99212 or 99213? It's All Greek to Me! Teaching Coding and Billing to Advanced Practice Nursing Students

Introduction and Purpose: The coding and billing process is an integral part of the clinic work day for providers. Students feel lost and discouraged when faced with deciding the correct E & M for their patients as they are concentrating on providing quality care to their patients. Additionally, the coding and billing process is confusing at times to even the most experienced provider. It is essential for Advanced Practice Nursing students to have a firm grasp on the regulations and process involved with coding and billing. It is important that faculty provide students with the skill needed to analyze a patient visit in order to select the correct code for billing. Providing an easy to understand explanation of the process and a step by step systematic method to apply to each patient visit is an important skill to teach students. These skills will easily transfer to the clinic setting upon graduation to support the student during the transition from student to provider.

Approach:  PowerPoint presentations detailing each section of the Coding and Billing process were posted in the course for students to review prior to an in-class presentation.  The in-class presentation reviewed the highlights of each section to clarify many points of confusion.  Faculty then utilized five patient H & Ps to guide the students step by step through the decision making process to reach the correct E & M code. The rationale for determining why a particular code was used was addressed.  Following the presentation, students were provided with an H & P from the faculty. Using the same systematic method, the students coded the H & P and provided rationale for their E & M code.  The assignment was corrected and feedback provided to the students. The students then picked a patient from their own clinical practice and submitted an H & P with their E & M code and rationale for review by faculty.  Student clinical logs were also reviewed to ensure the correct E & M codes were used in the clinical setting.

Results: Student evaluations and feedback of the assignment will be reviewed.