Submit E&M Codes under 95 or 97 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

Submit E&M Codes under 2021 Coding Guidelines

You can submit a calculated or selected E&M code to the Superbill using 2021 Coding Guidelines. Before you begin The encounter must be on or after the effective start date of 2021 Coding Guidelines entered on the Practice Configuration template. The visit type must fall under the guidelines. For more information on 2021 Coding Guidelines, go to NextGen Healthcare Success Community, and download the latest E&M Coding User Guide forNextGen®Adaptive Content Engine. You must select an assessment in the Today’s Assessments panel to be able to submit an E&M code. Open NextGen® Enterprise EHR. For a patient record, open a new encounter. Open the Finalize template. On the Evaluation and Management Coding panel, to use a calculated E&M code, review and select the Medical Decision Making (MDM) level or enter the total time. 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. Evaluation and

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

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

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

NextGen® Adaptive Content Engine Help Enterprise 8

Submit E&M Codes under 2021 Coding Guidelines on the FTS Finalize Template

Before you begin To submit an E&M code, you must have selected an assessment in the Today’s Assessments panel. For more information on assessments, go to NextGen Healthcare Success Community and download the latest Getting Started User Guide forNextGen®Adaptive Content Engine. Open the Finalize template and expand the Evaluation and Management Coding panel. Evaluation and Management Coding To use a calculated E&M code, review and select the MDM level or enter the total time. For more details, see Calculate an E&M Code under 2021 Coding Guidelines on the FTS Finalize Template. The Medical Decision Making section displays the prepopulated MDM level based on the calculated levels in the three tables in the Medical Decision-Making Elements panel. To bypass or override the calculated code, select an E&M code in the code option section at the bottom of the Evaluation and Management Coding panel. Note: Code 99201 cannot be selected. The code expires effective January 1, 2021. Code 99211 Nurse

Submit E&M Codes under 95 or 97 Coding Guidelines

Before you begin

Recommendations

Overview of Evaluation and Management Coding

Submit E&M Codes under 2021 Coding Guidelines

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

Calculate E&M Codes under 2021 Coding Guidelines

Enter Additional Visit Codes

Submit E&M Codes under 2021 Coding Guidelines on the FTS Finalize Template

Overview of Evaluation and Management Coding

Submit E&M Codes under 2021 Coding Guidelines

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

Calculate E&M Codes under 2021 Coding Guidelines

Enter Additional Visit Codes

Submit E&M Codes under 2021 Coding Guidelines on the FTS Finalize Template