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.
Assignment 1: 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.
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.
BRAINY PLEASE TAKE NOTE OF BELOW INSTRUCTOR’S EXPECTATIONS. THANKS.
Expectations
Assignments MUST have a 50% or less on Safe-assign. I have had students fail out of the course in the past for PLAGERISM.
SAFE-ASSIGN HAS TO BE LOWER THAN 50%, AND IF IT’S HIGHER AND THERE IS EVIDENCE THAT PAST ASSIGNMENTS WERE REUSED FROM ANOTHER COURSE OR THERE ARE ANY SIGNS OF PLAGIARISM, AN AI INVESTIGATION WILL BE OPEN.
Rubric Detail
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Content
Name: NRNP_6675_Week2_Assignment1_Rubric
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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. |
Points: Points Range: DSM-5 and ICD-10 codes assigned to the scenario are correct, with no more than a minor error. Feedback: |
Points: Points Range: DSM-5 and ICD-10 codes assigned to the scenario are mostly correct, with a few minor errors. Feedback: |
Points: Points Range: DSM-5 and ICD-10 codes assigned to the scenario contain several errors. Feedback: |
Points: Points Range: DSM-5 and ICD-10 codes assigned to the scenario contain significant errors, or response is missing. Feedback: |
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In 1–2 pages, address the following:
• Explain what pertinent information, generally, is required in documentation to support DSM-5 and ICD-10 coding. |
Points: Points Range: The response accurately and concisely explains what pertinent documentation information is required to support DSM-5 and ICD-10 coding. Feedback: |
Points: Points Range: The response accurately explains what pertinent documentation information is required to support DSM-5 and ICD-10 coding. Feedback: |
Points: Points Range: The response somewhat vaguely or inaccuratel
Psychiatric Patient Evaluation
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