New and Established Patients and Visit Types

NextGen® Adaptive Content Engine Help Enterprise 8

Obstetric Visit Types

The Obstetric (OB) visit types are very specific to the unique requirements for billing OB and prenatal visits. Use the OB Prenatal - Initial visit type to confirm and document the beginning of a pregnancy where the prenatal record has not been initiated. You can bill for the encounter using the standard E&M codes 99201–99215. Note: Effective January 1, 2021, code 99201 will be deactivated. Use the OB Prenatal visit type for encounters where you are using the prenatal record. The application tracks each encounter during the current pregnancy with the OB Prenatal visit type on a hidden field on the Home page. You can bill prenatal visits separately if a patient obtains a new insurance plan or changes providers, and/or other complications arise. The Finalize template adds the number of prenatal encounters that have been documented for the current pregnancy and calculates the appropriate prenatal E&M code. For the OB Prenatal and OB Postpartum visit types, you can select the Prenatal/Post

NextGen® Adaptive Content Engine Help Enterprise 8

Behavioral Health Billing on the Finalize Template

The Finalize template calculates the Evaluation and Management (E&M) code and submits the code to the NextGen® Enterprise PM application. The Evaluation and Management Coding panel on the Finalize template calculates the E&M code based on the elements documented or the amount of time documented when more than 50% of the visit is spent counseling and/or coordinating care. The system fills the Visit Code field with the suggested Current Procedural Terminology (CPT) codes. You should review the suggested CPT code prior to submitting the code for billing. When the practice selects the 97 Coding Guidelines option on the Practice Configuration practice template and the specialty is set to Behavioral Health, the system defaults to the '97 Single System Psychiatric exam guidelines for the following visit types: Family Consultation General Medical Exam Hospital Consult Medication Management without Psychotherapy Onsite Consult Psychotherapy - Individual with E&M Medication Management with Psych

NextGen® Orthopedic Suite Help 80.2.14.0

Visit Type

Select a visit type: NP (New Patient), Consult, or Est (Established). This is a required field. On the Billable Visit template, the Visit Type field is a required field. If the patient is not a new patient, the system suggests a Visit Type based on the last billed office visit date. Note: If the practice has configured the application to allow users to override the Visit Type, users can select a Visit Type other than the suggested ones. If this feature is disabled, you are limited to one of the suggested visit types. Note: For more information, go to NextGen Healthcare Success Community, and download the Configuration Guide for NextGen® Orthopedic Suite. Parent topic: Patient History

NextGen® Ophthalmic Suite Help 2022.2

2023 E&M Coding Guideline Changes

You can use the new Evaluation and Management (E&M) codes and guidelines that are effective from January 1, 2023. Most of the E&M codes from various visit types, such as Consult, Home Visit, Domiciliary Visit, Nursing Facility Care, Emergency Department, Inpatient, are now inclusive of 2023 E&M guideline. A few E&M codes such as Observation Care and Prolonged Service are removed and redirected to the existing visit type codes. The E&M code calculation logic is based on the patient encounter date (greater or equal to January 1st, 2023) and the selected visit type on the Finalize - OPH template. With the 2023 Coding Guidelines update, the 99241 code is disabled, and the labels for the following codes are updated in the Consultation section of the EM Code panel on the Finalize - OPH template: 99242: Straightforward 20-29 mins 99243: Low 30-39 mins 99244: Moderate 40 -54 mins 99245: High greater than 55 mins medical decision making/counseling template For more information about practice se

NextGen® Adaptive Content Engine Help Enterprise 8

Add and Map a Custom Visit Type

A custom visit type can be added only if you map the same with an existing visit type. In NextGen® Enterprise EHR, open the Visit Type Configuration window. Enter a visit type description in New Visit Type Description. Click the Map to EM Visit Type and select an existing visit type from the picklist. The application fills the existing visit type name and the associated E&M billing code in the Additional Info field. Click Add. The new visit type is added to the grid. Click OK. Parent topic: Configuration of Custom Visit Type

NextGen Behavioral Health Suite Help 5.5

Behavioral Health E&M Coding Guidelines

To submit a calculated or a selected Evaluation and Management (E&M) code from the Finalize template, you can use 97 or 2021 E&M coding guidelines configured on the Practice Configuration template. The available E&M codes vary by specialties and visit types. The 97 E&M Coding Guidelines calculate the E&M code based on one of the following: History and physical exam elements that were documented on templates and the Medical Decision Making (MDM) level selected Total visit time if more than 50 percent of the time was spent counseling or coordinating care When you enter the effective date in the 2021 Coding Guidelines Effective Date field on the Practice Configuration template, you must also select either the 97 Coding Guidelines for use with visit types and encounters that do not fall under the 2021 E&M Coding Guidelines. The current E&M coding guidelines will be in effect until the set date. You can set any date, change, or remove the date at any time. NextGen® Behavioral Health Suite u

New and Established Patients and Visit Types

Recommendations

Obstetric Visit Types

Behavioral Health Billing on the Finalize Template

Visit Type

2023 E&M Coding Guideline Changes

Add and Map a Custom Visit Type

Behavioral Health E&M Coding Guidelines

Obstetric Visit Types

Behavioral Health Billing on the Finalize Template

Visit Type

2023 E&M Coding Guideline Changes

Add and Map a Custom Visit Type

Behavioral Health E&M Coding Guidelines