NRNP 6675 WEEK 1 – PMHNP Across the Lifespan II
August 26, 2025
PRAC 6675 Week 1: Competencies of Advanced Nursing Practice
August 31, 2025
WEEK 2: Coding/Billing and Study PLAN
INTRODUCTION
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
Week 2: Assignment 1
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 case study patient. You will analyze the documentation to formulate DSM-5-TR diagnoses and ICD-10 coding. You will formulate a billing code for reimbursement of the case study. You will consider legal and ethical considerations for coding and billing. You will analyze and consider the documentation necessary to support accurate billing and coding procedures.
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
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 diagnoses, ICD-10, and reimbursement codes to services based on the patient case scenario.
Then, in 2-3 pages, address the following. You will add your narrative answers to these questions to the bottom of the case scenario document and submit them altogether as one document.
- What reimbursement billing code would you use for this session? Provide your justification for using this billing code.
- Explain what pertinent information is required in documentation to support your chosen DSM-5-TR diagnoses, ICD-10 coding, and billing code.
- Explain what pertinent documentation is missing from the case scenario and what other information would be helpful to narrow your coding and billing options. (There are at least 12 missing pertinent components of documentation).
- Discuss legal and ethical dilemmas related to overbilling, upcoding, and fraudulent practices. Propose 2 strategies for promoting legal and ethical coding and billing practices within your future clinical roles.
- Finally, explain how to improve documentation to support coding and billing for maximum reimbursement.
By Day 7 of Week 2
Rubric
| In the E/M patient case scenario provided: • Assign DSM-5-TR diagnoses and ICD-10 codes, and reimbursement codes to services based on the patient case scenario. Provides justifications | 20 to >17.0 pts Excellent 90%–100% DSM-5-TR diagnoses, ICD-10, and reimbursement codes assigned to the scenario are accurate. Response is justified and demonstrates critical thinking. 17 to >15.0 pts Good 80%–89% DSM-5-TR diagnoses, ICD-10, and reimbursement codes assigned to the scenario are mostly correct, with 1-2 minor errors. Response is justified but does not demonstrate critical thinking. 15 to >13.0 pts Fair 70%–79% Missing one of the DSM-5-TR diagnoses, ICD-10, or reimbursement codes assigned to the scenario; contains 2-3 significant errors. Justification is vague or inaccurate. 13 to >0 pts Poor 0%–69% Missing two or more DSM-5-TR diagnoses, and ICD-10, or reimbursement codes assigned to the scenario; contains 4+ errors, or response is missing. Missing Justification. | 20 pts |
| This criterion is linked to a Learning Outcome In 2-3 pages, address the following on the provided template: • Explain what pertinent information is required in documentation to support your chosen DSM-5-TR diagnoses, ICD-10 coding, and billing code. | 20 to >17.0 pts Excellent 90%–100% The response accurately and concisely explains what reimburse pertinent documentation information is required to support DSM-5-TR diagnoses and ICD-10 coding. 17 to >15.0 pts Good 80%–89% The response accurately explains what pertinent documentation information is required to support DSM-5-TR diagnoses and ICD-10 coding. 15 to >13.0 pts Fair 70%–79% The response somewhat vaguely or inaccurately explains what pertinent documentation information is required to support DSM-5-TR diagnoses and ICD-10 coding. 13 to >0 pts Poor 0%–69% The response vaguely or inaccurately explains what pertinent documentation information is required to support DSM-5-TR diagnoses and ICD-10 coding, or the explanation is incomplete or missing. | 20 pts |
| This criterion is linked to a Learning Outcome • Explain what pertinent documentation is missing from the case scenario, and what other information would be helpful to narrow your coding and billing options. (There are at least 12 missing pertinent components of documentation). | 15 to >13.0 pts Excellent 90%–100% The response accurately and concisely identifies the pertinent missing information from the case scenario and clearly identifies what additional information would narrow coding and billing options. Discusses at least 7 or more missing components of documentation. 13 to >11.0 pts Good 80%–89% The response accurately identifies the pertinent missing information from the case scenario and identifies what additional information would narrow coding and billing options. Discusses at least 4-6 missing components of documentation. 11 to >10.0 pts Fair 70%–79% The response somewhat vaguely or inaccurately identifies the pertinent missing information from the case scenario and identifies what additional information would narrow coding and billing options. Discusses at least 2-3 missing components of documentation. 10 to >0 pts Poor 0%–69% The response vaguely or inaccurately identifies the pertinent missing information from the case scenario or partially identifies what additional information would narrow coding and billing options, or this information is incomplete or missing. Discusses 1 or no conversation of missing components of documentation. | 15 pts |
| This criterion is linked to a Learning Outcome • Discuss legal and ethical dilemmas related to overbilling, upcoding, and fraudulent practices. Propose 2 strategies for promoting legal and ethical coding and billing practices within your future clinical roles. | 15 to >13.0 pts Excellent 90%–100% The response accurately and concisely explains legal and ethical dilemmas with 2 strategy proposals for future clinical practice. 13 to >11.0 pts Good 80%–89% The response accurately explains but is not concise in explanation of legal and ethical dilemmas with 2 strategy proposals for future clinical practice. 11 to >10.0 pts Fair 70%–79% The response somewhat vaguely or inaccurately explains legal and ethical dilemmas with 1 strategy proposal for future clinical practice. 10 to >0 pts Poor 0%–69% The response does not or vaguely, inaccurately explains either legal or ethical (not both) dilemmas with 1 or missing strategy proposals for future clinical practice. | 15 pts |
| This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. | 5 to >4.0 pts Excellent 90%–100% Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. 4 to >3.5 pts Good 80%–89% Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time…. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive. 3.5 to >3.0 pts Fair 70%–79% Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment are vague or off topic. 3 to >0 pts Poor 0%–69% Paragraphs and sentences follow writing standards for flow, continuity, and clarity <60% of the time…. Purpose statement, introduction, and conclusion were not provided. | 5 pts |
| This criterion is linked to a Learning Outcome • Finally, explain how to improve documentation to support coding and billing for maximum reimbursement. | 15 to >13.0 pts Excellent 90%–100% The response accurately and concisely explains how to improve documentation to support coding and billing for maximum reimbursement. 13 to >11.0 pts Good 80%–89% The response accurately explains how to improve documentation to support coding and billing for maximum reimbursement. 11 to >10.0 pts Fair 70%–79% The response somewhat vaguely or inaccurately explains how to improve documentation to support coding and billing for maximum reimbursement. 10 to >0 pts Poor 0%–69% The response vaguely or inaccurately explains how to improve documentation to support coding and billing for maximum reimbursement, or response may be incomplete or missing. | 15 pts |
| This criterion is linked to a Learning Outcome Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation | 5 to >4.0 pts Excellent 90%–100% Uses correct grammar, spelling, and punctuation with no errors 4 to >3.5 pts Good 80%–89% Contains 1-2 grammar, spelling, and punctuation errors 3.5 to >3.0 pts Fair 70%–79% Contains 3-4 grammar, spelling, and punctuation errors 3 to >0 pts Poor 0%–69% Contains five or more grammar, spelling, and punctuation errors that interfere with the reader’s understanding | 5 pts |
| This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for parenthetical/in-text citations and reference list. | 5 to >4.0 pts Excellent 90%–100% Uses correct APA format with no errors 4 to >3.5 pts Good 80%–89% Contains 1-2 APA format errors 3.5 to >3.0 pts Fair 70%–79% Contains 3-4 APA format errors 3 to >0 pts Poor 0%–69% Contains five or more APA format errors | 5 pts |
Week 2: Assignment 1
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.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
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. You will submit 2 documents: the previous NRNP 6665 study plan and your NRNP 6675 revised study plan.
By Day 7 of Week 2
Submit your previous NRNP 6665 study plan and revised NRNP 6675 study plan.
submission information
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
Rubric
NRNP_6675_Week2_Assignment2_Rubric
| Criteria | Ratings | Pts |
|---|---|---|
| This criterion is linked to a Learning Outcome Revise your study plan, summarizing your current strengths and opportunities for improvement. Uploads previous NRNP 6665 study plan to demonstrate revisions. | 25 to >22.0 pts Excellent 90%–100% The response provides an accurate, clear, and complete summary of revision for both current strengths and opportunities for improvement. Uploads NRNP 6665 study plan. 22 to >19.0 pts Good 80%–89% The response provides an accurate summary of revision for both current strengths and opportunities for improvement. Uploads NRNP 6665 study plan. 19 to >17.0 pts Fair 70%–79% The response provides a somewhat vague and/or inaccurate summary of revision for both current strengths and opportunities for improvement. Missing upload of NRNP 6665 student plan. 17 to >0 pts Poor 0%–69% A summary of revision for both the current strengths and opportunities for improvement are incomplete or missing. | 25 pts |
| This criterion is linked to a Learning Outcome 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. | 30 to >26.0 pts Excellent 90%–100% The response provides 3-4 new clear and appropriate SMART goals for the study plan, including tasks to complete to accomplish each goal. A clear timeline is provided for the study plan as well as a description of how progress toward goal completion will be measured. 26 to >23.0 pts Good 80%–89% The response provides 3-4 new appropriate SMART goals and objectives for the practicum experience. Appropriate tasks, timeline, and description of how progress will be measured are provided. 23 to >20.0 pts Fair 70%–79% The response provides 3-4 somewhat vague or general goals for the study plan. Tasks, timeline, and description of how progress toward goals will be measured are vague or somewhat inappropriate. 20 to >0 pts Poor 0%–69% The response provides 3-4 unclear or inappropriate goals for the study plan, or goals are missing. Tasks, timeline, and a description for how progress will be measured are incomplete or missing. | 30 pts |
| This criterion is linked to a Learning Outcome 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. | 30 to >26.0 pts Excellent 90%–100% The response provides a clear description of appropriate resources to support the study plan that are tailored to individual need. 26 to >23.0 pts Good 80%–89% The response provides a description of appropriate resources to support the study plan that are somewhat tailored to individual need. 23 to >20.0 pts Fair 70%–79% The response provides a description of general resources that are not tailored to individual need. 20 to >0 pts Poor 0%–69% The response provides a description of inappropriate resources to support the study plan, or the description of resources is vague or missing. | 30 pts |
| This criterion is linked to a Learning Outcome Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria. | 5 to >4.0 pts Excellent 90%–100% Paragraphs and sentences follow writing standards for flow, continuity, and clarity…. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. 4 to >3.5 pts Good 80%–89% Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time…. Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive. 3.5 to >3.0 pts Fair 70%–79% Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time…. Purpose, introduction, and conclusion of the assignment are vague or off topic. 3 to >0 pts Poor 0%–69% Paragraphs and sentences follow writing standards for flow, continuity, and clarity <60% of the time…. Purpose statement, introduction, and conclusion were not provided. | 5 pts |
| This criterion is linked to a Learning Outcome Written Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation | 5 to >4.0 pts Excellent 90%–100% Uses correct grammar, spelling, and punctuation with no errors 4 to >3.5 pts Good 80%–89% Contains 1-2 grammar, spelling, and punctuation errors 3.5 to >3.0 pts Fair 70%–79% Contains 3-4 grammar, spelling, and punctuation errors 3 to >0 pts Poor 0%–69% Contains five or more grammar, spelling, and punctuation errors that interfere with the reader’s understanding | 5 pts |
| This criterion is linked to a Learning Outcome Written Expression and Formatting – The paper follows correct APA format for parenthetical/in-text citations and reference list. | 5 to >4.0 pts Excellent 90%–100% Uses correct APA format with no errors 4 to >3.5 pts Good 80%–89% Contains 1-2 APA format errors 3.5 to >3.0 pts Fair 70%–79% Contains 3-4 APA format errors 3 to >0 pts Poor 0%–69% Contains five or more APA format errors | 5 pts |
Learning Resources/Required Readings
- American Psychiatric Association. (2024). CPT coding and reimbursement. https://www.psychiatry.org/psychiatrists/practice/practice-management/coding-and-reimbursement
- American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders. Section II. In Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.eduurl=https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787
- Buppert, C. (2021). Nurse practitioner’s business practice and legal guide (7th ed.). Jones & Bartlett Learning.
- Chapter 9, “Reimbursement for Nurse Practitioner Services”
- Chapter 9, “Reimbursement for Nurse Practitioner Services”
- Centers for Medicare & Medicaid Services. (2023). Medicare & mental health coverage. https://www.cms.gov/files/document/mln1986542-medicare-mental-health-coverage.pdf
- Centers for Medicare & Medicaid Services. (2023). Your billing responsibilities. https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/ProviderServices/Your-Billing-Responsibilities
- DeNisco, S. M. (2023). Role development for the nurse practitioner (3rd ed.). Jones & Bartlett Learning.
- Chapter 17, “Reimbursement for Nurse Practitioner Services” (pp. 403-427)
- Chapter 14, “Concepts and Challenges of the Professional Nurse Practitioner” (pp. 351-362)
- Chapter 15, “Health Policy and the Nurse Practitioner” (pp. 367-384)
- Chapter 16, “Mentoring and Lifelong Learning” (pp. 389-399)
- 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”
- Chapter 4 “Neuroanatomy, Physiology, and Mental Illness”
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