Tidbits on Billing in Primary and Acute Care

Advanced Practice Registered Nurses (APRNs) must understand billing and coding to accurately document their work and maximize their value. There is an ongoing need for education in billing and coding, as new knowledge emerges each year. Audits and investigations for billing breaches can lead to fraud charges and penalties due to a lack of knowledge. This article will review the background of medical billing, discuss primary care Current Procedural Terminology codes and evaluation/management codes, and cover recent updates in the primary care setting. It will then review acute care billing, including the pediatric intensive care unit, inpatient setting, and emergency room. As employers increasingly evaluate APRNs' productivity and revenue, proper coding, billing, and revenue generation are crucial for demonstrating APRNs value in both outpatient and inpatient settings.