Functional Reporting/Quality Measure Codes and DME

NextGen® Therapy Suite Help 30.3.13.0

Charges Grid

On the Charges grid, the Description column displays the Visit code (if applicable) and any documented treatments from Single Visit except for DME items. Note: You cannot change any charges on the Fee Sheet. You must make all documentation changes on the appropriate templates and then reopen the Fee Sheet to display the appropriate charges for that encounter. All necessary modifiers are automatically applied to the CPT codes based on the rules set up on the Billing Config system template for the payer attached to the case. If a code is shown as Not Billed, the system will not send that CPT to NextGen® Enterprise PM. A Not Billed designation could be due to the following: The code is prevented for that payer on the Billing Config system template. The code does not have enough time documented based on the configuration for that code. The code was marked as Concurrent on the template. Any code marked as Concurrent will not be billed. The payer is following Medicare Rules for timed codes a

NextGen® Orthopedic Suite Help 80.2.14.0

Coding Procedures

You can view all procedures, diagnoses, and modifiers that need to be billed for the current encounter to finalize a visit. The coding grid on the Finalize Visit template displays the following items that need to be billed for the current encounter. Procedures Diagnoses Modifiers Orders for durable medical equipment (DME) that are dispensed by your practice The following details are displayed for each item in the coding grid. Visit type Billing status of the procedure Description of the procedure to be billed Primary diagnosis codes after it is been coded Modifiers Code being sent for billing Coding grid on the Finalize Visit template The billing status is displayed as Coded for the items that have a diagnosis code, and the billing status is blank for the items without a diagnosis code. After you submit the charges, the billing status is displayed as Submitted for all items in the coding grid. The following table describes the buttons that are used for modifying items in the coding gri

NextGen® Therapy Suite Help 30.3.13.0

Document a DME Supply Item

Select the Types field, and then select the supply category. DME Item Types picklist The grid displays all items of that type and their supply CPT codes. Note: All Types and supply CPT codes tied to Types are configured in the Billing Configuration template. Select the supply item from the grid. The item description, code, and price appear in a row of fields to the right of the grid. Item details added to secondary grid Indicate a Qty. This is required. Select the R, L, or B option for right side, left side, or both. This drives RT, LT, or both modifiers that attach to the CPT code. If applicable, document Position of Orthosis, Type of prosthesis, and Extremity involved. If applicable, document additional information in Comments. Parent topic: Document a DME Only Visit

NextGen® Therapy Suite Help 30.3.13.0

Document Orthosis and DME Management

Use the Orthosis/DME template to dispense and bill durable medical equipment (DME), document orthosis and orthotic planning, and track billable time for the fitting of and training on orthotics, prosthetics, and braces, and for cast application. Note: All DME items that can be listed in the orthosis grid are set up in the Billing Configuration system template. Select the Types field. The DME Item Types picklist opens and displays a list of DME types. DME Item Types picklist Select the kind of DME items you want to view. Items related to the selected DME type appear in the grid. Select an item from the grid. The details relevant to selected item appear in the corresponding fields to the right of the grid. Indicate a Quantity and if the item is specific to R, L, or B. If one of the options is selected, you will see RT/LT modifiers attached to the CPT code on the Fee Sheet. Quantity added to Qty field Note: If you document a DME CPT code that is not active in the SIM library or if you ent

NextGen® Therapy Suite Help 30.3.13.0

DME Supplies Panel

Use the DME Supplies grid to configure items that appear in grids on the treatment Orthosis/DME template and on AUD HD Fitting/Repair template. Those grids show durable medical equipment that can be dispensed to the patient. Initially, the DME Supplies grid is blank until items are added to the SIM library during implementation. Then, the grid pulls directly from the values built in the SIM library – including the name of the supply. Each code in the SIM library can be entered only once. Therefore, an item cannot exist under multiple types. DME Supplies panel with items from SIM library After an item with a new DME type name is entered into the grid, the type name appears in the DME Types picklist. This enables you to have supplies under whichever Type you would like. Add a New DME Item Parent topic: Billing Configuration

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

Functional Reporting/Quality Measure Codes and DME

Recommendations

Charges Grid

Coding Procedures

Document a DME Supply Item

Document Orthosis and DME Management

DME Supplies Panel

MIPS Quality Measures

Charges Grid

Coding Procedures

Document a DME Supply Item

Document Orthosis and DME Management

DME Supplies Panel

MIPS Quality Measures