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Ehr e&m

mcwhite

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Is anyone having problems with Nextgen EHR chosing the E&M codes. My facility is getting ready to start EHR with Nextgen. I found out that the E&M is being chose by documentation not medical necessity. I have been argueing this but need some opinion on this. I am able to get facility to understand medical necessity is the correct way.
Michelle
 

Pam Brooks

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Depending on the version of NextGen's KBM that you have, NG will choose the E&M code based on MDM and one of the other key components, but I believe you have to set it up that way, otherwise it picks two out of three (for established patients). Unfortunately NG's templates don't choose the level of MDM....your provider does. We spend hours (make that years...) training our docs on the criteria necessary to support the levels of MDM. And you're correct, NG cannot abstract medical necessity because that abilty is not a feature of any EHR system. The solution is to train your physicians with regard to making sure they document only that which is appropriate for the nature of the presenting problems, and to not get 'click happy'.

If you want to talk further, send me a PM, and I can either call or email you.
 
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