Setting up Vaccine Billing Administration Codes

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

Set up Vaccine Administration SIM Billing Codes

In File Maintenance, select System > EHR > Vaccine Admin Billing. The Vaccine Admin Billing List window opens. Select the Open Menu button, and then select New. The Vaccine Admin Billing window opens. To add the administration SIM codes, select the Open Record button. Search for a SIM code to include in the Vaccine Billing Administration list, if necessary. To select a SIM code, select the right arrow. The SIM code moves to the Included section. If required, continue selecting SIM codes to map. Select OK. The selected SIM codes display in the Vaccine Admin Billing Item window. Select OK. The full list of Vaccine Administration SIM codes display in the in the Vaccine Admin Billing List window. Parent topic: Setting up Vaccine Billing Administration Codes

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

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

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

Create SIM Codes for COVID-19 Vaccines

Each manufacturer’s vaccines are represented by individual unique CPT4® and administration codes. You can add the unique COVID-19 vaccine codes to the Service Item Library. Open File Maintenance. Under Libraries, select Service Items. The Service Items List window opens. To add codes to a library, select an existing library and select open menu , and then select Open. Note: You can create a Service Item (SIM) library for COVID-19 vaccines by selecting open menu and then selecting New. The Service Item Library Maintenance window opens. Add the vaccine CPT4 codes and administration codes to the SIM Library and select OK. Note: Each manufacturer’s vaccines are represented by individual unique CPT and administration codes. Parent topic: Recommended Setup and Testing Preparation

Setting up Vaccine Billing Administration Codes

Recommendations

Setting Up and Mapping Custom SIM Codes for Immunizations Billing

Set up Vaccine Administration SIM Billing Codes

Setting up Immunizations Tasks to Streamline Vaccine Billing

Vaccine Master Files

Immunizations Setup Best Practices for Billing VFC and Medicare Patients

Create SIM Codes for COVID-19 Vaccines