Terms to Know before Immunizations Setup

Term	Description
Vaccine Relationships	Vaccine Relationships enable certain vaccines to be grouped together. For example, MMRV is a combo vaccine that includes MMR and Varicella. Vaccine groupings enable users to more efficiently process Immunizations when selecting and administrating Immunizations to patients. These groupings are categorized as follows: Vaccine Display Relationships Vaccine Exclusion Relationships
Vaccine Display Relationships	The Immunizations module recognizes combo vaccines and shows only the display name on the Immunizations Recommendation Schedule and Chart View. These groupings enable users to more easily view and select vaccines when administering Immunizations. You can update these display relationships in File Maintenance.
Vaccine Exclusion Relationships	Users may need to exclude certain vaccines from a patient's Immunizations schedule due to patient safety or other reasons (for example, pregnancy). When administrating Immunizations, you can exclude one vaccine, a vaccine group, or multiple vaccine groups. For example, during a patient's pregnancy, she cannot receive certain Immunizations. A user would need to select the appropriate vaccine groups to exclude for the duration of the pregnancy. The "exclusion relationships" are pre-determined and these are the vaccine groups that display when you select to exclude a vaccine. You can update these exclusion relationships in File Maintenance.
Q Codes	To bill immunizations with alternate Medicare codes associated with Flu vaccines (Q codes), you must add these codes and corresponding information in the NDC Library. Q codes enable the system to map a SIM/CPT code as an alternate billing code when the payer is Medicare. When you administer Flu Immunizations in the Immunizations module, if you have set up Q codes, you can select them to send the charges to billing. For more information about setting up Q codes, refer to Setting up Alternate Medicare Billing Codes in the NDC Library.
G Codes	NextGen installs the G Codes prior to your practice's upgrade to the most recent 5.8x release. The G Codes (G008 to G0010) are used for Medicare billing and are associated with specific CPT/CVX codes for the following vaccines: Flu, Hepatitis B, and Pneumococcal. These codes display in the Admin Code field when you administer vaccines associated with the appropriate CPT4 codes.
Configure NDC IDs	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 the NDC IDs in the NDC Library. For more information, refer the Immunizations Set Up Process Overview and the Immunizations Billing Set Up Best Practices.

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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

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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

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

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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

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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

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Select an Immunizations Order Filter

If you select Immunizations Order Type, you can generate various reports by selecting the appropriate Immunizations filters. Examples of some of the types of immunization reports you might need to generate follow: Patients who have had a particular vaccine within a certain time period. All immunizations completed on a specific date. Immunizations marked as an error for the current date. Vaccines that have been ordered but not yet administered. Vaccine for Children (VFC) Immunizations information. For example, a report that lists American Indian or Alaskan natives who are VFC-eligible and have received VFC Immunizations by a certain date. Select Orders from the Report Filter Settings List. Report Filter Select Immunizations from the Select Order Type list. Select the Performing Entity (registry) from the list. If necessary, select to display the Registries Search window. Select a registry, if necessary, and select OK. Select a Vaccine name from the list or select to search for a vaccine

Terms to Know before Immunizations Setup

Recommendations

Set up the Vaccine Inventory for Immunizations

Immunizations Setup Best Practices for Billing VFC and Medicare Patients

Immunizations Billing Setup Best Practices

Administer Immunizations with Alternate Medicare Q Codes

Setting up Immunizations Tasks to Streamline Vaccine Billing

Select an Immunizations Order Filter

Set up the Vaccine Inventory for Immunizations

Immunizations Setup Best Practices for Billing VFC and Medicare Patients

Immunizations Billing Setup Best Practices

Administer Immunizations with Alternate Medicare Q Codes

Setting up Immunizations Tasks to Streamline Vaccine Billing

Select an Immunizations Order Filter