Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process.  Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.

The PICOT question will provide a framework for your capstone project change proposal.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Describe the problem in the PICOT question as it relates to the following:

1. Evidence-based solution
2. Nursing intervention
3. Patient care
4. Health care agency
5. Nursing practice

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Assignment 1: Evaluation and Management (E/M)

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 patient and perform a crosswalk of codes from DSM-5 to ICD-10. 

Photo Credit: Getty Images/Tetra images RF

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 and ICD-10 codes to services based upon the patient case scenario. 

Then, in 1–2 pages address the following. You may add your narrative answers to these questions to the bottom of the case scenario document and submit altogether as one document.

• Explain what pertinent information, generally, is required in documentation to support DSM-5 and ICD-10 coding.
• Explain what pertinent documentation is missing from the case scenario, and what other information would be helpful to narrow your coding and billing options.
• Finally, explain how to improve documentation to support coding and billing for maximum reimbursement.   

1st page- Cover page

2nd page- Abstract (include what is the purpose of this project) 

3rd page- Answering the following questions:

Describe the differences among a sole proprietorship, partnership, and corporation.

1.    Identify the major disadvantage of a sole proprietorship or a partnership.

2.    How does a corporation differ from a partnership?

3. What conflicts exist when a MCO provides bonuses to physicians for providing fewer tests?

4th page- References

APA citation is required.

Chapter Overview

Chapter 1 covers a lot of ground and sets the stage for the rest of the text. The premise of this text is that the health care industry is a big business and what medical office professionals do on the frontline matters. Students’ understanding of the laws and issues related to working in a medical office will help them protect patients, their employers, and themselves from unnecessary risks.

The scope of practice is a foundational issue discussed in Chapter 1. Because both state and federal law regulate the practice of medicine, it is necessary for students to be aware that there is an assortment of statutes and regulations that define the procedures they will be permitted to perform. This chapter also features discussion of the standard of care for medical professionals and laypersons and what it means to be a medical assistant.

Technical aspects of the law are useful for medical office professionals so they can understand the business aspects of working in a medical office. That is why this chapter includes discussion of the several types of legal entities, such as corporations, limited liability companies, and sole proprietorships, among others.

Another foundational issue is managed care organizations (MCOs), including HMOs, PPOs, and ACOs. It will be necessary for students to be familiar with the many facets of MCOs, including the focused objectives of reducing costs and delivering quality health care.

And, finally, this chapter features a discussion about telemedicine as an alternative health care delivery system that has become increasingly commonplace. The use of telemedicine is still in its infancy, but it has the potential to dramatically change the practice of medicine. Your students will learn that telemedicine is one more example of how health care has become big business.

 

Remember to submit your work following the file naming convention FirstInitial.LastName_M01.docx. For example, J.Smith_M01.docx. Remember that it is not necessary to manually type in the file extension; it will automatically append.

Start by reading and following these instructions:

1. Quickly skim the questions or assignment below and the assignment rubric to help you focus.

2. Read the required chapter(s) of the textbook and any additional recommended resources.  Some answers may require you to do additional research on the Internet or in other reference sources.  Choose your sources carefully.

3. Consider the discussion and any insights you gained from it.

4. Create your Assignment submission and be sure to cite your sources, use APA style as required, check your spelling.

Assignment:

1. Locate an article that discusses a bioethics issue. First, provide a summary of the article and the bioethics issue being presented. Next, discuss what ethical actions the nurse should take in relation to the issue being presented. Also, discuss possible legal issues that the nurse should be aware of. This section should include at least 1 outside reference and your textbook and should be at least 1 ½ pages long.

2. Analyze the following case study and then answer the following questions:

You are working on the Operating Room and the trauma alert goes off. You respond to the ER to provide support. Once in the ER, you receive report that an 89 year old male is coming in with a self-inflicted GSW (Gun Shot Wound) to the head.  You listen to the radio traffic between the ER and ambulance to get an idea what kind of surgery you need to set up for and what will be needed as far as lines and fluid.  Here is the report:

HR: 121

B/P: 60/45

Saturation: 93%

Patient is intubated and non-responsive. Right pupil is fixed and dilated. Paramedic also states there is a large extended family headed to the ER. The patient lost his wife of 60 years 1 week ago and left a note stating that he is too heartbroken to go on. The patient and family arrive. The neurosurgeon discusses that their father’s potential outcome, even with surgery, is not good. The family still insists that the neurosurgeon complete the surgery.

1. What are the ethical and legal issues in this case study. Be specific and support your response with references

Once you have the patient in the room and you are prepped and ready for surgery, the phone rings. You receive word that the patient signed DNR orders two days ago.

1. As the OR nurse what are your legal and ethical issues now? Was the patient of sound mind when he signed this order? Do you honor the DNR or the family’s wishes? Explain and support your response.  

Your response to this case study should be at least 2 pages and include 2 outside references and your textbook.

Please submit one paper which includes both assignments.

There are 2 discussions: Topic 1 & Topic 2 (They both require references please) 

Discussion Topic 1: Third-party Payment 

How does third-party payment distort the market for health care? If it is so distorted why does every wealthy country insist on using third-party intermediaries to purchase health care? Why do we carve out a separate payment program for our elder citizens? 

Discussion Board:  Minimum 200 words, APA Style, Time New Roman,  Font 12,   (3 references- in text citations) not older than (2012-2017). No Plagiarism 

please.

Discussion Topic 2: Medicaid and Medicare 

Summarize ways in which health insurance fails, as people get older. Distinguish between Medicaid and Medicare. Determine whether your state has expanded Medicaid. Why would states choose not to participate in Medicaid expansion?  

Discussion Board:  Minimum 200 words, APA Style, Time New Roman,  Font 12,   (3 references- in text citations) not older than (2012-2017). No Plagiarism please