Mapping Unique SIM Codes and Selecting VFC SIM Code Defaults

NextGen® Enterprise EHR Help

Recommended Workflow for Configuring and Processing Custom VFC SIM Codes

The following process is a recommended best practice for configuring and mapping your custom VFC SIM codes. For more detailed information, refer to the references. Set up your custom VFC SIM codes in the SIM Library in File Maintenance > Libraries. Verify that the custom VFC SIM code's NDC ID number is in the NDC Library in File Maintenance > Practice Preferences > Orders Module > Immunizations. Map the custom VFC SIM Code to the CPT4 code and select the appropriate check box to indicate that the code is the Default VFC code (VFC Default) or not (Non-VFC Default), in File Maintenance > System > EHR > Vaccine Billing. Select the appropriate vaccine and administer the Immunization for the VFC-eligible patient in EHR > Orders > Immunizations. To verify the charges in NextGen® Enterprise EHR, access the Superbill module or the NextGen® Enterprise EHR Procedures module, if necessary. You can also verify that the administration CPT4 code matches the item in these modules for the applicable e

NextGen® Enterprise EHR Help

Setting Up and Mapping Custom SIM Codes for Immunizations Billing

If your practice administers immunizations for VFC-eligible patients, for billing purposes, you can set up custom VFC SIM codes for these patients. Using the Vaccine Billing option in File Maintenance, you can indicate that a VFC custom SIM code is a default billing code. The default indicates that an immunization is being administered for a VFC-eligible patient. When administering Immunizations using the Orders' Immunization function, the default VFC Vaccine Billing code automatically displays in the Vaccine Billing code field on the Create New/Update Immunizations Order for patient name window. After the immunization is Completed or Partially Administrated, the Vaccine Billing codes are then passed to NextGen® Enterprise PM for charge processing. Recommended Workflow for Configuring and Processing Custom VFC SIM Codes Mapping Unique SIM Codes and Selecting VFC SIM Code Defaults Parent topic: Setting up Immunizations Tasks to Streamline Vaccine Billing

NextGen® Enterprise EHR Help

Select Custom SIM Codes to Map

You can select custom (or alternate) SIM codes for mapping. In File Maintenance, select System > Vaccine Billing. The Vaccine Billing List window opens. Select the Open Menu button, and then select New. The Add Vaccine Billing Item window opens. Note: Only active CPT Codes display for the current practice. If you are mapping SIM Groups, select SIM Group Only and then select the Open Record button. The Vaccine SIM Code Search window opens. Note: If you are searching for a SIM Group, the SIM Groups dialog box displays. Search for a SIM code or SIM groups to map, if necessary. To select a SIM code or SIM Group to map, select the right arrow. The SIM Code moves to the Included section. Continue selecting SIM codes to map, if necessary, and then select OK. The selected SIM codes display in the Add Vaccine Billing Item window. To select the default VFC SIM code, highlight the appropriate code in the Linked Items section and select the VFC Default check box. For other custom SIM codes in the

NextGen® Enterprise EHR Help

Update the Mapped Custom SIM Codes

You can update your mapped custom (or alternate) SIM codes. In File Maintenance, select System > Vaccine Billing. Select the Open Menu button, and then select Open OR select the appropriate CPT Code and double-click. The Update Vaccine Billing Item window opens. If you are updating mapped SIM Groups, select SIM Group Only, and then select the Open Record button. The Vaccine SIM Code Search window or the SIM Groups window opens. If required, search for a SIM code or SIM groups to update the mapping selections. To add a SIM code or SIM Group to the mapped items, in the Available section, select the right arrow. The SIM Code moves to the Included section. To remove a SIM code or SIM Group from the mapped items, in the Included section, select the left arrow. The SIM Code moves to the Available section. Continue selecting SIM codes to update, if necessary, and select OK. The updated SIM codes display in the Update Vaccine Billing Item window. Select the Non VFC Default check box. If the SI

NextGen® Enterprise EHR Help

Access Vaccine Billing While Administering Immunizations

When administering immunizations, you can access the Vaccine Billing option from the Create New/Update Immunizations Order <patient name> window. This enables you to: Map custom VFC SIM codes and other unique Immunization codes. Indicate which VFC SIM code is the VFC default. Note: Once the Immunizations administration is complete, the appropriate billing codes are then sent to NextGen® Enterprise PM for charge processing. Open Immunizations tab from the NextGen® Enterprise EHR Orders module and create a immunizations order. On the Select Vaccines tab, select a vaccine or vaccines. To access Vaccine Billing, from the Create New/Update Immunizations Order <patient name> window, select the button at the top right of the window. A list displays Vaccine Inventory and Vaccine Billing. Select Vaccine Billing. The Vaccine Billing List window opens. To map customized VFC SIM codes or non-VFC codes for billing purposes, select New from the Open Menu button. To update a CPT code, select a CPT co

NextGen® Enterprise EHR Help

Immunizations Billing Setup Best Practices

After the Immunizations have been setup, the charges are sent to NextGen® Enterprise PM for billing processing. As of January 1, 2014, to enable the government to identify vaccine brands for vaccine distribution planning, Immunization charges must have an associated NDC ID, including Basis of Measure and Drug Unit Count fields. Therefore, you must configure a NDC ID in the NDC Library. To help your practice streamline this process, you need to ensure that billing administrators and appropriate clinical staff set up your NDC ID codes and SIM codes appropriately. The following are best practices and considerations you need to consider for more accurate billing. Ensure you have downloaded the most recent CPT4 codes for the current year. Ensure you have run the most recent Medication Update. Before you set up the vaccine inventory, select your practice’s default NDC Library and set up the NDC Library. The NDC details in the NDC Lookup when you add or update the vaccine inventory; or when y

Mapping Unique SIM Codes and Selecting VFC SIM Code Defaults

Recommendations

Recommended Workflow for Configuring and Processing Custom VFC SIM Codes

Setting Up and Mapping Custom SIM Codes for Immunizations Billing

Select Custom SIM Codes to Map

Update the Mapped Custom SIM Codes

Access Vaccine Billing While Administering Immunizations

Immunizations Billing Setup Best Practices

Recommended Workflow for Configuring and Processing Custom VFC SIM Codes

Setting Up and Mapping Custom SIM Codes for Immunizations Billing

Select Custom SIM Codes to Map

Update the Mapped Custom SIM Codes

Access Vaccine Billing While Administering Immunizations

Immunizations Billing Setup Best Practices