Evaluation and Management

NRNP_6675_Week2_Assignment1_Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning OutcomeIn 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 ptsExcellent 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 ptsGood 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 ptsFair 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 ptsPoor 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 OutcomeIn 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 ptsExcellent 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 ptsGood 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 ptsFair 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 ptsPoor 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 ptsExcellent 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 ptsGood 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 ptsFair 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 ptsPoor 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 ptsExcellent 90%–100%The response accurately and concisely explains legal and ethical dilemmas with 2 strategy proposals for future clinical practice.

13 to >11.0 ptsGood 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 ptsFair 70%–79%The response somewhat vaguely or inaccurately explains legal and ethical dilemmas with 1 strategy proposal for future clinical practice.

10 to >0 ptsPoor 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 OutcomeWritten 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 ptsExcellent 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 ptsGood 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 ptsFair 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 ptsPoor 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 ptsExcellent 90%–100%The response accurately and concisely explains how to improve documentation to support coding and billing for maximum reimbursement.

13 to >11.0 ptsGood 80%–89%The response accurately explains how to improve documentation to support coding and billing for maximum reimbursement.

11 to >10.0 ptsFair 70%–79%The response somewhat vaguely or inaccurately explains how to improve documentation to support coding and billing for maximum reimbursement.

10 to >0 ptsPoor 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 OutcomeWritten Expression and Formatting – English Writing Standards: Correct grammar, mechanics, and proper punctuation

5 to >4.0 ptsExcellent 90%–100%Uses correct grammar, spelling, and punctuation with no errors

4 to >3.5 ptsGood 80%–89%Contains 1-2 grammar, spelling, and punctuation errors

3.5 to >3.0 ptsFair 70%–79%Contains 3-4 grammar, spelling, and punctuation errors

3 to >0 ptsPoor 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 OutcomeWritten Expression and Formatting – The paper follows correct APA format for parenthetical/in-text citations and reference list.

5 to >4.0 ptsExcellent 90%–100%Uses correct APA format with no errors

4 to >3.5 ptsGood 80%–89%Contains 1-2 APA format errors

3.5 to >3.0 ptsFair 70%–79%Contains 3-4 APA format errors

3 to >0 ptsPoor 0%–69%Contains five or more APA format errors

5 pts