Prolonged Service Code

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® Ophthalmic Suite Help 2022.2

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

Before you begin You must configure the 95 or 97 Coding Guidelines selected on the Practice Configuration practice template. For more information on the 95 and 97 Coding Guidelines, go to the NextGen Healthcare Success Community and download the latest E&M Coding User Guide for NextGen® Adaptive Content Engine. The '95 and '97 guidelines base the Evaluation and Management (E&M) code calculation on the selected Medical Decision Making (MDM) level and the 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 - OPH template. If the patient was counseled, enter counseling and educational details and factors. Select the level of complexity associated with the encounter in the Medical Decision Making section. To calculate the code based on the total visit time, click the Total visit time (minutes) field, enter the total time in minutes, including counseling time, and click OK.

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

Select a Prolonged Time Code

Before you begin You must have calculated or manually selected the visit code 99205 or 99215 in the Evaluation and Management Coding panel of the Finalize (BH) template. You can report time more than 74 minutes for a new patient for code 99205 or more than 54 minutes for an established patient for code 99215. Open the Finalize (BH) template and then expand the Evaluation and Management Coding panel. Select the first blank Visit code field. The Visit Code Service Category window appears. Select Prolonged and then select the code for the prolonged service time. The prolonged service time code appears in the Visit code field. Parent topic: Finalize Documentation Related tasks Submit E&M Codes per the 2021 Coding Guidelines

NextGen® Adaptive Content Engine Help Enterprise 8

Select a Prolonged Time Code

You can select a prolonged time code to report time that surpasses the threshold for code 99205 or 99215 on the Finalize template. Before you begin You must calculate or manually select the visit code 99205 or 99215 in the Evaluation and Management Coding panel. You can report a time of more than 74 minutes for a new patient for code 99205, or more than 54 minutes for an established patient for code 99215. Open NextGen® Enterprise EHR. Open the Finalize template. On the Evaluation and Management Coding panel, select the first blank Visit code field. The Visit Code Service Category Name window opens. Select Prolonged, and select the code for the prolonged service time. The prolonged service time code appears in the Visit code field. Parent topic: Overview of Evaluation and Management Coding Parent topic: Enter Additional Visit Codes Parent topic: Overview of the Finalize Template Workflow

NextGen Behavioral Health Suite Help 5.5

Select a Prolonged Time Code

You can select a prolonged time code to report time that surpasses the threshold for code 99205 or 99215 on the Finalize template. Before you begin You must calculate or manually select the visit code 99205 or 99215 in the Evaluation and Management Coding panel. You can report a time of more than 74 minutes for a new patient for code 99205, or more than 54 minutes for an established patient for code 99215. Open NextGen® Enterprise EHR. Open the Finalize template. On the Evaluation and Management Coding panel, select the first blank Visit code field. The Visit Code Service Category Name window opens. Select Prolonged, and select the code for the prolonged service time. The prolonged service time code appears in the Visit code field. Parent topic: Finalize (BH) Panels

Prolonged Service Code

Recommendations

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

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

2021 E&M Coding Guideline Changes

Select a Prolonged Time Code

Select a Prolonged Time Code

Select a Prolonged Time Code

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

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

2021 E&M Coding Guideline Changes

Select a Prolonged Time Code

Select a Prolonged Time Code

Select a Prolonged Time Code