Setting Up and Mapping Custom SIM Codes for Immunizations Billing

NextGen® Enterprise EHR Help

Setting up Vaccine Billing Administration Codes

To select billing administration codes more easily, you can 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). Set up Vaccine Administration SIM Billing Codes Parent topic: Setting up Immunizations Tasks to Streamline Vaccine Billing

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

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 Immunizations Tasks to Streamline Vaccine Billing

To streamline vaccine billing as you complete various Immunizations tasks, ensure that billing administrators and appropriate clinical staff set up your NDC ID codes and SIM codes appropriately. Set up and map Custom SIM Codes for Immunizations Billing Set up Vaccine Billing Administration codes. Before you set up the vaccine inventory, select your practice’s default NDC Library and set up the NDC Library. Note: This enables the system to display the NDC details in the NDC Lookup when you add or update the vaccine inventory; or when you administer Immunizations in the Immunizations module. For accurate billing of alternate Medicare billing codes of certain Flu vaccines, your billing administrators also need to set up the NDC ID codes in the NDC Library. If you administer VFC Immunizations to VFC-eligible patients in your practice, for VFC billing purposes, you can configure unique custom SIM codes for the VFC and non-VFC patients for each location. Setting Up and Mapping Custom SIM Cod

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

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

Setting Up and Mapping Custom SIM Codes for Immunizations Billing

Recommendations

Setting up Vaccine Billing Administration Codes

Mapping Unique SIM Codes and Selecting VFC SIM Code Defaults

Recommended Workflow for Configuring and Processing Custom VFC SIM Codes

Setting up Immunizations Tasks to Streamline Vaccine Billing

Access Vaccine Billing While Administering Immunizations

Select Custom SIM Codes to Map

Setting up Vaccine Billing Administration Codes

Mapping Unique SIM Codes and Selecting VFC SIM Code Defaults

Recommended Workflow for Configuring and Processing Custom VFC SIM Codes

Setting up Immunizations Tasks to Streamline Vaccine Billing

Access Vaccine Billing While Administering Immunizations

Select Custom SIM Codes to Map