WK2 NRNP 6675

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Walden University

Walden University Walden University

NRNP 6675: PMHNP Care Across the Lifespan II NRNP 6675: PMHNP Care Across the Lifespan II | Week 2 ☰Menu

Walden University

Walden University Walden University

NRNP 6675: PMHNP Care Across the Lifespan II NRNP 6675: PMHNP Care Across the Lifespan II | Week 2 ☰Menu
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  • NRNP 6675: PMHNP Care Across the Lifespan II

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Week 2: Coding/Billing and Study Plan

Reimbursement and the appropriate coding to support it are of paramount importance to the business side of the medical field. When a service is provided, a code is used to extract billable information from the medical documentation, which results in insurance reimbursements to the provider. Reimbursement rates and medical coding can be almost as complicated as treating some mental illnesses, and you will need to understand how to accurately code services for documentation, billing, and reimbursement.

This week, you analyze the relationships among documentation, coding, and billing in advanced practice nursing as you practice applying diagnostic criteria and service codes to a case study. You will also evaluate the progress you made on the study plan that you created in NRNP 6665 and develop additional goals to help you prepare for your nurse practitioner national certification exam. 

Learning Objectives

Students will:

  • Apply DSM-5-TR diagnosis criteria and ICD-10 codes to patient service documentation
  • Analyze the relationships among documentation, coding, and billing in advanced practice nursing
  • Evaluate mastery of nurse practitioner knowledge in preparation for the nurse practitioner national certification examination
  • Create a study plan for the nurse practitioner national certification examination

Learning Resources

Required Readings (click to expand/reduce)

American Psychiatric Association. (2020). Updates to DSM–5 criteria, text and ICD-10 codes. https://www.psychiatry.org/psychiatrists/practice/dsm/updates-to-dsm-5

American Psychiatric Association. (2013). Insurance implications of DSM-5. 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.

https://www.psychiatry.org/psychiatrists/practice/practice-management/coding-reimbursement-medicare-and-medicaid/coding-and-reimbursement

American Psychiatric Association. (2013). Numerical listing of DSM-5 diagnoses and codes (ICD-10-CM). In Diagnostic and statistical manual of mental disorders (5th ed.). https://go.openathens.net/redirector/waldenu.edu?url=https://dsm.psychiatryonline.org/doi/10.1176/appi.books.9780890425596.ICD10Num_list

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 responsibilities. https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/ProviderServices/Your-Billing-Responsibilities

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 goals. https://academicguides.waldenu.edu/ld.php?content_id=51901492

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

Reminder: Keep Your Library of Advanced Practice Nursing Texts at Your Fingertips

    Several textbooks are assigned in multiple courses in your program. That is, you will see reading assignments from the books assigned in the Learning Resources of more than one course. You should, however, keep all prior textbooks, not just the ones explicitly assigned, readily accessible. The expectation is that you will independently consult these prior textbooks to synthesize information needed to complete your final courses. This is your time to “put it all together” to more fully embrace the advanced practice nursing role. Part of the responsibility of advanced practice is developing information literacy skills to know where to locate needed information for your clinical practice. 

    Photo Credit: [Peter Polak]/[iStock / Getty Images Plus]/Getty Images

    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. 

      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.   
      By Day 7 of Week 2

      Submit your Assignment. 

      Submission and Grading Information

      To submit your completed Assignment for review and grading, do the following:

      • Please save your Assignment using the naming convention “WK2Assgn1+last name+first initial.(extension)” as the name.
      • Click the Week 2 Assignment 1 Rubric to review the Grading Criteria for the Assignment.
      • Click the Week 2 Assignment 1 link. You will also be able to “View Rubric” for grading criteria from this area.
      • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn1+last name+first initial.(extension)” and click Open.
      • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
      • Click on the Submit button to complete your submission.
      Grading Criteria

      To access your rubric:

      Week 2 Assignment 1 Rubric

      Check Your Assignment Draft for Authenticity

      To check your Assignment draft for authenticity:

      Submit your Week 2 Assignment 1 draft and review the originality report.

      Submit Your Assignment by Day 7 of Week 2

      To participate in this Assignment:

      Week 2 Assignment 1

      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.
        By Day 7 of Week 2

        Submit your study plan.

        Submission and Grading Information

        To submit your completed Assignment for review and grading, do the following:

        • Please save your Assignment using the naming convention “WK2Assgn2+last name+first initial.(extension)” as the name.
        • Click the Week 2 Assignment 2 Rubric to review the Grading Criteria for the Assignment.
        • Click the Week 2 Assignment 2 link. You will also be able to “View Rubric” for grading criteria from this area.
        • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK2Assgn2+last name+first initial.(extension)” and click Open.
        • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
        • Click on the Submit button to complete your submission.
        Grading Criteria

        To access your rubric:

        Week 2 Assignment 2 Rubric

        Check Your Assignment Draft for Authenticity

        To check your Assignment draft for authenticity:

        Submit your Week 2 Assignment 2 draft and review the originality report.

        Submit Your Assignment by Day 7 of Week 2

        To participate in this Assignment:

        Week 2 Assignment 2

        What’s Coming Up in Module 2?

          Photo Credit: [BrianAJackson]/[iStock / Getty Images Plus]/Getty Images

          In Module 2, you will practice assessing, diagnosing, and formulating treatment plans for various mental health disorders across the lifespan. You will also explore controversies and treatment issues related to certain disorders. Disorders not covered in NRNP 6665 will be covered in this course. You will complete your midterm exam in Week 6. 

          Next Module

          To go to the next module:

          Module 2