Effectiveness of documentation for APRN services

20^th Global Nursing Education Conference

March 21-23, 2018 | New York, USA

Lynn Rapsilber

NP Business Consultants, USA

Posters & Accepted Abstracts: J Nurs Care

Abstract :

It is every APRNs fiscal responsibility to understand the revenue stream within a practice. APRN education focuses on the clinical aspects of training and little on the business side of generating revenue for a practice by correct coding and documentation for APRN services. APRN documentation reflects what transpired during the rendering of service. Reimbursement for that service requires utilization of history, physical examination and medical decision-making occurring during the time of service. Knowledge of Current Procedural Terminology (CPT) provides documentation of â�?�?What was done?â�? This includes: procedures and office visit codes. International Classification of Disease (ICD-10) yields â�?�?Why it was done?â�? This includes classification of diseases and symptoms. The linkage of CPT and ICD-10 equals medical necessity. Lastly, evaluation and management documentation guidelines provide criteria for level of history, physical examination and medical decision-making performed to secure a billable for the APRN service. Without a thorough understanding in utilization of evaluation and management guidelines, documentation to support CPT and ICD-10 coding levels, practice revenue stream can be affected. When a service is under coded, the documentation provided actually supports a higher level of billable and causes a revenue loss. When a service is over coded, the service was overvalued for the documentation rendering and overcharge costing the practice financially, increasing potential liability. This project reviewed documentation based on billables for APRN services pre-intervention. Dissemination of best practices in coding, documentation and reimbursement occurred through a PowerPoint presentation. Evaluation of documentation of billables post intervention is still ongoing. APRNs that can accurately document and code their services bring value to a practice and add to the evidence base for the quality and cost-effectiveness of APRN care.

Biography :

Lynn Rapsilber has completed her Diploma in Nursing at St. Mary’s Hospital School of Nursing and BSN from University of Connecticut and MSN at University of Connecticut. She Graduated with a Doctorate in Nursing Leadership from Quinnipiac University, May 2016. She received the Benjamin and Juliette Trewin Award for Professional Leadership in Nursing. Her Portfolio Project “Reimbursement for Nurse Practitioner Services” was selected for presentation at the Eastern Nursing Research Society conference as a poster presentation. She recently received the Quinnipiac Transformational Nurse Leader Alumni Award for 2017 and was the keynote speaker at the DNP hooding ceremony. She is the Co-owner of NP Business Consultants, LLC providing dissemination of information regarding reimbursement for nurse practitioner and other health care provider services. She is recognized as an expert on coding and documentation for APRNs. She has presented at local, state and national forums. She is author and educator of NP students and seasoned NPs. She also serves as the Chair of the Connecticut Coalition of Advanced Practice Nurses. Under her leadership, full practice authority for APRNs in the state of Connecticut was attained with the passage of PA 14-12. She is the Connecticut State Representative for the American Association of Nurse Practitioners. She was bestowed induction as a Fellow in the American Association of Nurse Practitioners. She currently works as a GI Nurse Practitioner for Connecticut GI in Torrington, CT.