Billing and Coding for Nurse Practitioners: Office Visits (Tutorial with Examples)

Billing and coding your office visits for for your office visits can feel overwhelming, tedious and too-hard-to-learn
But one under-charge here and there may not seem like much, but when you add them all up...
In this week's video, though, I'm breaking it down SUPER simply (with a cheat sheet!)
Plug the data in and out pops the right E&M code to use.
You'll learn:
- How to accurately bill for new and established office visits (primary care only!)
- The key differences between level 3&4 (and the most common pitfall I see!)
- A few patient examples to apply it to (and a walk-through of the plug-and-go cheat sheet)
Download the cheat sheet here: www.realworldnp.com/026-opt-in
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Don't forget to grab your free Ultimate Resource Guide for the New NP at www.realworldnp.com/guide
More Resources:
Lab Interpretation Crash Course: www.realworldnp.com/labs
Digital NP Binder: www.realworldnp.com/binder
Diabetes Medication Workshop: www.realworldnp.com/diabetes
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Come follow along for even more tips and inspiration:
Instagram: / realworldnp
Facebook: / realworldnp

[@anniesstudiothemakersofall4395]

I sure appreciate this video. We need more like it. I don't think we discuss charting enough. Thank you!!!

[@RealWorldNP]

You're welcome!!

[@oo3xstrongoo]

Your service is so valuable! I often find myself looking at your videos for refreshers/updates. Thank you for your contributions to our community. Most appreciated. CRNP- Pennsylvania

[@RealWorldNP]

Thank you so much - we appreciate the kind words!

[@shellyprichard809]

FINALLY! I understand this and feel more confident billing! You ROCK!

[@RealWorldNP]

Awesome!! You're welcome!

[@tiffmarie5128]

Yes!!!! You read my mind! Needed this!

[@RealWorldNP]

Yay!!!

[@letrinh7931]

Thank you for your Video Liz, please make more. I'm starting work next week and can not wait to use my CME money to support you. Please make a video on common medications in the primary care settings and their adverse effects.

[@RealWorldNP]

I will add to the list! Thank you!

[@tanyamvaughn]

This is very helpful! I do not think that we get enough coding and billing throughout school. I think that some try really hard to add it to the curriculum however it seems fractionated and hard to understand. This video makes sense and explains what is needed to be able to bill appropriately. Thank you!

[@RealWorldNP]

Glad it was helpful!

[@isakelockettholloway4367]

Thnak you so much, this is so valuable!

[@RealWorldNP]

You're so welcome!!

[@ceiaraburchett6027]

Can you do a comparison with the new 2021 guidelines? Thank you for all the videos you make! I also have the NP binder! 😊

[@RealWorldNP]

I am adding that to my list - thanks for supporting and giving us your thoughts!

[@theresavanderheiden2733]

Found the sheets! Thank you

[@RealWorldNP]

Great! Thank you!

[@dkibwage]

needed this thank you

[@RealWorldNP]

You're so welcome!

[@kendrakells4300]

Thank you !

[@RealWorldNP]

You're welcome!

[@michellewoocoad9511]

Loved this!! Esp as a new NP. Question for you, APEA has a billing & coding guide, and wanted to get your thoughts on this, if it’s good for new NPs, not...I’m nervous to code for billing when I start later this month

[@RealWorldNP]

Hey! I haven't actually taken that guide myself unfortunately. Depending on the practice type you're in, you may get more guidance than others directly from the billing department, like if you're doing too many low codes or high codes, and a lot of time they'll also orient you to it as you start!

[@bethanymichaelis]

Could you do an update video on billing and coding for the new 2021 cms guidelines? 😊

[@RealWorldNP]

It's been added to our to do list!

[@michaelthey7330]

Thank you very much for your helpful cheat sheet.

[@RealWorldNP]

You're welcome.

[@unapologetically_me]

This is awesome, have they updated this recently?

[@RealWorldNP]

Yes! I did another video here: kzbin.info/www/bejne/ameumIFrr66brqM

[@alyssaedwardson7054]

Hi there! Thank you so much for all you do!! Where May I find the cheat sheets? Thanks again!!!

[@RealWorldNP]

Hi! The link is in the description. For Billing and Coding, the link is: www.realworldnp.com/026-opt-in. Thanks!

[@genillreynoso2396]

Can you do a video on prescribing antidepressants? :)

[@RealWorldNP]

Great topic idea!! I'll add it to the queue :) Also -- I post lots of tips over in instagram/facebook if you want to check it out. Instagram.com/realworldnp and facebook.com/realworldnp

[@sixthangel9716]

Thank you. Do you have a video on 1099 and per patient reimbursement?

[@RealWorldNP]

Hi! We have not, but our friends at The Resume Rx may have some info on that. Check Amanda out here: www.theresumerx.com/podcast/. I hope that helps!

[@susanrice4003]

Thank you for this helpful video! I would love to download the resource, but I can't seem to locate the link.

[@RealWorldNP]

Thank you! We have updated the link for the sheet here: www.realworldnp.com/026-opt-in

[@isura1493]

I was viewing your billing segment on KZbin and wondered if an NP could bill for therapeutic touch or lymphedema therapy. I ask because I know nurses do therapeutic touch in some hospitals, but I don't know if it can be billed in private practice. I'm a nurse practitioner, but I also have a background as a state-licensed medical massage therapist. In some instances, I would love to combined therapeutic touch and lymphedema therapy for patients suffering from diseases like lymphedema or fibromyalgia. Your feedback is most appreciated.

[@RealWorldNP]

Hey that's a great question! Unfortunately, I'm not quite sure! I'm not well versed in the procedural CPT codes, but that's the place I would look to see if there's a specific procedural CPT code for that service!

[@bethherbert1656]

Can you make an updated one with the new guidelines?

[@RealWorldNP]

It's added to the list! Thanks!

[@PunmasterSTP]

Billing for NPs? More like “Thrilling if you can make more money!” Thanks for sharing these tips.

[@RealWorldNP]

You're so welcome!

[@leticiab503]

Hi How do you code If you do a physical exam and it is the z00.001 (abnormal findings ) how can you code or add modifiers for the extra time in addition to the physical exam ? for instance for a regular visit you do modifier 25 and depending on how extensive you do 99214 or 99213 But how would you code having a long visit for a physical with abnormal findings inside of the physical visit ? 45 min visit ? 3-4 extra diagnosis ?

[@RealWorldNP]

These are great questions Leticia! I'll have to make another updated Billing and Coding video to address these!

[@leticiab503]

@@RealWorldNP thanks dear just something I came a cross

[@totoro3124]

Hi, can we also have a link for the table of risk please? Thank you.

[@RealWorldNP]

The link to get the cheat sheet is listed in the description - the sheet has info about billing and coding, as well as the table of risk.

[@totoro3124]

@@RealWorldNP Hi Liz, I was only able to access the other cheat sheet but not the table of risk. Was the table of risk paid?

[@farzanagilani6771]

what about covid testing, screening and FU with education and symptom management

[@RealWorldNP]

My video tomorrow, Tuesday, 3/2, is all about post covid symptoms. Check it out!

[@shellyprichard809]

where do I get the cheat sheet below? I do not see it. Thanks!

[@RealWorldNP]

Hi, You can find the cheat sheet over on the blog - realworldnp.com

[@isura1493]

I was wondering if elements are still counted for 2021 for Medicare?

[@RealWorldNP]

So I just made an updated video about the 2021 guidelines so definitely check that out, but the new one says "history and physical only as medically necessary," but isn't crystal clear about whether or not those elements are still counted piece by piece the way they were before, so I'm still documenting in that way out of habit.

[@cloudten3220]

Where can I find these tables you are going over in the video?

[@RealWorldNP]

www.realworldnp.com/026-opt-in click here to access it!

[@jegreen4227]

I downloaded the first and 2nd pages with the different code categories, but didn't see where to download the sheet with the categories- low, moderate and high. anyone know?

[@RealWorldNP]

Hi! Email us at [e-mail] and we can re-send the sheet for you

[@raymareyes]

How long should new np orientation be?

[@RealWorldNP]

That's a great question,and I may have to make a video about it. It depends on the NP, the clinical site and the type of practice. I had about 2 weeks of shadowing, followed by 6 patients a day with my supervisor and colleagues available close by so I felt supported, although still terrified. Definitely check out the 3 tips for new NP survival, I talk about it a bit more there: kzbin.info/www/bejne/l6GkZaalmbl1Y9k

[@raymareyes]

@@RealWorldNP that it is awesome , I went to an interview where they offer shadowing but not on payroll :(

[@happyv268]

I can’t see the cheat sheet anymore for some reason :/

[@RealWorldNP]

Send us an email at [e-mail] and we can send you one!

[@happyv268]

@@RealWorldNP thank you so very much!!

[@barbararodenius528]

I don't see the notes to download.

[@RealWorldNP]

Download the cheat sheet here: www.realworldnp.com/026-opt-in

[@DarkAvenger1234]

you need to tone down that ring light.

[@RealWorldNP]

Thanks - that's an older video and I have changed the lighting since then!

[@theresavanderheiden2733]

Trolling....