Calculate the E&M Code under 95 or 97 Coding Guidelines

NextGen® Ophthalmic Suite Help 2022.2

Submit the EM Code Using the 2021 E&M Coding Guidelines

Before you begin The date of the encounter must be on or after the effective start date entered for the 2021 Coding Guidelines on the Practice Configuration template. The visit type must fall under the guidelines. For information on the 2021 Coding Guidelines, go to the NextGen Healthcare Success Community and download the latest E&M Coding User Guide for NextGen® Adaptive Content Engine. Also, you must select an assessment in the Today’s Assessments panel to be able to submit an E&M code You can switch between selecting the Medical Decision Making (MDM) level and entering the total time to compare the code calculated by the application for each method and determine which to use before you submit the code. The application uses the last calculated code. For guidance on the level of complexity and risks involved in MDM, click the View MDM Guidelines link.A window opens, describing the elements of MDM for each available E&M code and level along with the risks of complications and morbidit

NextGen® Adaptive Content Engine Help Enterprise 8

Calculate E&M Codes under the 95 or 97 Coding Guidelines

You can base the E&M code calculation on the selected Medical Decision Making (MDM) level, documented history, and physical exam elements, or on the total visit time if more than 50 percent of the time was spent counseling or coordinating care. Open NextGen® Enterprise EHR. For a patient record, open a new encounter. Open the Finalize template. On Evaluation and Management Coding, do one of the following: To calculate the E&M code based on the MDM Level, documented history, and physical exam elements, select the level of complexity associated with the encounter in the Medical Decision Making section. For guidance in determining the level of complexity involved in MDM, you can select the View MDM Guidelines link and the level of risk associated with the encounter, select the View Risk link and refer to the details. To calculate the code based on the total visit time, do the following: Select Counsel Details and enter counseling and educational details on the Counseling Details template.

NextGen Behavioral Health Suite Help 5.5

Calculate an E&M Code Under 97 Coding Guidelines

You can base the Evaluation and Management (E&M) code calculation on the selected Medical Decision Making (MDM) level and documented history and physical exam elements or on the total visit time if more than 50 percent of the time was spent counseling or coordinating care. Open the Finalize (BH) template and then expand the Evaluation and Management Coding panel. Enter a start and end time. The duration calculates and displays in the corresponding field. When you enter a start and end time initially, the Time visit time (minutes) field updates with the same value. If you then edit the Time visit time (minutes) value and manually select an E&M code, the updated time overrides the original time entered. To calculate the E&M code based on the MDM Level and documented history and physical exam elements, select the level of complexity associated with the encounter in the Medical Decision Making section. For guidance in determining the level of complexity involved in MDM, select the View MDM

NextGen® Ophthalmic Suite Help 2022.2

2021 E&M Coding Guideline Changes

Effective January 1, 2021, Evaluation & Management (E&M) coding is based on Medical Decision Making (MDM) or time. History and physical exam elements are not used in the 2021 coding calculations. The established patient code 99211 is used for nurse visits. The 2021 Coding Guidelines calculate E&M codes based on one of the following: MDM level selected Time- Total time spent on patient care and documentation for the visit, which includes the face-to-face time with the patient and other time personally spent by the physician and/or other qualified healthcare professionals on the day of the encounter. You can include counseling time in the total time, but the 2021 guidelines do not require that over 50% of the total time be spent in counseling or coordinating care. The 2021 Coding Guidelines apply to certain visit types that use codes 99202-99205 for a new patient and 99211-99215 for an established patient. Code 99201 expires effective January 1, 2021. In NextGen® Ophthalmic Suite, the sy

NextGen Behavioral Health Suite Help 5.5

Submit E&M Codes per the 2021 Coding Guidelines

You can submit a calculated or selected Evaluation and Management (E&M) code to the Superbill using the 2021 Coding Guidelines. Before you begin The date of the encounter must be on or after the effective start date entered for the 2021 Coding Guidelines on the Practice Configuration template. The visit type must be one of the visit types impacted by the 2021 guidelines. For more information on the 2021 Coding Guidelines, go to NextGen Healthcare Success Community, and download the E&M Coding User Guide forNextGen®Adaptive Content Engine. Also, you must select an assessment in the Today’s Assessment panel to be able to submit an Evaluation and Management (E&M) code. For guidance on how to use the 2021 E&M Coding Guidelines based on Medical Decision Making (MDM) level and time, you can use the information Info Icon icon. For guidance on the level of complexity and risks involved in MDM, you can use the View MDM Guidelines link. From an encounter, select the Templates Template Icon icon.

NextGen® Adaptive Content Engine Help Enterprise 8

Calculate E&M Codes under 2021 Coding Guidelines

You can calculate the Evaluation and Management (E&M) code under 2021 Coding Guidelines in Evaluation and Management. You can base the Evaluation and Management (E&M) code calculation on the selected Medical Decision Making (MDM) level or total visit time. Open NextGen® Enterprise EHR. For a patient record, open a new encounter. Open the Finalize template. On the Evaluation and Management Coding panel, to calculate the E&M code based on the MDM level, review the prepopulated complexity level or manually select the level of complexity associated with the encounter in the Medical Decision Making section. The Medical Decision Making section displays the MDM level based on the calculated levels in the three tables in the Medical Decision - Making Elements panel. To change the MDM level, change the automatically-calculated MDM levels in the MDM tables, or by making corrections in the encounter chart note. For guidance on using the 2021 Coding Guidelines based on MDM level and time, select t

Calculate the E&M Code under 95 or 97 Coding Guidelines

Before you begin

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Submit the EM Code Using the 2021 E&M Coding Guidelines

Calculate E&M Codes under the 95 or 97 Coding Guidelines

Calculate an E&M Code Under 97 Coding Guidelines

2021 E&M Coding Guideline Changes

Submit E&M Codes per the 2021 Coding Guidelines

Calculate E&M Codes under 2021 Coding Guidelines

Submit the EM Code Using the 2021 E&M Coding Guidelines

Calculate E&M Codes under the 95 or 97 Coding Guidelines

Calculate an E&M Code Under 97 Coding Guidelines

2021 E&M Coding Guideline Changes

Submit E&M Codes per the 2021 Coding Guidelines

Calculate E&M Codes under 2021 Coding Guidelines