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.
Coded results mapping provides the following configurable options to facilitate claim-based reporting CPT II Codes for your practice:
- Automatic: The system automatically submits the configured CPT II code to the Superbill without a diagnosis code. To enable the automatic option, you must select Submit CPT II code without diagnosis code on the Practice Configuration template.
- Semi-automatic: The system automatically sends the configured CPT II code to the CPT II Claims Based Measure Reporting panel on the Finalize template. You can assign a diagnosis code before submitting the codes to Superbilll. To enable the semi-automatic option, you must select the Assign diagnosis code to CPT II on Finalize option on the Practice Configuration template.
- Manual: The system enables your practice to display codes and their descriptions on the Exception/Measures template, which allows providers to select the CPT II code for a patient for a specific encounter.
Configuration for the three methods is similar and covered in the Common Configuration Settings for CPT II Claims Based Reporting section. Additional configuration is required based on the selected method used by your practice. Configurations specific to each option is included in the corresponding section.
For more information about CPT II claims-based reporting, go to NextGen Healthcare Success Community, and download the following documents:
- CPT II Lab Codes Update for NextGen® Adaptive Content Engine
- Provider CQM Maintenance System Template for NextGen® Adaptive Content Engine
- Data Sets Setup Practice Template User Guide for NextGen® Adaptive Content Engine
- Getting Started User Guide for NextGen® Adaptive Content Engine