NOTE SETUP GUIDE

GO TO

Go to Administration > EMR Setup > Note Setup.

STEPS

Practice Default Template – This is the default template for note display.

• Font Size – Allows you to choose note font size  8pt, 9pt, 10pt, 11pt. You may adjust the font size to 11pt (extra large) for better visibility.
• Include Practice Logo – if enabled, the Practice logo will be incorporated into patient notes.
  
• Include CPT and ICD9 Codes – Allows you to include CPT and ICD codes in the note. Disabling this feature will only show the description of the codes.
  
• Include SNOMED – if the feature is enabled, the patient’s SNOMED code  will be included in the note.
  
• Show Abnormal In Red and Italic Font – if the feature is enabled, the patient’s abnormal findings  will be reflected in Red and Italic Font.
  

• Show Immunization History – if the feature is enabled, the patient’s Immunization history will be included in the note.
  

• Diagnosis Plan Text Carry Over – If activated, this feature ensures that the Diagnosis Plan text from the preceding diagnosis will be seamlessly carried forward to the subsequent visit note.
• Diagnosis “Include in Note” Carry Over – When this feature is activated, diagnoses that are marked for inclusion in the note will be automatically transferred to the next visit’s note.
  
• Show RX Note to Pharmacist – If activated, this feature ensures that the narrative under Note to Pharmacist will be included in the note.
  
• Missing Diagnosis Code at Note Signing – If activated, this feature ensures that the alert will pop up if there is a missing diagnosis on the patient’s note. Users will have 3 options: Alert Warning, Stop Note Signing, and Stop Note Signing if F0 code is the primary code.
  
• Missing Billable CPT Code at Note Signing – If activated, this feature ensures that the alert will pop up if there are missing billable CPT and ICD codes on the patient’s note. Users will have 2 options: Alert Warning and Stop Note Signing.
  

  
• Provider-Patient Location checking at Note – if the feature is enabled, a warning message will appear if Patient-Provider Location is incorrect.
  
• Auto-Populate assessment From Chief Complaint – if the feature is enabled, it will auto-populate the assessment when selecting the chief complaint from the drop-down option.
  
• Show Finalize Order(S) Button – if the feature is enabled, the Finalize Order button will appear whenever a user adds a CPT code under the Order tab.
  
• Set up Drop Down Options – this pertains to the ROS and Physical Exam Customized Drop down list. Enabling the “COMBINED LIST FROM PRACTICE USERS” feature results in the copying of all lists added under the ROS and Physical Exam pages by various practitioners. Conversely, the “SYSTEM AND PRACTICE DEFAULT ONLY” option operates oppositely, restricting the list to include only default items set at the system or practice level, while excluding any additional items contributed by individual users.
• Missing Time at Note Signing</b – >if the feature is enabled, CPT codes that do not have a designated time selected under the Service Coding section under the Orders & Procedures page will alert the system when viewing the note.
• CPT Codes Related to “Missing Time at Note Signing” – if the feature is enabled, the CPT code related to missing time at Note signing will reflect in Note Set up.