Setting up Immunizations Tasks to Streamline Vaccine Billing

NextGen® Enterprise EHR Help

Immunizations Workflows

For each visit, you need the flexibility to work with the Immunization functions as each event occurs in real time. If needed, for example, you may need to do any of the following: View or hide dose exceptions when administering immunizations. Select and document Excluded Immunizations. Document that an Immunizations series is complete. Mark a patient who has no previously documented immunizations for reporting purposes and tracking. Report adverse events. Document erroneous or wasted immunizations. Open File Maintenance or the Vaccine Inventory as you process an Immunization order. Viewing or Hiding Dose Exceptions when Administering Immunizations Select Vaccines to Exclude Document that a Series is Complete Patient with no Previously Documented Immunizations Reporting Adverse Events and Accessing Other Immunizations Schedules Documenting Erroneous or Wasted Immunizations Access the Vaccine Inventory While Administering Immunizations Access Vaccine Billing While Administering Immuniza

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

Set up the Vaccine Inventory for Immunizations

Before you start, run the most recent Medications Update. Set up your practice's Vaccine Inventory. Note: By default, the CPT code is mapped to the Service Item Master code. If your practice uses custom SIM codes, you can map these codes to the appropriate CPT code in File Maintenance > Systems > Vaccine Billing. Before building your vaccine inventory, it is recommended that you map your custom (or alternate) SIM codes, if necessary. Set up specific lot numbers for a component, if necessary. If your practice administers Immunizations to VFC-eligible patients and you have set up custom VFC SIM codes, you must select the VFC SIM code as the default or non-default using the Vaccine Billing option in File Maintenance. If your practice administers Flu Immunizations to patients with Medicare as the payer, you can set up the alternate Medicare Billing codes (Q codes) in the NDC Library to ensure accurate billing. Set up the Immunizations Practice Preferences: Allergy Review option Ignore pedi

NextGen® Enterprise EHR Help

Immunizations Setup Best Practices for Billing VFC and Medicare Patients

If your practice does the following: Follow These Best Practices: Uses standard CPT4 codes only Has Medicare patients and bills Flu vaccines Set up altenate Medicare Billing Code (Q codes) in the NDC Library. Select your practice's NDC Library in File Maintenance > Practice > Preferences. Tip: The Q codes are added to your practice's Service Item Library (SIM) when the CPT codes are updated annually. Uses CPT4 codes and custom SIM codes (for example, no charge billing and VFC billing) Treats VFC-eligible patients and uses custom VFC SIM codes Has Medicare patients and bill Flu vaccines Set up a custom VFC SIM code for a specific CPT4 code in the Service Item Library. Define the VFC SIM code default in Vaccine Billing by mapping to the appropriate CPT4 Code. Note: To be able to set up the VFC code in Vaccine Billing, you must apply Hot Fix 51. Set up Medicare Billing Code (Q codes) in the NDC Library. Select your practice's NDC Library in File Maintenance > Practice > Preferences. Uses

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

Administer Immunizations with Alternate Medicare Q Codes

If your practice administers Immunizations with Alternate Medicare codes (Q codes) to Medicare patients, you must first set up these codes in the NDC Library before placing an Immunizations order. These codes display on the Create New/Update Immunizations Order patient name window (Vaccine Details tab) in the Billing Code field. You must select these codes to ensure more accurate billing for Flu immunizations in NextGen® Enterprise PM. After you select the vaccines on the Select Vaccines tab, select the Vaccine Details tab. The Create New/Update Immunizations Order for <patient name> window opens on the Vaccine Details tab. On the Vaccine Details tab, select the vaccine, and provide the Vaccine and Immunizations details. Select a Registry from the list, if necessary. Select the Lot Number from the list or enter it manually, if necessary. The vaccine data defaults from the Vaccine Inventory, including the NDC ID if it exists. Enter additional information for the selected Immunization or

Setting up Immunizations Tasks to Streamline Vaccine Billing

Recommendations

Immunizations Workflows

Immunizations Billing Setup Best Practices

Set up the Vaccine Inventory for Immunizations

Immunizations Setup Best Practices for Billing VFC and Medicare Patients

Setting Up and Mapping Custom SIM Codes for Immunizations Billing

Administer Immunizations with Alternate Medicare Q Codes

Immunizations Workflows

Immunizations Billing Setup Best Practices

Set up the Vaccine Inventory for Immunizations

Immunizations Setup Best Practices for Billing VFC and Medicare Patients

Setting Up and Mapping Custom SIM Codes for Immunizations Billing

Administer Immunizations with Alternate Medicare Q Codes