Visit Types for Psychiatry Evaluations

NextGen® Adaptive Content Engine Help Enterprise 8

Complete the General Panel of the BH Psychiatric Evaluation

To access the BH - Psychiatric Evaluation do one of the following: Click the Psychiatry Eval tab. Click Psychiatric Evaluation from the navigation bar. Navigate to the General panel and click the Program name field. Program names can be added and/or edited by the practice on the Custom Picklists Setup, system template. Select the appropriate name from the list. Click the clock button to enter the current time in the Start field. The Start and End buttons are available here and at the bottom of the Psychiatric Eval tab in the Behavioral health billing section. The values documented in either place are immediately reflected in the same fields in the other section. Entered times can be modified by clicking in the field. It is important to follow the established format: 0:00 AM or PM. Parent topic: BH - Psychiatric Evaluation

NextGen® Adaptive Content Engine Help Enterprise 8

Enter Program Information for a Psychiatric Evaluation

Navigate to the General panel and click the Program name field. Program names can be added and/or edited by the practice on the Custom Picklists Setup, system template. Select the appropriate name from the list. Click the clock button to enter the current time in the Start field. The Start and End buttons are available here and at the bottom of the Psychiatric Eval tab in the Behavioral health billing section. The values documented in either place are immediately reflected in the same fields in the other section. Entered times can be modified by clicking in the field. It is important to follow the established format: 0:00 AM or PM. Parent topic: BH - Psychiatric Evaluation

NextGen® Adaptive Content Engine Help Enterprise 8

Enter Psychiatric Evaluation Presenting Concerns

The Presenting Concerns panel enables you to document the symptoms and presenting issues, in the client's own words, which prompted a visit to the office in the Reason for referral field. In the Presenting Concerns panel select No or Yes to answer the question: Comprehensive Assessment has been completed. If Yes, enter the date of the most recent assessment into the field. In the Reason for referral and chief complaint field, click to enter or dictate notable symptoms, presenting problems, behavioral and functional needs, etc. Enter Family/guardian description of problem. For History of present psychiatric illness, do one of the following actions: Select None reported. Enter or dictate history details. Parent topic: BH - Psychiatric Evaluation

NextGen® Adaptive Content Engine Help Enterprise 8

Mental Status Evaluation Panel

The Mental Status Evaluation panel enables you to enter a narrative description, including the client's appearance, mood, affect, speech, thought process/content, cognition, and insight/judgment. Use the Mental status exam link to document a more comprehensive record. Complete the Mental Status Exam Template Parent topic: BH Hx Section Tab Overview Parent topic: BH - Psychiatric Evaluation

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Document Mental Health and Addiction Treatment Service Histories

On the Mental Health and Addiction Treatment Service History panel, do one of the following: Place a check mark for None reported. In the Treatment services history within the past five years section, enter as much information acquired from the client in the fields. Type of service is the only required field in this section. Click Add. In the Outpatient section, select Not applicable or enter the Age at time of initially seeking outpatient treatment services. Enter the Total number of lifetime outpatient treatment experiences. In the Inpatient section, select Not applicable or enter the Age at time of initial inpatient treatment. Click the Total number of lifetime inpatient treatment experiences field to enter a value. In the Er/detox section, select Not applicable or enter the Total number of er visits in the last 6 months. Enter the Number of non detox hospital days in the past 6 months and select a reason. Medical Psychiatric Both Click the Number of days the client has been in drug

NextGen® Adaptive Content Engine Help Enterprise 8

BH - Psychiatric Evaluation

The Psychiatry Eval tab is designed to be a stand-alone template for a psychiatrist, nurse practitioner (NPP), or other Behavioral Health professional who is qualified to conduct and document an initial psychiatric assessment of the client. The information on the Psychiatry Eval tab overlaps with the data recorded on the Comp Assess tab. Of the 17 panels on the tab, only two (Physical Health History and Issues for Children/Adolescents) are not identical to the corresponding panels on the Comprehensive Assessment. If a Comprehensive Assessment was completed for this client prior to the Psychiatric Evaluation, much of the information is filled. It is important to note that medications can be prescribed during the psychiatric evaluation. The Behavioral health billing section is available at the bottom of the Psychiatry Eval and Progress Note tabs to submit billing codes. Some providers may want to use the SOAP tab to document additional elements of the physical exam. For more information

Visit Types for Psychiatry Evaluations

Recommendations

Complete the General Panel of the BH Psychiatric Evaluation

Enter Program Information for a Psychiatric Evaluation

Enter Psychiatric Evaluation Presenting Concerns

Mental Status Evaluation Panel

Document Mental Health and Addiction Treatment Service Histories

BH - Psychiatric Evaluation

Complete the General Panel of the BH Psychiatric Evaluation

Enter Program Information for a Psychiatric Evaluation

Enter Psychiatric Evaluation Presenting Concerns

Mental Status Evaluation Panel

Document Mental Health and Addiction Treatment Service Histories

BH - Psychiatric Evaluation