NRNP 6675 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.

TO PREPARE

· Review this week’s Learning Resources on coding, billing, reimbursement. (See below)

· Review the E/M patient case scenario provided. (Attached document)

THE ASSIGNMENT

· Use the case template (attached document) to complete Week 2 Assignment. On page 5, assign DSM-5-TR and Updated ICD-10 codes to the services documented.

· Assign  DSM-5-TR and ICD-10 codes to services based upon the patient case scenario.

Then, in 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.

· APA 7

· At least 3 references

resources

 

· American Psychiatric Association. (2022).   ICD-10-CM Codes Update Links 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 Diagnoses Links 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 codes  Links to an external site. . https://www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm-5

· American Psychiatric Association. (2013).  Insurance implications of DSM-5 Links to an external site. . https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM_Insurance-Implications-of-DSM-5.pdf

· Clicking on this link will initiate the download of the PDF.

· American Psychiatric Association. (2020).  Coding and reimbursement  Links to an external site. . https://www.psychiatry.org/psychiatrists/practice/practice-management/coding-reimbursement-medicare-and-medicaid/coding-and-reimbursement

· American Psychiatric Association. (2022). Numerical listing of DSM-5 diagnoses and codes (ICD-10-CM).  In  Diagnostic and statistical manual of mental disorders Links to an external site.  (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url=https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787