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Category: Nursing

  • [Solved] WK4 DISCUSSION1 HP-214

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    COMPLETE WITH 250 WORDS – ## WK4DISCUSSION1HP-214.docx **## WK4DISCUSSION1HP-214.docx** WK4 DISCUSSION1 HP-214 CDI and Qualified Coders Clinical Documentation Improvement (CDI) programs facilitate accurate, thorough documentation in the medical record. This program also identifies discrepancies that…

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    COMPLETE WITH 250 WORDS

    – ## WK4DISCUSSION1HP-214.docx

    **## WK4DISCUSSION1HP-214.docx**

    WK4 DISCUSSION1 HP-214

    CDI and Qualified Coders

    Clinical Documentation Improvement (CDI) programs facilitate accurate, thorough documentation in the medical record.  This program also identifies discrepancies that may exist in the provider documentation when the codes are being selected. The successful request for clarification via the physician query process is enhanced when the coding specialist has a strong foundation knowledge base. This points to the importance of coder qualifications. Also, in 2018, Medicare was found to have a billing error rate of 8.1% which equated to a loss of $31.6 Billion. Programs were developed to detect and correct past improper payments. A portion of the focus on these programs is to identify areas of provider confusion within Medicare billing and to develop compliance programs. The Office of the Inspector General, OIG, Compliance Program Guidance states, “Because incorrect procedure coding may lead to overpayments and subject a hospital to liability for the submission of false claims, hospitals need to pay close attention to coder training and qualifications.”

    Explore ways facilities ensure that coders are properly trained and are qualified

    Include the following aspects in the discussion:

    · Research Internal compliance programs and/or external compliance programs

    · Discuss the effects of including Clinical Documentation Improvement (CDI) on coder’s accuracy rates

    · Discuss which measures health care facilities can take to ensure that coders are properly trained and are qualified

    ·
    Discuss the effects of including CDI on coder’s accuracy rates

    250 WORDS

    **## WK4DISCUSSION1HP-214.docx**

    WK4 DISCUSSION1 HP-214

    CDI and Qualified Coders

    Clinical Documentation Improvement (CDI) programs facilitate accurate, thorough documentation in the medical record.  This program also identifies discrepancies that may exist in the provider documentation when the codes are being selected. The successful request for clarification via the physician query process is enhanced when the coding specialist has a strong foundation knowledge base. This points to the importance of coder qualifications. Also, in 2018, Medicare was found to have a billing error rate of 8.1% which equated to a loss of $31.6 Billion. Programs were developed to detect and correct past improper payments. A portion of the focus on these programs is to identify areas of provider confusion within Medicare billing and to develop compliance programs. The Office of the Inspector General, OIG, Compliance Program Guidance states, “Because incorrect procedure coding may lead to overpayments and subject a hospital to liability for the submission of false claims, hospitals need to pay close attention to coder training and qualifications.”

    Explore ways facilities ensure that coders are properly trained and are qualified

    Include the following aspects in the discussion:

    · Research Internal compliance programs and/or external compliance programs

    · Discuss the effects of including Clinical Documentation Improvement (CDI) on coder’s accuracy rates

    · Discuss which measures health care facilities can take to ensure that coders are properly trained and are qualified

    ·
    Discuss the effects of including CDI on coder’s accuracy rates

    250 WORDS

  • [Solved] WK4 DISCUSSION2 HP-214

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    COMPLETE WITH 250 WORDS – ## WK4DISCUSSION2HP-214.docx **## WK4DISCUSSION2HP-214.docx** WK4 DISCUSSION2 HP-214 Coding for Optimum Reimbursement We have focused on key coding topics this week because you must apply them when completing the CMS-1500 for billing purposes. These key coding topics have o…

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    COMPLETE WITH 250 WORDS

    – ## WK4DISCUSSION2HP-214.docx

    **## WK4DISCUSSION2HP-214.docx**

    WK4 DISCUSSION2 HP-214

    Coding for Optimum Reimbursement

    We have focused on key coding topics this week because you must apply them when completing the CMS-1500 for billing purposes. These key coding topics have origins within the Medicare program. Some examples of these key topics are demonstrating medical necessity when a R/O diagnosis can be coded, the difference between “principal” and “first-listed” diagnosis, CPT coding and using the listed content page that is in the front of each tabular section, using RVUs when selecting the order of several CPT codes, when to use modifier 26 and TC, and the concepts of global packages. Of the topics that we discussed, which two did you find of most value, and why?

    Articulate the meanings of coding compliance and CDI (Clinical Documentation Improvement.)

    Include the following aspects in the discussion:

    · Provide a description of each coding topic (two) including how it relates to either compliance or CDI?

    · Of the topics that we discussed this week, which two did you find of most value and why?

    · Discuss if the topic was new to you or did it help to clarify or reinforce previous learning?

    ·
    Did the topic change the way in which you may use the coding books (ICD-10 or CPT)?  If so, how?

    250 WORDS

    **## WK4DISCUSSION2HP-214.docx**

    WK4 DISCUSSION2 HP-214

    Coding for Optimum Reimbursement

    We have focused on key coding topics this week because you must apply them when completing the CMS-1500 for billing purposes. These key coding topics have origins within the Medicare program. Some examples of these key topics are demonstrating medical necessity when a R/O diagnosis can be coded, the difference between “principal” and “first-listed” diagnosis, CPT coding and using the listed content page that is in the front of each tabular section, using RVUs when selecting the order of several CPT codes, when to use modifier 26 and TC, and the concepts of global packages. Of the topics that we discussed, which two did you find of most value, and why?

    Articulate the meanings of coding compliance and CDI (Clinical Documentation Improvement.)

    Include the following aspects in the discussion:

    · Provide a description of each coding topic (two) including how it relates to either compliance or CDI?

    · Of the topics that we discussed this week, which two did you find of most value and why?

    · Discuss if the topic was new to you or did it help to clarify or reinforce previous learning?

    ·
    Did the topic change the way in which you may use the coding books (ICD-10 or CPT)?  If so, how?

    250 WORDS

  • [Solved] WK4 ASSIGNMENT HP-214

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    COMPLETE WITH INSTRUCTIONS – ## WK4ASSIGNMENTHP-214.docx **## WK4ASSIGNMENTHP-214.docx** WK4 ASSIGNMENT HP-214 Billing Correctly This week’s assignment involves the coding of three case studies, followed by the completion of the bottom portion of the CMS 1500 claim form. This part of the claim form …

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    Assignment Prompt & Instructions

    COMPLETE WITH INSTRUCTIONS

    – ## WK4ASSIGNMENTHP-214.docx

    **## WK4ASSIGNMENTHP-214.docx**

    WK4 ASSIGNMENT HP-214

    Billing Correctly

    This week’s assignment involves the coding of three case studies, followed by the completion of the bottom portion of the CMS 1500 claim form. This part of the claim form is for your practice in documenting the CPT codes and the ICD-10 codes that meet the requirement for medical necessity. We are going to pretend that the three fictitious case studies are being performed in an outpatient surgical facility.

    Use the attached assignment document to complete and submit for grading.

    USE THE INFO BELOW TO COMPLETE

    **Billing Correctly**

    This week’s assignment involves the coding of three case studies, followed by the completion of the bottom portion of the CMS 1500 claim form. This part of the claim form is for your practice in documenting the CPT codes and the ICD-10 codes that meet the requirement for medical necessity. We are going to pretend that the 3 fictitious case studies are being performed in an outpatient surgical facility.
    [Download this fillable CMS 1500 claim form](https://content.grantham.edu/academics/GU_AH214b/W4ACMS1500.pdf). You must decide which of the CPT codes should be listed first and second. This information is covered for you in both the lecture and in the PowerPoint. While you might not look up the RVUs for every procedure when working as a billing specialist, this is a good foundation activity that will help to instill in you the ability to choose the CPT codes that are the most labor-intensive.

    **Connect the CPT code on a claim form with the ICD-10 code that demonstrates medical necessity.**

    Please use the information from each case study to
    **complete a separate form**. You only need to fill in the following numbered boxes on the claim form.

    17 – The physician’s name

    21 – The ICD-10 codes (these are the codes that you will indicate by their letters A-L)

    24 A – The DOS – Enter an eight-digit date
    _with_ spaces (MM DD YYYY).

    24 D – The CPT code and up to four modifiers

    24 E – the ICD-10 indicator, which will be the letter of the code in box 21 of the ICD-10 codes that show medical necessity for each CPT code.

    **## WK4ASSIGNMENTHP-214.docx**

    WK4 ASSIGNMENT HP-214

    Billing Correctly

    This week’s assignment involves the coding of three case studies, followed by the completion of the bottom portion of the CMS 1500 claim form. This part of the claim form is for your practice in documenting the CPT codes and the ICD-10 codes that meet the requirement for medical necessity. We are going to pretend that the three fictitious case studies are being performed in an outpatient surgical facility.

    Use the attached assignment document to complete and submit for grading.

    USE THE INFO BELOW TO COMPLETE

    **Billing Correctly**

    This week’s assignment involves the coding of three case studies, followed by the completion of the bottom portion of the CMS 1500 claim form. This part of the claim form is for your practice in documenting the CPT codes and the ICD-10 codes that meet the requirement for medical necessity. We are going to pretend that the 3 fictitious case studies are being performed in an outpatient surgical facility.
    [Download this fillable CMS 1500 claim form](https://content.grantham.edu/academics/GU_AH214b/W4ACMS1500.pdf). You must decide which of the CPT codes should be listed first and second. This information is covered for you in both the lecture and in the PowerPoint. While you might not look up the RVUs for every procedure when working as a billing specialist, this is a good foundation activity that will help to instill in you the ability to choose the CPT codes that are the most labor-intensive.

    **Connect the CPT code on a claim form with the ICD-10 code that demonstrates medical necessity.**

    Please use the information from each case study to
    **complete a separate form**. You only need to fill in the following numbered boxes on the claim form.

    17 – The physician’s name

    21 – The ICD-10 codes (these are the codes that you will indicate by their letters A-L)

    24 A – The DOS – Enter an eight-digit date
    _with_ spaces (MM DD YYYY).

    24 D – The CPT code and up to four modifiers

    24 E – the ICD-10 indicator, which will be the letter of the code in box 21 of the ICD-10 codes that show medical necessity for each CPT code.

  • [Solved] Nevents

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    The Centers for Medicare & Medicaid Services (CMS) formed its no-pay policy based on the growing work of National Quality Forum (NQF) of “never events.” Meaning, CMS will no longer pay for certain conditions that result from what might be termed poor practice or events that should never have occurre…

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    Assignment Prompt & Instructions

    The Centers for Medicare & Medicaid Services (CMS) formed its no-pay policy based on the growing work of National Quality Forum (NQF) of “never events.” Meaning, CMS will no longer pay for certain conditions that result from what might be termed poor practice or events that should never have occurred while a patient was under the care of a healthcare professional.
    Discuss specific examples of “never events” and their impact in your workplace.
    What issues are you considering for your clinical project and why?

  • [Solved] Evidence-Based Project, Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

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    Executive Solution Overview

    **To Prepare:** – Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry. – Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entir…

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    Assignment Prompt & Instructions

    **To Prepare:**
    – Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
    – Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.
    – Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
    – Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.
    **The Assignment** (Evidence-Based Project)
    _Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews_
    Create a 6- to 7-slide PowerPoint presentation in which you do the following:
    – Identify and briefly describe your chosen clinical issue of interest.
    – Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
    – Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
    – Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
    – Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.

  • [Solved] Evidence-Based Project, Part 3: Critical Appraisal of Research

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    **To Prepare:** – Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3. – Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3. – Review and downlo…

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    Assignment Prompt & Instructions

    **To Prepare:**
    – Reflect on the four peer-reviewed articles you selected in Module 2 and the four systematic reviews (or other filtered high- level evidence) you selected in Module 3.
    – Reflect on the four peer-reviewed articles you selected in Module 2 and analyzed in Module 3.
    – Review and download the Critical Appraisal Tool Worksheet Template provided in the Resources.
    **The Assignment** (Evidence-Based Project)
    **Part 3A: Critical Appraisal of Research**
    Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.
    **Note**: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.
    **Part 3B: Critical Appraisal of Research**
    Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research.

  • [Solved] Evidence-Based Project, Part 4: Recommending an Evidence-Based Practice Change

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    **To Prepare:** – Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT. – Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest a…

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    Assignment Prompt & Instructions

    **To Prepare:**
    – Reflect on the four peer-reviewed articles you critically appraised in Module 4, related to your clinical topic of interest and PICOT.
    – Reflect on your current healthcare organization and think about potential opportunities for evidence-based change, using your topic of interest and PICOT as the basis for your reflection.
    – Consider the best method of disseminating the results of your presentation to an audience.
    **The Assignment:** (Evidence-Based Project)
    _Part 4: Recommending an Evidence-Based Practice Change_
    Create an 8- to 9-slide **narrated** PowerPoint presentation in which you do the following:
    – Briefly describe your healthcare organization, including its culture and readiness for change. (You may opt to keep various elements of this anonymous, such as your company name.)
    – Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.
    – Propose an evidence-based idea for a change in practice using an EBP approach to decision making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.
    – Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.
    – Explain how you would disseminate the results of your project to an audience. Provide a rationale for why you selected this dissemination strategy.
    – Describe the measurable outcomes you hope to achieve with the implementation of this evidence-based change.
    – Be sure to provide APA citations of the supporting evidence-based peer reviewed articles you selected to support your thinking.
    – Add a lessons learned section that includes the following:
    – A summary of the critical appraisal of the peer-reviewed articles you previously submitted
    – An explanation about what you learned from completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template (1-3 slides)

  • [Solved] The Nurse Leader as Knowledge Worker

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    **To Prepare:** – Review the concepts of informatics as presented in the Resources. – Reflect on the role of a nurse leader as a knowledge worker. – Consider how knowledge may be informed by data that is collected/accessed. **The Assignment:** – Explain the concept of a knowledge worker. – Define an…

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    **To Prepare:**
    – Review the concepts of informatics as presented in the Resources.
    – Reflect on the role of a nurse leader as a knowledge worker.
    – Consider how knowledge may be informed by data that is collected/accessed.
    **The Assignment:**
    – Explain the concept of a knowledge worker.
    – Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.
    – Include one slide that visually represents the role of a nurse leader as knowledge worker.
    – Your PowerPoint should Include the hypothetical scenario you originally shared in the Discussion Forum. Include your examination of the data that you could use, how the data might be accessed/collected, and what knowledge might be derived from that data. Be sure to incorporate feedback received from your colleagues’ responses.

  • [Solved] Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies

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    In-depth study guidance and analytical solution covering Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies.

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    Assignment Prompt & Instructions

    Full assignment prompt and step-by-step guidance are included in the downloadable solution file.

  • [Solved] Discussion Post

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    In-depth study guidance and analytical solution covering Discussion Post.

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    Assignment Prompt & Instructions

    Full assignment prompt and step-by-step guidance are included in the downloadable solution file.