Exclusions

NextGen® Orthopedic Suite Help 80.2.14.0

MIPS Quality Measures

You can set up eligible financial classes for MIPS Quality Measures and the codes for the measures on the MIPS Quality Measures panel of the Billing Configuration practice template. You can also set certain payers as exceptions to general financial class rules. MIPS Quality Measures panel on the Billing Configuration template Note: By default, submitting charges on the Finalize Visit template sends the codes configured for MIPS Quality Measures. If your practice does not report on these measures, select the This Practice does not require MIPS Quality Measures check box to disable this feature. Enable a Financial Class for MIPS Quality Measures Disable a Financial Class MIPS Quality Measures Exclude Payers from MIPS Quality Measures Eligibility Add a CPT Code or Visit Code to the Group Type Remove a Code from the Applicable CPT Codes Grid Configure the CPT Code and ICD Code for a Type Within a Group Parent topic: Billing Configuration

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 to an Exclusion Type

On the Billing Configuration practice template, expand the Exclusions panel. From the Exclusion Type grid, select the office visit type. In the field below the Financial classes grid, select the financial class that excludes that office visit type. Click Add. Select the financial class in the grid. All the payers within that financial class appear in the Payers in the exclusion list grid. Parent topic: Exclusions

NextGen® Orthopedic Suite Help 80.2.14.0

Add a Consult Visit Code

You can add consult visit codes for financial classes that exclude consult visits. Note: The Consult Visit Codes grid comes pre-loaded with AMA consult visit codes. On the Billing Configuration practice template, expand the Exclusions panel. From the Exclusion Type grid, select Consult. Click in the field below the Consult Visit Codes grid. The IORTSConsult EM Code picklist opens. Consult visit codes in the Exclusions panel Select a code in the list, and click OK. Click Add. Parent topic: Exclusions

NextGen® Orthopedic Suite Help 80.2.14.0

Move Payers Out of the Exclusion List

You can move specific payers from the exclusion list if they allow the office visit type. On the Billing Configuration practice template, expand the Exclusions panel. From the Exclusion Type grid, select the office visit type. From the Financial classes grid, select the financial class. In the Payers in the exclusion list grid, select the payer. Use the right-pointing arrow to move the payer to the Payers not in the exclusion list grid. Exclusions panel on the Billing Configuration template Parent topic: Exclusions

NextGen® Orthopedic Suite Help 80.2.14.0

Remove a Financial Class From an Exclusions Type

You can remove a financial class from an exclusions type if the financial class no longer excludes that type of visit. On the Billing Configuration practice template, expand the Exclusions panel. From the Exclusion Type grid, select the office visit type. From the Financial classes grid, select the financial class. Click Delete. Parent topic: Exclusions

Exclusions

Recommendations

MIPS Quality Measures

Configuring Preferences for Non-Billable Procedures

Add a Financial Class to an Exclusion Type

Add a Consult Visit Code

Move Payers Out of the Exclusion List

Remove a Financial Class From an Exclusions Type

MIPS Quality Measures

Configuring Preferences for Non-Billable Procedures

Add a Financial Class to an Exclusion Type

Add a Consult Visit Code

Move Payers Out of the Exclusion List

Remove a Financial Class From an Exclusions Type