Submit E&M Codes under 2021 Coding Guidelines

NextGen® Adaptive Content Engine Help Enterprise 8

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

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

NextGen® Adaptive Content Engine Help Enterprise 8

Calculate E&M Codes under 2021 Coding Guidelines

You can calculate the Evaluation and Management (E&M) code under 2021 Coding Guidelines in Evaluation and Management. You can base the Evaluation and Management (E&M) code calculation on the selected Medical Decision Making (MDM) level or total visit time. Open NextGen® Enterprise EHR. For a patient record, open a new encounter. Open the Finalize template. On the Evaluation and Management Coding panel, to calculate the E&M code based on the MDM level, review the prepopulated complexity level or manually select the level of complexity associated with the encounter in the Medical Decision Making section. The Medical Decision Making section displays the MDM level based on the calculated levels in the three tables in the Medical Decision - Making Elements panel. To change the MDM level, change the automatically-calculated MDM levels in the MDM tables, or by making corrections in the encounter chart note. For guidance on using the 2021 Coding Guidelines based on MDM level and time, select t

NextGen® Adaptive Content Engine Help Enterprise 8

Submit E&M Codes under 95 or 97 Coding Guidelines

You can submit a calculated or selected E&M code to the Superbill under the 95 or 97 Coding Guidelines. Before you begin You must select an assessment in the Today’s Assessments panel to submit an E&M code. Open NextGen® Enterprise EHR. For a patient record, open a new encounter. Open the Finalize template. Expand the Evaluation and Management Coding panel. Evaluation and Management Coding To use a calculated E&M code, you can select the MDM level, or enter the total visit time. Enter any additional visit codes. To meet visit code criteria for Quality Reporting, select a SNOMED CT code. To override the calculated code, select an E&M code in the code options section at the bottom of the Evaluation and Management Coding panel. Note: The 99201 code cannot be selected as the code has expired on January 1, 2021. To generate a note, referral, lab order, requisition, or another document, select Generate Note and select an option. Select Submit Code. The code appears in the Submitted field. Th

NextGen® Adaptive Content Engine Help Enterprise 8

Calculate E&M Codes under the 95 or 97 Coding Guidelines

You can base the E&M code calculation on the selected Medical Decision Making (MDM) level, documented history, and physical exam elements, or on the total visit time if more than 50 percent of the time was spent counseling or coordinating care. Open NextGen® Enterprise EHR. For a patient record, open a new encounter. Open the Finalize template. On Evaluation and Management Coding, do one of the following: To calculate the E&M code based on the MDM Level, documented history, and physical exam elements, select the level of complexity associated with the encounter in the Medical Decision Making section. For guidance in determining the level of complexity involved in MDM, you can select the View MDM Guidelines link and the level of risk associated with the encounter, select the View Risk link and refer to the details. To calculate the code based on the total visit time, do the following: Select Counsel Details and enter counseling and educational details on the Counseling Details template.

NextGen® Adaptive Content Engine Help Enterprise 8

Enter Additional Visit Codes

You can enter two additional codes. The entered codes can be additional E&M codes, behavioral health codes, medicare preventive codes, or visit code service codes. Open NextGen® Enterprise EHR. For a patient record, open a new encounter. Open the Finalize template. In Evaluation and Management Coding, do the following: To enter a visit code service code, select the second or third Visit code field, and then select a code from the list. Note: You can update the items in the Visit Code Service Category list in File Maintenance under Service Categories. To enter an E&M, behavioral health, or medicare preventive code, select the corresponding links, and then select the code. Add Visit Code Modifiers You can add or replace visit code modifiers. Select a Prolonged Time Code You can select a prolonged time code to report time that surpasses the threshold for code 99205 or 99215 on the Finalize template. Select SNOMED CT Codes for Quality Reporting You can use SNOMED® CT codes for Quality Repo

Submit E&M Codes under 2021 Coding Guidelines

Before you begin

Recommendations

Overview of Evaluation and Management Coding

Evaluation and Management Coding Under 2021 Coding Guidelines

Calculate E&M Codes under 2021 Coding Guidelines

Submit E&M Codes under 95 or 97 Coding Guidelines

Calculate E&M Codes under the 95 or 97 Coding Guidelines

Enter Additional Visit Codes

Overview of Evaluation and Management Coding

Evaluation and Management Coding Under 2021 Coding Guidelines

Calculate E&M Codes under 2021 Coding Guidelines

Submit E&M Codes under 95 or 97 Coding Guidelines

Calculate E&M Codes under the 95 or 97 Coding Guidelines

Enter Additional Visit Codes