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

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

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

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

Setting Up and Mapping Custom SIM Codes for Immunizations Billing

Recommendations

Setting up Vaccine Billing Administration Codes

Setting Up and Mapping Custom SIM Codes for Immunizations Billing

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

Mapping Unique SIM Codes and Selecting VFC SIM Code Defaults

Setting Up and Mapping Custom SIM Codes for Immunizations Billing

Setting up Vaccine Billing Administration Codes

Setting Up and Mapping Custom SIM Codes for Immunizations Billing

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

Mapping Unique SIM Codes and Selecting VFC SIM Code Defaults