Recommended Workflow for Configuring and Processing Custom VFC SIM Codes

NextGen® Enterprise EHR Help

Mapping Unique SIM Codes and Selecting VFC SIM Code Defaults

As part of your vaccine inventory set up, you have the option to override the SIM code defaults for vaccine items by mapping your practice's customized SIM codes to CPT codes. If your practice has created custom (or alternate) SIM codes or SIM groups, you can map these codes to CPT codes for system billing purposes. For example, if you are using a custom SIM code for influenza, when you are administrating this vaccine for a VFC patient, you would need the system to reference this code to ensure proper billing. CAUTION: To ensure that the appropriate SIM codes are available when setting up your vaccine inventory, map your SIM codes and/or SIM Groups before you begin to set up your vaccine inventory. If you have created custom VFC SIM codes in the SIM Library, you must select a VFC SIM code as the VFC default and other custom SIM codes (non-VFC) as the non-VFC default. This ensures that the correct SIM code is available for selection from the Billing Code picklist and for billing process

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

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

NextGen® Enterprise EHR Help

Administer Immunizations for VFC-Eligible Patients

If your practice treats VFC-eligible patients, you can administer immunizations to them. Note: Before administering Immunizations, ensure that you have completed the recommended set up and mapping steps for custom VFC SIM codes. After selecting the vaccines on the Select Vaccines tab, select the Vaccine Details tab. The Create New/Update Immunizations Order for patient name window displays (on the Vaccine Details tab). On the Vaccine Details tab, select the vaccine, and provide the Vaccine and Immunizations Detail. For a VFC-eligible patient immunization, select the VFC Reason check box and select a VFC Reason from the list. In the Vaccines grid list, for the selected vaccine, Is VFC is selected and the VFC Reason displays. Select the Lot Number, if it does not display, enter it manually. Vaccine Inventory data populates. Enter additional information for the selected Immunization order, for example, Vaccine date, Brand Name, or Route, patient received counseling (Counseled); or if the

File Maintenance Help for NextGen® Enterprise 8

Vaccine Master Files

The Vaccine (Immunizations) Master Files are updated and maintained in File Maintenance. Master File Description Vaccine Admin Billing To select billing administration codes more easily, this master file enables you to set up a picklist of vaccine administration SIM billing codes at the practice level in File Maintenance. You can also set up custom SIM codes you have configured, such as a no charge employee Flu vaccine. The Vaccine Administration SIM Billing Codes enable you to select the billing administration codes to display when you administer immunizations (on the Vaccine Details tab's Admin CPT4 code field). Vaccine 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 VFC-eligible patient

Recommended Workflow for Configuring and Processing Custom VFC SIM Codes

Recommendations

Mapping Unique SIM Codes and Selecting VFC SIM Code Defaults

Setting Up and Mapping Custom SIM Codes for Immunizations Billing

Access Vaccine Billing While Administering Immunizations

Immunizations Billing Setup Best Practices

Administer Immunizations for VFC-Eligible Patients

Vaccine Master Files

Mapping Unique SIM Codes and Selecting VFC SIM Code Defaults

Setting Up and Mapping Custom SIM Codes for Immunizations Billing

Access Vaccine Billing While Administering Immunizations

Immunizations Billing Setup Best Practices

Administer Immunizations for VFC-Eligible Patients

Vaccine Master Files