Configure Payers That Do Not Accept a Single Bilateral Code

NextGen® Orthopedic Suite Help 80.2.14.0

Configure Financial Classes that Accept a Bilateral Code

Before you begin Financial classes and payers must be configured in File Maintenance before configuring bilateral billing. By default, the NextGen® Orthopedic Suite submits two codes for bilateral radiology tests (a code for left and a code for right). For radiology tests performed internally, you can configure financial classes and payers that accept a single bilateral code in the Bilateral Billing for Internal Orders panel on the Radiology Configuration practice template. Note: Financial classes and payers must be configured in File Maintenance before configuring bilateral billing. On the Radiology Configuration practice template, go to the Bilateral Billing for Internal Orders panel. Click the field under the Financial Classes That Accept a Single Code for Bilateral Billing grid to select a financial class containing payers who accept a single code for bilateral tests performed in-house. The payers for the financial class appear in the Payers that Accept a Bilateral Code grid. Paren

NextGen® Orthopedic Suite Help 80.2.14.0

Bilateral Billing for Internal Orders

By default, the NextGen® Orthopedic Suite submits two instances of a code for bilateral tests, one for the right side and one for the left side. In the Bilateral Billing for Internal Orders panel, you can configure financial classes and payers that accept a single code with a bilateral modifier on the Radiology Configuration template. Note: The system bills a single bilateral code on the Radiology Order or Single Order template when the following is true: The encounter insurance has been configured as a payer that accepts a bilateral code in the Bilateral Billing for Internal Orders panel. The Performed: Internal Today or Internal Later option is selected. A bilateral test is selected. Note: Financial classes and payers must be set up in File Maintenance before configuring bilateral billing requirements. All External orders use two codes for bilateral billing, one for right and one for left. Configure Financial Classes that Accept a Bilateral Code Configure Payers That Do Not Accept a

NextGen® Orthopedic Suite Help 80.2.14.0

Edit Radiology Test Configuration

The Manage Radiology Tests grid on the Radiology Configuration practice template does not display any data until you select a value in the filter fields above the grid. The Category and Body Part fields use picklists from the Radiology Picklists panel. Note: Use the fields below the grid to edit the selected radiology test. The fields below the grid are referred to by the corresponding column name. Select an option for Sort Tests By: Body Part or Description. Note: This sort option also determines how the Radiology Tests grid on the Radiology Order template and the Radiology panel of the Single Order template is sorted. In the Filters section, click any field to select a value to filter the grid. Select a row from the grid. Use the fields below the grid to make the desired changes. To edit the description, click the Description field. To configure the Picklist that opens when the test is ordered, select the picklist. To add the bilateral code, click the Bilat. Code field to search, and

NextGen® Orthopedic Suite Help 80.2.14.0

Configuring Settings for Radiology Tests

You can configure picklists and settings for various radiology tests. You can use the Radiology Configuration practice template for configuring general radiology settings, picklists, standard radiology tests, provider custom tests, and provider custom multi-test groups. Radiology Configuration template The Radiology Configuration template is preloaded with the radiology codes. You must ensure that the radiology codes are configured in the service item (SIM) library for the practice to bill them. The following table describes the panels on the Radiology Configuration template. Panel Description General To configure general settings for documenting radiology tests. Bilateral Billing for Internal Orders To configure financial classes and payers for billing bilateral tests. Manage Radiology Tests To configure settings for documenting standard radiology tests. Radiology Picklists To configure picklists for documenting radiology tests. Provider Custom Tests To configure the provider's prefer

NextGen® Orthopedic Suite Help 80.2.14.0

Configuring Preferences for Non-Billable Procedures

You can update the procedure information and configure financial classes and payers for various non-billable procedures. You can use the Non-billable panel on the Billing Configuration practice template to do the following for a non-billable procedure. Select a Current Procedural Terminology (CPT) code Select an International Classification of Diseases (ICD) code Manage financial classes that require specific ICD codes Manage payers in the exclusion list for a financial class Non-billable panel on the Billing Configuration template Selecting a procedure from the Procedures grid displays the description, CPT code, and ICD code in their corresponding fields, and you can update them as needed. You can also add or remove financial classes in the Financial Classes grid for the selected procedure. If you select an existing financial class from the Financial Classes grid, the applicable payers are displayed in their corresponding grids that help you manage the payers in the exclusion list for

NextGen® Orthopedic Suite Help 80.2.14.0

Add a Financial Class that Requires Different ICD Codes

You can add a financial class that requires different ICD codes for a procedure. When you do this, all the payers in the financial class enter the Payers in the exclusion list grid. On the Billing Configuration practice template, expand the Non-billable panel. In the Procedures grid, select a procedure. The Procedure description and CPT Code for the selected procedure appear the fields below the grid and financial classes already configured to require different ICD codes for that procedure appear in the Financial Classes grid. In the field below the Financial classes grid, select the financial class. Click Add. In the ICD for these specific payers field, enter the ICD code for that financial class. In the ICD for all others field, enter the ICD code for this procedure for all other payers. Click Update. Parent topic: Configuring Preferences for Non-Billable Procedures

Configure Payers That Do Not Accept a Single Bilateral Code

Before you begin

Recommendations

Configure Financial Classes that Accept a Bilateral Code

Bilateral Billing for Internal Orders

Edit Radiology Test Configuration

Configuring Settings for Radiology Tests

Configuring Preferences for Non-Billable Procedures

Add a Financial Class that Requires Different ICD Codes

Configure Financial Classes that Accept a Bilateral Code

Bilateral Billing for Internal Orders

Edit Radiology Test Configuration

Configuring Settings for Radiology Tests

Configuring Preferences for Non-Billable Procedures

Add a Financial Class that Requires Different ICD Codes