Assignment 1: Evaluation and Management
Assignment 1: Evaluation and Management
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.
Photo Credit: Getty Images/Tetra images RF
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.
Rubric Detail
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Name: NRNP_6675_Week2_Assignment1_Rubric
| Excellent 90%–100% | Good 80%–89% | Fair 70%–79% | Poor 0%–69% | |
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In the E/M patient case scenario provided: • Assign DSM-5 and ICD-10 codes to services based upon the patient case scenario. |
18 (18%) – 20 (20%) DSM-5 and ICD-10 codes assigned to the scenario are correct, with no more than a minor error. |
16 (16%) – 17 (17%) DSM-5 and ICD-10 codes assigned to the scenario are mostly correct, with a few minor errors. |
14 (14%) – 15 (15%) DSM-5 and ICD-10 codes assigned to the scenario contain several errors. |
0 (0%) – 13 (13%) DSM-5 and ICD-10 codes assigned to the scenario contain significant errors, or response is missing. |
|
In 1–2 pages, address the following: • Explain what pertinent information, generally, is required in documentation to support DSM-5 and ICD-10 coding. |
23 (23%) – 25 (25%) The response accurately and concisely explains what pertinent documentation information is required to support DSM-5 and ICD-10 coding. |
20 (20%) – 22 (22%) The response accurately explains what pertinent documentation information is required to support DSM-5 and ICD-10 coding. |
18 (18%) – 19 (19%) The response somewhat vaguely or inaccurately explains what pertinent documentation information is required to support DSM-5 and ICD-10 coding. |
0 (0%) – 17 (17%) 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. |
| • Explain what pertinent documentation is missing from the case scenario, and what other information would be helpful to narrow your coding and billing options. |
23 (23%) – 25 (25%) 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. |
20 (20%) – 22 (22%) The response accurately identifies the pertinent misssing information from the case scenario and identifies what additional information would narrow coding and billing options. |
18 (18%) – 19 (19%) 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. |
0 (0%) – 17 (17%) 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. |
| • Finally, explain how to improve documentation to support coding and billing for maximum reimbursement. |
14 (14%) – 15 (15%) The response accurately and concisely explains how to improve documentation to support coding and billing for maximum reimbursement. |
12 (12%) – 13 (13%) The response accurately explains how to improve documentation to support coding and billing for maximum reimbursement. |
11 (11%) – 11 (11%) The response somewhat vaguely or inaccurately explains how to improve documentation to support coding and billing for maximum reimbursement. |
0 (0%) – 10 (10%) 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. |
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Written 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 (5%) – 5 (5%) 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 (4%) – 4 (4%) 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 (3.5%) – 3.5 (3.5%) 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. |
0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity <60% of the time. Purpose statement, introduction, and conclusion were not provided. |
|
Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation |
5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors |
4 (4%) – 4 (4%) Contains 1-2 grammar, spelling, and punctuation errors |
3.5 (3.5%) – 3.5 (3.5%) Contains 3-4 grammar, spelling, and punctuation errors |
0 (0%) – 3 (3%) Contains five or more grammar, spelling, and punctuation errors that interfere with the reader’s understanding |
|
Written Expression and Formatting – The paper follows correct APA format for parenthetical/in-text citations and reference list. |
5 (5%) – 5 (5%) Uses correct APA format with no errors |
4 (4%) – 4 (4%) Contains 1-2 APA format errors |
3.5 (3.5%) – 3.5 (3.5%) Contains 3-4 APA format errors |
0 (0%) – 3 (3%) Contains five or more APA format errors |
| Total Points: 100 |
Name: NRNP_6675_Week2_Assignment1_Rubric
Assignment 2: Study Plan
Photo Credit: [Jacob Ammentorp Lund]/[iStock / Getty Images Plus]/Getty Images
Can you imagine an athlete deciding to run a marathon without training for the event? Most ambitious people who have set this goal will follow a specific training plan that will allow them to feel confident and prepared on the big day. Similarly, if you want to feel confident and prepared for your certification exam, you should create and follow a plan that will thoroughly prepare you for success.
In this Assignment, you will review the study plan that you developed in NRNP 6665, and revise your plan as necessary, which will serve as the road map for you to follow to attain your certification.
To Prepare
· Reflect on the study plan you created in NRNP 6665. Did you accomplish your SMART goals? What areas of focus still present opportunities for growth?
The Assignment
· Revise your study plan summarizing your current strengths and opportunities for improvement.
· Develop 3–4 new SMART goals for this quarter and the tasks you need to complete to accomplish each goal. Include a timetable for accomplishing them and a description of how you will measure your progress.
· Describe resources you would use to accomplish your goals and tasks, such as ways to participate in a study group or review course, mnemonics and other mental strategies, and print or online resources you could use to study.
Rubric Detail
Select Grid View or List View to change the rubric’s layout.
Name: NRNP_6675_Week2_Assignment2_Rubric
| Excellent 90%–100% | Good 80%–89% | Fair 70%–79% | Poor 0%–69% | |
| Revise your study plan, summarizing your current strengths and opportunities for improvement. |
23 (23%) – 25 (25%) The response provides an accurate, clear, and complete summary of both current strengths and opportunities for improvement. |
20 (20%) – 22 (22%) The response provides an accurate summary of both current strengths and opportunities for improvement. |
18 (18%) – 19 (19%) The response provides a somewhat vague and/or inaccurate summary of both current strengths and opportunities for improvement. |
0 (0%) – 17 (17%) A summary of both the current strengths and opportunities for improvement are incomplete or missing. |
| Develop 3-4 new SMART goals for this quarter and the tasks you need to complete to accomplish each goal. Include a timetable for accomplishing them and a description of how you will measure your progress. |
27 (27%) – 30 (30%) The response provides 3-4 new clear and appropriate SMART goals for the study plan, including tasks to complete to accomplish each goal. A clear timeline is provided for the study plan as well as a description of how progress toward goal completion will be measured. |
24 (24%) – 26 (26%) The response provides 3-4 new appropriate SMART goals and objectives for the practicum experience. Appropriate tasks, timeline, and description of how progress will be measured are provided. |
21 (21%) – 23 (23%) The response provides 3-4 somewhat vague or general goals for the study plan. Tasks, timeline, and description of how progress toward goals will be measured are vague or somewhat inappropriate. |
0 (0%) – 20 (20%) The response provides 3-4 unclear or inappropriate goals for the study plan, or goals are missing. Tasks, timeline, and a description for how progress will be measured are incomplete or missing. |
| Describe resources you would use to accomplish your goals and tasks, such as ways to participate in a study group or review course, mnemonics and other mental strategies, and print or online resources you could use to study. |
27 (27%) – 30 (30%) The response provides a clear description of appropriate resources to support the study plan that are tailored to individual need. |
24 (24%) – 26 (26%) The response provides a description of appropriate resources to support the study plan that are somewhat tailored to individual need. |
21 (21%) – 23 (23%) The response provides a description of general resources that are not tailored to individual need. |
0 (0%) – 20 (20%) The response provides a description of inappropriate resources to support the study plan, or the description of resources is vague or missing. |
|
Written 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 (5%) – 5 (5%) 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 (4%) – 4 (4%) 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 (3.5%) – 3.5 (3.5%) 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. |
0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity <60% of the time. Purpose statement, introduction, and conclusion were not provided. |
|
Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation |
5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors |
4 (4%) – 4 (4%) Contains 1-2 grammar, spelling, and punctuation errors |
3.5 (3.5%) – 3.5 (3.5%) Contains 3-4 grammar, spelling, and punctuation errors |
0 (0%) – 3 (3%) Contains five or more grammar, spelling, and punctuation errors that interfere with the reader’s understanding |
| Written Expression and Formatting – The paper follows correct APA format for parenthetical/in-text citations and reference list. |
5 (5%) – 5 (5%) Uses correct APA format with no errors |
4 (4%) – 4 (4%) Contains 1-2 APA format errors |
3.5 (3.5%) – 3.5 (3.5%) Contains 3-4 APA format errors |
0 (0%) – 3 (3%) Contains five or more APA format errors |
| Total Points: 100 |
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