Document Needle Placement Confirmation and Medical Necessity

NextGen® Medication Inventory Control Help 10.6.3.0

Additional Procedure Information

If needle placement is confirmed using one of the above listed techniques the Medical Necessity field becomes required. The Technique, Anesthetic, Needle Gauge and Sterile Dressing fields are all optional. Selecting an item in one the of fields automatically opens the picklist for the field that follows. To conclude documentation at any point, click Cancel in the picklist, or close the picklist. Select the Medical Necessity field and select the item from the picklist. The MLTSTechniquePL picklist opens. Select a technique from the picklist and click OK. The MLTSanestheticPL picklist opens. Select an anesthetic from the picklist and click OK. The system runs a DUR Check for the medication and the MLTSneedleGaugePL picklist opens. Select the needle gauge from the picklist and click OK. The MLTS SterileDressPL picklist opens. Select the sterile dressing from the picklist and click OK. All the procedure information is now filled in. You can use the Procedure Notes field below the panel to

NextGen® Medication Inventory Control Help 10.6.3.0

Document Aspiration Procedure Information

You can manually document aspiration procedure in the Procedure Type panel on the MICS Injections/Aspirations template. You can manually document the aspiration procedure in the following fields or using a Quickpick. On the MICS Injections/Aspirations template, expand the Procedure Type panel. Select the Procedure Type as Aspiration. In the Admin Type field, select administration type. The Body Parts picklist opens. Select the body part from the picklist, and select OK. The Sides picklist opens. Select the side from the picklist, and select OK. The Locations picklist opens. Select the location from the picklist, and select OK. The Portal/Approach picklist opens. Select the portal and approach from the picklist, and select OK. All the fields display the values you selected. The CPT code field is filled based on the Admin Type selected. The Modifier field is filled based on the Side selected. To associate a diagnosis code with the procedure, select a diagnosis in the Diagnosis field. Not

NextGen® Medication Inventory Control Help 10.6.3.0

Needle Placement Confirmation

If needle placement was confirmed using ultrasound, CT, MRI, Fluoroscopy, or manual palpitation, you can document the means used. If you select any guidance other than Manual Palpation, the Medical Necessity field becomes required. Select the Placement Confirmed By field and select the method used to confirm needle placement from the picklist. Ultrasound Guidance Codes CT Guidance Codes MRI Guidance Codes Fluoroscopy Guidance Codes Parent topic: Documenting an Injection

NextGen® Medication Inventory Control Help 10.6.3.0

Ultrasound Guidance

When ultrasound guidance is used to confirm needle placement in a small, intermediate, or major joint, the application sends different codes for aspirations. For small joint needle placement with ultrasound guidance, the application sends the CPT code 20604 instead of 20600. For intermediate joint needle placement with ultrasound guidance, the application sends the CPT code 20606 instead of 20605. For major joint needle placement with ultrasound guidance, the application sends the CPT code 20611 instead of 20610. For the other joint needle placements with ultrasound guidance, the application sends send the ultrasound CPT code 76942 in conjunction to the procedure code. Parent topic: Document Needle Placement Confirmation and Medical Necessity

NextGen® Medication Inventory Control Help 10.6.3.0

Fluoroscopy Guidance

For Fluoroscopic needle placement guidance, 77002 is used in conjunction with the procedure code EXCEPT for when the PRP code (0232T) is used, as it is excluded. Parent topic: Document Needle Placement Confirmation and Medical Necessity

NextGen® Medication Inventory Control Help 10.6.3.0

Documenting an Aspiration

You can document the general procedure details, appearance, and quantity of the fluid drawn off, and the patient’s response for an aspiration procedure in the Procedure Type panel on the MICS Injections/Aspirations template. You can manually document the aspiration procedure information or use QuickPicks. Document Aspiration Procedure Information You can manually document aspiration procedure in the Procedure Type panel on the MICS Injections/Aspirations template. Document Needle Placement Confirmation and Medical Necessity Additional Procedure Information Appearance and Quantity of Fluid Drawn Parent topic: Documenting Injections and Aspirations Related tasks Document Using QuickPicks

Document Needle Placement Confirmation and Medical Necessity

Recommendations

Additional Procedure Information

Document Aspiration Procedure Information

Needle Placement Confirmation

Ultrasound Guidance

Fluoroscopy Guidance

Documenting an Aspiration

Additional Procedure Information

Document Aspiration Procedure Information

Needle Placement Confirmation

Ultrasound Guidance

Fluoroscopy Guidance

Documenting an Aspiration