NRNP 6675 PMHNP Care Across the Life Span II: Evaluation and Management Essay

NRNP 6675 PMHNP Care Across the Life Span II: Evaluation and Management Essay

NRNP 6675 PMHNP Care Across the Life Span II: Evaluation and Management Essay

NRNP 6675 PMHNP Care Across the Life Span II: Evaluation and Management Sample Essay

ICD-10 and DSM-5 documentation and coding require various information. In general, some of the information required includes the patient’s history, time, the nature of the problem, coordination of care, medical decision-making, and examination. Each of these elements usually has sub-elements that must be captured correctly (Green, 2020). For instance, when taking information about the history, the information needed may include the relevant past social and family history, a comprehensive review of symptoms, the history of present illness, and chief complaint.

ORDER A PLAGIARISM-FREE PAPER HERE ON; NRNP 6675 PMHNP Care Across the Life Span II: Evaluation and Management Essay

The case scenario is of a twenty-five-year-old Russian female patient. Even though much information was captured that could be useful in coding and billing, additional information can also be obtained to help narrow the billing and coding options (Venkatesh et al.,2023). It is important to note that the patient’s case is well-established. Therefore, little could be added. For example, it will be critical to perform a comprehensive review of her documents to gain enhanced insight into the diagnosis and progress of her condition based on the patient’s engagement with the recently retired provider. Such a review would be useful in narrowing down the billing and coding.

Maximum reimbursement heavily depends on the nature of the documentation available. Therefore, institutions should improve documentation to enhance maximum reimbursement. One of the strategies is to adopt more efficient documentation systems such as electronic medical records (Bajowala et al.,2020). Such systems make it easier to update records in comparison to traditional methods. The staff dealing with coding and billing should also be trained regularly regarding current trends in coding and billing so that they be up to date with the most current process. For example, learning on reduction of partial payments and delayed reimbursement. It is key that organizations develop good documentation cultures to support maximum reimbursements.

References

Bajowala, S. S., Milosch, J., & Bansal, C. (2020). Telemedicine pays: Billing and coding update. Current Allergy and Asthma Reports, 20, 1-9. https://doi.org/10.1007/s11882-020-00956-y

Green, M. (2020). Understanding Health Insurance: A Guide to Billing and Reimbursement-2020. Cengage Learning.

Venkatesh, K. P., Raza, M. M., & Kvedar, J. C. (2023). Automating the overburdened clinical coding system: challenges and next steps.  Digital Medicine, 6(1), 16. https://doi.org/10.1038/s41746-023-00768-0

NRNP 6675 PMHNP Care Across the Life Span II: 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 the E/M patient case scenario provided. (attached in files)

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.

Submit your Assignment.