Explain what pertinent information, generally, is required in documentation to support DSM-5-TR and ICD-10 coding
Explain what pertinent information, generally, is required in documentation to support DSM-5-TR and ICD-10 coding
· EVALUATION AND MANAGEMENT (E/M)Insurance coding and billing is complex, but it boils down to how to accurately apply a code, or CPT (current procedural terminology), to the service that you provided. The payer then reimburses the service at a certain rate. As a provider, you will have to understand what codes to use and what documentation is necessary to support coding.For this Assignment, you will review evaluation and management (E/M) documentation for a patient and perform a crosswalk of codes from DSM-5-TR to ICD-10.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources. WEEKLY RESOURCES
TO PREPARE
- Review this week’s Learning Resources on coding, billing, reimbursement.
- Review the E/M patient case scenario provided.
THE ASSIGNMENT
- Assign DSM-5-TR and ICD-10 codes to services based upon the patient case scenario.
Then, in 1–2 pages address the following. You may add your narrative answers to these questions to the bottom of the case scenario document and submit altogether as one document.
- Explain what pertinent information, generally, is required in documentation to support DSM-5-TR and ICD-10 coding.
- Explain what pertinent documentation is missing from the case scenario, and what other information would be helpful to narrow your coding and billing options.
- Finally, explain how to improve documentation to support coding and billing for maximum reimbursement.
BY DAY 7 OF WEEK 2
Submit your Assignment.SUBMISSION INFORMATIONBefore submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
- To submit your completed assignment, save your Assignment as WK2Assgn1_LastName_Firstinitial
- Then, click on Start Assignment near the top of the page.
- Next, click on Upload File and select Submit Assignment for review.
Rubric
NRNP_6675_Week2_Assignment1_Rubric
| NRNP_6675_Week2_Assignment1_Rubric | ||
| Criteria | Ratings | Pts |
| This criterion is linked to a Learning OutcomeIn the E/M patient case scenario provided:• Assign DSM-5 and ICD-10 codes to services based upon the patient case scenario. | 20 to >17.0 ptsExcellent 90%–100%DSM-5 and ICD-10 codes assigned to the scenario are correct, with no more than a minor error. 17 to >15.0 ptsGood 80%–89%DSM-5 and ICD-10 codes assigned to the scenario are mostly correct, with a few minor errors. 15 to >13.0 ptsFair 70%–79%DSM-5 and ICD-10 codes assigned to the scenario contain several errors. 13 to >0 ptsPoor 0%–69%DSM-5 and ICD-10 codes assigned to the scenario contain significant errors, or response is missing. | 20 pts |
| This criterion is linked to a Learning OutcomeIn 1–2 pages, address the following: • Explain what pertinent information, generally, is required in documentation to support DSM-5 and ICD-10 coding. | 25 to >22.0 ptsExcellent 90%–100%The response accurately and concisely explains what pertinent documentation information is required to support DSM-5 and ICD-10 coding. 22 to >19.0 ptsGood 80%–89%The response accurately explains what pertinent documentation information is required to support DSM-5 and ICD-10 coding. 19 to >17.0 ptsFair 70%–79%The response somewhat vaguely or inaccurately explains what pertinent documentation information is required to support DSM-5 and ICD-10 coding. 17 to >0 ptsPoor 0%–69%The response vaguely or inaccurately explains what pertinent documentation information is required to support DSM-5 and ICD-10 coding, or the explanation is incomplete or missing. | 25 pts |
| This criterion is linked to a Learning Outcome• Explain what pertinent documentation is missing from the case scenario, and what other information would be helpful to narrow your coding and billing options. | 25 to >22.0 ptsExcellent 90%–100%The response accurately and concisely identifies the pertinent misssing information from the case scenario and clearly identifies what additional information would narrow coding and billing options. 22 to >19.0 ptsGood 80%–89%The response accurately identifies the pertinent misssing information from the case scenario and identifies what additional information would narrow coding and billing options. 19 to >17.0 ptsFair 70%–79%The response somewhat vaguely or inaccurately identifies the pertinent misssing information from the case scenario and identifies what additional information would narrow coding and billing options. 17 to >0 ptsPoor 0%–69%The response vaguely or inaccurately identifies the pertinent misssing information from the case scenario or partially identifies what additional information would narrow coding and billing options, or this information is incomplete or missing. | 25 pts |
| This criterion is linked to a Learning Outcome• Finally, explain how to improve documentation to support coding and billing for maximum reimbursement. | 15 to >13.0 ptsExcellent 90%–100%The response accurately and concisely explains how to improve documentation to support coding and billing for maximum reimbursement. 13 to >11.0 ptsGood 80%–89%The response accurately explains how to improve documentation to support coding and billing for maximum reimbursement. 11 to >10.0 ptsFair 70%–79%The response somewhat vaguely or inaccurately explains how to improve documentation to support coding and billing for maximum reimbursement. 10 to >0 ptsPoor 0%–69%The response vaguely or inaccurately explains how to improve documentation to support coding and billing for maximum reimbursement, or response may be incomplete or missing. | 15 pts |
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. | 5 to >4.0 ptsExcellent 90%–100%Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. 4 to >3.5 ptsGood 80%–89%Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time…. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive. 3.5 to >3.0 ptsFair 70%–79%Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment are vague or off topic. 3 to >0 ptsPoor 0%–69%Paragraphs and sentences follow writing standards for flow, continuity, and clarity <60% of the time…. Purpose statement, introduction, and conclusion were not provided. | 5 pts |
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation | 5 to >4.0 ptsExcellent 90%–100%Uses correct grammar, spelling, and punctuation with no errors 4 to >3.5 ptsGood 80%–89%Contains 1-2 grammar, spelling, and punctuation errors 3.5 to >3.0 ptsFair 70%–79%Contains 3-4 grammar, spelling, and punctuation errors 3 to >0 ptsPoor 0%–69%Contains five or more grammar, spelling, and punctuation errors that interfere with the reader’s understanding | 5 pts |
| This criterion is linked to a Learning OutcomeWritten Expression and Formatting – The paper follows correct APA format for parenthetical/in-text citations and reference list. | 5 to >4.0 ptsExcellent 90%–100%Uses correct APA format with no errors 4 to >3.5 ptsGood 80%–89%Contains 1-2 APA format errors 3.5 to >3.0 ptsFair 70%–79%Contains 3-4 APA format errors 3 to >0 ptsPoor 0%–69%Contains five or more APA format errors | 5 pts |
| Total Points: 100 | ||
· merican Psychiatric Association. (2022). ICD-10-CM Codes UpdateLinks to an external site.. https://www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm/updates-to-dsm-5-tr-criteria-text
·
· American Psychiatric Association. (2022). Changes to ICD-10-CM Codes for DSM-5 DiagnosesLinks to an external site.. https://www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm/coding-updates
· American Psychiatric Association. (2020). Updates to DSM–5 criteria, text and ICD-10 codesLinks to an external site.. https://www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm-5
· American Psychiatric Association. (2013). Insurance implications of DSM-5Links to an external site.. https://www.psychiatry.org/File%20Library/Psychiat…
- Clicking on this link will initiate the download of the PDF.
· American Psychiatric Association. (2020). Coding and reimbursementLinks to an external site..
https://www.psychiatry.org/psychiatrists/practice/…
· American Psychiatric Association. (2022). Numerical listing of DSM-5 diagnoses and codes (ICD-10-CM). In Diagnostic and statistical manual of mental disordersLinks to an external site. (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?u…
· Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.
- Chapter 9, “Reimbursement for Nurse Practitioner Services”
· Centers for Medicare & Medicaid Services. (2020). Your billing responsibilitiesLinks to an external site.. https://www.cms.gov/Medicare/Coordination-of-Benef…
· Stewart, J. G., & DeNisco, S. M. (2019). Role development for the nurse practitioner (2nd ed.). Jones & Bartlett Learning.
- Chapter 15, “Reimbursement for Nurse Practitioner Services”
· Walden University Academic Skills Center. (2017). Developing SMART goalsLinks to an external site.. https://academicguides.waldenu.edu/ld.php?content_…
· Zakhari, R. (2021). The psychiatric-mental health nurse practitioner certification review manual. Springer Publishing Company.
- Chapter 4 “Neuroanatomy, Physiology, and Mental Illness”
· Document: E/M Patient Case Study
Requirements: 1-2 pages | .doc file
Nursing
Answer preview for the paper on ‘Explain what pertinent information, generally, is required in documentation to support DSM-5-TR and ICD-10 coding’
APA 2028 words
Click the purchase button below to download full answer…….