Codes per the 2021 Coding Guidelines