Add a Modifier

NextGen® Therapy Suite Help 30.3.13.0

Modifiers

In the Modifiers grid, you can specify codes or code combinations that require a modifier to be attached to the selected code. In the example below, if (97110) is documented, then the 59 modifier must be attached to the PT Re-Evaluation code (97164). Modifiers grid Add a Modifier Parent topic: Payer Specific Billing Panel

NextGen® Therapy Suite Help 30.3.13.0

Configure a Financial Category Replacement Code

Select the code in the CPT Codes grid (in the CPT Codes panel) that you want to apply a replacement code for. Select the Financial Category field under the Financial Category Replacement Code grid. CPT Codes panel and Payer Specific Billing panel A picklist opens, of all financial categories that have been configured for your organization. Select the financial category, and then select OK. If this replacement only applies to a specific payer within a financial category, select the Payer Name field and select a payer from the list. Otherwise leave this field blank, and the replacement code will apply to all payers within that financial class. If this replacement applies only to a specific visit set, select the Visit Set field, and then select the visit set. Otherwise leave this field blank. Enter the replacement code into the Replacement Cpt Code field. Select Add/Update. The new entry appears in the grid. Parent topic: The Financial Category Replacement Code

NextGen® Therapy Suite Help 30.3.13.0

Configure Payer-Specific Adjustments

Set up a payer that allows less than 8 minutes in order to bill a unit. Note: You must apply adjustments to each code for which they apply. Select a code in the CPT Codes grid (in the CPT Codes panel), that you want to apply the override to. This pulls that code into the fields above the grids in the Payer Specific Billing panel. Select the Finclass Name field under the Payer Specific Adjustments grid. This opens a picklist of all financial classes that have been configured for your organization. Select the financial class, and then select OK. Select the Payer Name field and select a payer name from the list. Enter in the Time Rule amount. Enter the new minimum time that the payer allows. If the payer has a maximum number of allowable units that differs from the standard, enter that in the Max Units field. Payer Specific Adjustments grid If Medicare is the secondary insurance, select the MC Rule checkbox. The system uses the payer-specific adjustments (minimum minutes) and then applies

NextGen® Orthopedic Suite Help 80.2.14.0

Attach Other Modifiers

You can attach modifiers outside the suggested ones using a configurable picklist. Click the View button. The IORTS FV View template opens. IORTS FV View template Select a procedure from the top Procedures grid. The fields below the grid fill in with the description of the procedure (Order item), the performed date, the CPT code, Proc Status, and Billing Status. Click the modifier fields and select a modifier from the IORTS Modifier picklist. Click OK. Click Update to save changes. Click Close to return to the Finalize Visit template. Parent topic: Coding Procedures Parent topic: Apply Diagnoses to Procedures

File Maintenance Help for NextGen® Enterprise 8

Attaching Taxonomy Codes to Groups

From the Master Files list, select Practice > Groups. Select the group. If you want to select a default taxonomy code for the group, select a code from the Taxonomy Code field. A taxonomy code added to the default location with a specific payer row applies only for that payer across all locations. The code overrides the taxonomy code at the top of the group screen for that payer. If you want to select a taxonomy code for the group at the location level: Select a service location. Then double-click a payer name in the Payer column. And then select the code from the Taxonomy Code field. A taxonomy code added to the default payer row at a specific location applies for all payers at that location. The code can also be payer-specific at a specific location. The most specific setting is always selected above the other settings. If you want to set taxonomy codes for specific procedure ranges, select the CPT4 Group Information button. The CPT4 Group Information for [Group Name] window displays

File Maintenance Help for NextGen® Enterprise 8

Attach a Taxonomy Code for the Provider at the Practice Level

To attach a taxonomy code for the provider at the practice level: From the Master Files list, select System or PM > Providers. Select the provider. Select the Practice tab. Select the Rendering provider at this practice check box. Select a service location from the Service Location field, and then double-click on the applicable payer listed under Group Information. If you select the default location and a specific payer, then the code applies for this payer at all locations. If you select a specific location and the default payer, then the row applies for all payers at that location. If you select a specific location and specific payer, then the code applies only to this payer at this location. The Modify Provider Practice Payer window displays. Select the taxonomy code from the Taxonomy Code field. If you want to set taxonomy codes for specific procedure ranges, select the CPT4 Provider Nbrs button. The Valid Provider Numbers for [Payer Name] window displays. Select the Open Menu butt

Add a Modifier

Recommendations

Modifiers

Configure a Financial Category Replacement Code

Configure Payer-Specific Adjustments

Attach Other Modifiers

Attaching Taxonomy Codes to Groups

Attach a Taxonomy Code for the Provider at the Practice Level

Modifiers

Configure a Financial Category Replacement Code

Configure Payer-Specific Adjustments

Attach Other Modifiers

Attaching Taxonomy Codes to Groups

Attach a Taxonomy Code for the Provider at the Practice Level