Submitting Procedure Coded Measures

NextGen® Adaptive Content Engine Help Enterprise 8

Submitting CPT II Codes Semi-automatically with Diagnosis

You can to configure additional options to semi-automatically submit the CPT II codes to Superbill. In addition to the configuration in the “Common Configuration for CPT II Claims Based Reporting” section, you must enable the automatic functionality in the Practice Configuration template. When configured for semi-automatic submission of CPT II codes and patient documentation meets the criteria that is mapped for a measure on the Coded Results Mapping template, the CPT II code is automatically assigned and submitted to the CPT Claims Based Measure Reporting panel on the Finalize template. A provider assigns a diagnosis code to the CPT II code on the Finalize template. You need to report measure exceptions on the Exceptions/Measures template for the CPT II code semi-automatic submission functionality to work. Enable Semi-Automatic Submission of CPT II Codes You can send the configured CPT II codes to CPT II Claims Based Measure Reporting on the Finalize template. Parent topic: Submitting

NextGen® Adaptive Content Engine Help Enterprise 8

Submitting CPT II Codes Automatically without Diagnosis

You can to configure additional options to automatically submit the CPT II codes to Superbill. In addition to the CPT II configuration in the “Common Configuration for CPT II Claims Based Reporting” section, you also need to configure the following areas to automatically submit the CPT II codes without the diagnosis option: Claim Edit Library Practice Configuration When configured to automatically submit the CPT II codes, the codes are automatically assigned and submitted to Superbill for a patient documentation that meets the criteria mapped for a measure on the Coded Results Mapping template. The claim edits activated during the configuration select all claims without a diagnosis. The diagnosis can be added later in NextGen® Enterprise PM. You need to report measure exceptions on the Exceptions/Measures template for the CPT II code auto-submission functionality to work. Enable Automatic Submission of CPT II Codes You can automatically submit CPT II codes to the Superbill and Procedur

NextGen® Adaptive Content Engine Help Enterprise 8

Submit CPT II Procedure Codes and Measure Exceptions

You can manually submit CPT II procedure codes and the measure exceptions in the Procedure Coded Measures panel on the Exceptions/Measures template. To open the Exceptions/Measures template, do one of the following: From the navigation bar, select Exceptions/Measures. From the Finalize template, expand the CPT II Claims Based Reporting panel, and select the Exceptions/Measures link. Select the Exceptions/Measures link on templates. Expand the Procedure Coded Measures panel. Procedure Coded Measures Select a measure from the grid.The fields below the grid are filled accordingly and the I accept responsibility to provide supporting documentation check box is selected. Note: Measures that have modifiers indicate the measure is an exception. If you want to exclude a measure from claims-based reporting, select and submit the exception measure.You must assign providers to the measures on the Provider CQM Maintenance template for the measures to be displayed on the Exceptions/Measures templat

NextGen® Adaptive Content Engine Help Enterprise 8

Manually Submitting CPT II Codes for Claims-Based Reporting

You can configure codes and their descriptions for an encounter, and select the CPT II code for a patient for a specific encounter. To use the manual submission option, you must set up the codes and exclusion modifiers, and then assign the measure to the provider on the Provider CQM Maintenance template. Note: To exclude a measure from claims-based reporting, you must use the Exceptions/Measures template to report the exception. Additionally, you must configure the Claim Edit Library. When CPT II codes are configured, providers can select and submit the necessary codes using the Procedure Coded Measures panel on the Exceptions/Measures template. The defined quality measures for providers, patients, and encounters are displayed in the grid in the Procedure Coded Measures panel. Configuring Claim Edits for CPT II Claims-Based Reporting You must configure the claim edits from the Claims Edit Library for CPT II codes. Parent topic: Reporting CPT II Procedure Codes

NextGen® Adaptive Content Engine Help Enterprise 8

Viewing Exceptions and Measures

You can manage exceptions and view measure details on the Exceptions/Measures template. You can open the Exceptions/Measures template from the navigation bar or from the CPT II Claims Based Reporting panel on the Finalize template. You can view the following types of exceptions and measures on the Exception/Measures template: Registry-based measures Procedure coded measures Custom data mapping Exception/Measures For information on how to address specific measures, go to NextGen Healthcare Success Community, and download the latest guides for NextGen® HQM. Viewing Registry-Based Measures You can view the status and explanation of a selected registry-based measure on the top section of the Exceptions/Measures template. Submitting Procedure Coded Measures You can select and submit a procedure code to satisfy a claims-based measure. Reporting Through Custom Data Mapping You can use the Custom Data Mapping panel for reporting. When you update NextGen® Enterprise EHR, data recorded on the Cu

NextGen® Adaptive Content Engine Help Enterprise 8

Submitting CPT II Codes Automatically

You can select the automating submission method after completing the configuration steps. The CPT II code automatic submission functionality facilitates claim-based quality measure reporting by automatically assigning and submitting CPT II codes. Selected HEDIS measures are mapped to the CPT II code system on the Coded Results Mapping template. Practices can configure additional measures. When the CPT II code automation functionality is enabled, documentation that meets the criteria setup on the Coded Results Mapping template automatically assigns a CPT II code when the template that contains the configured field is saved. You can either send the CPT II code directly to the Superbill without assigning a diagnosis, or you can send it to the Finalize template where a provider assigns the diagnosis before submitting to the Superbill. Note: You must report any measure excluded from claims-based reporting on the Exception/Measures template. The auto-submission methods are: Automatic: activa

Submitting Procedure Coded Measures

Recommendations

Submitting CPT II Codes Semi-automatically with Diagnosis

Submitting CPT II Codes Automatically without Diagnosis

Submit CPT II Procedure Codes and Measure Exceptions

Manually Submitting CPT II Codes for Claims-Based Reporting

Viewing Exceptions and Measures

Submitting CPT II Codes Automatically

Submitting CPT II Codes Semi-automatically with Diagnosis

Submitting CPT II Codes Automatically without Diagnosis

Submit CPT II Procedure Codes and Measure Exceptions

Manually Submitting CPT II Codes for Claims-Based Reporting

Viewing Exceptions and Measures

Submitting CPT II Codes Automatically