Assign CPT4 Codes

NextGen® Enterprise EHR Help

Skip the Medical Necessity Check if Test has no CPT4 Code

You can set up NextGen® Medical Necessity Check to skip those tests that do not have a CPT4 code assigned. NextGen® Medical Necessity Check will check tests with CPT4 codes and will not produce errors if a test with no CPT4 code is found. Select File Maintenance > System > Practices. Select the list or enter your location name and select Open Menu to open your practice. Select Preferences. In the Practice Preferences window, select Order module > Lab/Rad tab. To indicate that the Medical Necessity Check should not run when a test does not contain a CPT4 code, select Skip Medical Necessity Check if no CPT4 code. Select OK to save this preference. Select OK to exit the Modify Practice Information window. Parent topic: Medical Necessity Setup

NextGen® Enterprise EHR Help

Link a CPT4 Code to a Specific Test

Select File Maintenance > Master Files > Order Tests. The Order Tests List window opens. Double-click to select a specific test. The Modify Order Test Information window opens. Select the folder next to CPT4 Codes. The CPT4 Code Search window opens. Select the Description heading, and enter a description of the test in the Available field. Select the corresponding test and select the right arrow to link the CPT4 code to the test. To save this CPT4 code with this test, select OK . The CPT4 Code Search window closes. The added CPT4 codes appear in the Modify Order Test Information window. Select OK to exit the Modify Order Test Information window. Parent topic: Assign CPT4 Codes

NextGen® Enterprise EHR Help

Medical Necessity Setup

You must set up the NextGen® Medical Necessity Check to determine if Medicare will pay for a test when selecting a diagnosis for an order and run it when you place a test order. If Medicare or other insurance does not cover the costs of the test, you can print an Advanced Beneficiary Notice (ABN) and record the patients' decision about how to handle test codes. If an order does not contain Medicare or other insurance then you can't run NextGen® Medical Necessity Check as this follows the Medicare guidelines. Note: You need to obtain a license to run NextGen® Medical Necessity Check. To set up the NextGen® Medical Necessity Check locations, do the following: Access and download the NextGen® Medical Necessity Check update package from the NextGen Healthcare Success Community. This package populates the Locations (and associated data) in the Orders Module tab. Set up the appropriate NextGen® Medical Necessity Check encounter level insurance for the appropriate location. For more informati

File Maintenance Help for NextGen® Enterprise 8

Skip the Medical Necessity Check if Test has no CPT4 Code

You can set up NextGen® Medical Necessity Check to skip those tests that do not have a CPT4 code assigned. NextGen® Medical Necessity Check will check tests with CPT4 codes and will not produce errors if a test with no CPT4 code is found. Select File Maintenance > System > Practices. Select the list or enter your location name and select Open Menu to open your practice. Select Preferences. In the Practice Preferences window, select Order module > Lab/Rad tab. To indicate that the Medical Necessity Check should not run when a test does not contain a CPT4 code, select Skip Medical Necessity Check if no CPT4 code. Select OK to save this preference. Select OK to exit the Modify Practice Information window. Parent topic: Orders Module Practice Preferences Setup

File Maintenance Help for NextGen® Enterprise 8

CPT4 Codes

The NextGen® Enterprise applications come pre-loaded with CPT4 codes that have descriptions you can modify. You can also add new CPT4 codes that contain up to nine characters. When you use modifiers, you can then set up variable charges in the Service Item Maintenance and in the Contract Library Maintenance windows for the same procedure code with or without modifier codes. You can generate CPT4 Codes Master report from the CPT4 Codes master file. For more information, go to NextGen Healthcare Success Community and download the latest Reports User Guide for NextGen® Enterprise PM. Add or Modify a CPT4 Code CPT4 Codes Greater than 5 Digits Parent topic: Master Files - System

Help Guide for NextGen® Enterprise PM 8

Attach CPT4 Codes to Field Locator 51

In File Maintenance, select Master Files - System and then Payers. Select the payer from the Payers List window. The Add/Modify Payer Information window opens. Select the Practice Parameters tab and then UB tab. Select the Open Menu button at the bottom of the window and select New. The Field Loc 51 for a CPT4 Range window opens. Enter the CPT4 code you want to attach to the provider in the CPT4 field. If you want to enter a range of CPT4 codes, your entry in this field serves as the beginning of the range. This field is required. Note: Select the Question Mark icon to perform a CPT4 Code search. You can search by code or by description. To enter a range of CPT4 codes, enter a second CPT4 code in the Thru CPT4 field. Enter the provider number in the Field Locator 51 field. This field is required. Select OK. Parent topic: UB Claims

Assign CPT4 Codes

Recommendations

Skip the Medical Necessity Check if Test has no CPT4 Code

Link a CPT4 Code to a Specific Test

Medical Necessity Setup

Skip the Medical Necessity Check if Test has no CPT4 Code

CPT4 Codes

Attach CPT4 Codes to Field Locator 51

Skip the Medical Necessity Check if Test has no CPT4 Code

Link a CPT4 Code to a Specific Test

Medical Necessity Setup

Skip the Medical Necessity Check if Test has no CPT4 Code

CPT4 Codes

Attach CPT4 Codes to Field Locator 51