Course
Prefix/Number: ALHT 130
Course
Title: Introduction
to Medical Coding
Division: Outreach and Workforce Development
Program: Health
Information Technology
Credit
Hours: 3.0
Initiation/Revised
Date: Fall
2007
CLASSIFICATION OF
INSTRUCTION
This
course prepares students for entry level positions in a physician’s office or
other medical facility. The focus of this
class is learning the coding rules for the Current Procedural Terminology (CPT), International Classification of Diseases, 9th
Revision, Clinical Modification
(ICD-9-CM), and Level II (HCPCS) coding systems and then applying the rules to
code patient services. Students will need CPT and ICD-9-CM manuals for the course.
PREREQUISITIES AND/OR
COREQUISITES:
None
REQUIRED
TEXTBOOKS:
CPT/HCPCS Coding and
Reimbursement for Physician Services, 2007 edition, Kuehn, AHIMA. ISBN/ISSN: 1-58426-175-7
Current Procedural Terminology. American Medical Association,
Current year edition.
ICD-9-CM, Volumes 1 and 2, Current year
edition.
HCPCS
Level I, Current year edition.
RECOMMENDED
TEXTBOOKS:
Course
Study Guide, NCCC. Current semester edition.
COURSE OUTCOMES/COMPETENCIES (as
Required)
Demonstrate an understanding
of CPT coding manual in order to assign valid procedure codes.
Competencies:
A. Identify
the purpose of the CPT manual.
B. Identify
placement of CPT codes on CMS-1500 insurance form.
C. Recognize
the symbols used in the CPT manual.
D. List
the major sections found in the CPT manual.
E. Interpret
information in section Guidelines and notes.
F. Apply
modifiers.
G. Determine
when to assign unlisted and Category III codes.
H. State
the purpose and contents of a special report.
I. Locate
terms in the CPT index.
J. Identify content of CPT appendices.
Outcome II:
Demonstrate an understanding
of coding and classification systems in order to assign valid evaluation and
management CPT procedure codes (Evaluation and Management codes 99201-99499).
Competencies:
A.
Identify and explain the three
factors of E/M code assignment.
B.
Analyze the differences among new,
established, inpatient, and outpatient.
C.
Explain the levels of E/M service.
D.
Analyze the key component and
contributing factors.
E.
Identify critical elements of
Documentation Guidelines.
F.
Distinguish between professional
and facility services.
G. Assign E/M codes to services and
procedures.
Outcome III:
Demonstrate an understanding of coding and
classification systems in order to assign valid CPT procedure codes (Anesthesia codes 00100-01999).
Competencies:
A.
Define uses of anesthesia.
B.
Apply anesthesia formula.
C.
Understand separate procedure
designation.
D.
Analyze the contents of a surgical
package.
E.
Understand what is meant by a
surgical tray.
F. Assign Surgery codes to
services and procedures.
G. Assign Anesthesia codes to services and
procedures.
Outcome IV:
Demonstrate an understanding
of coding and classification systems in order to assign valid CPT procedure
codes (Pathology and Laboratory codes 70000-99602).
Competencies:
A. Assign Pathology and Laboratory codes to
services and procedures.
B. Understand the use of
venipuncture with pathology and laboratory services.
C. Demonstrate an understanding of radiology
terminology.
D. Analyze the elements of component coding
in reporting radiology services.
E.
State the appropriate coding of
contrast material.
F. Assign Radiology codes to services and
procedures.
G. Assign Medicine codes to services and
procedures.
H. Define a facility indicator.
I. Understand the coding of immunizations.
Outcome V:
Demonstrate an understanding
of coding and classification systems in order to assign valid CPT procedure
codes (Surgery/Integumentary/Musculoskeletal/Respiratory/Cardiology/ Digestive/
Urinary/Male and Female Genital/Nervous/Eye and Ocular codes 10000-69999).
Competencies:
A.
Identify the major factors in wound
repair.
B. Calculate area and degree of burns.
C. State the important coding considerations
in destruction.
D. Differentiate among fracture treatments.
E. Understand elements of endoscopic
procedures.
F. Analyze cast application, strapping
procedures, and traction.
G. Differentiate among codes based on the
surgical approach.
H. State the coding rules of arteries and
veins.
I. Define the critical terms in maternity
and delivery services.
G. Analyze services in the global maternity
and delivery package.
Outcome VI:
Demonstrate an
understanding of coding and classification systems in order to assign valid
ICD-9-CM diagnostic codes.
Competencies:
A. List the uses of the ICD-9-CM.
B. Explain ICD-9-CM coding conventions.
C. Identify the characteristics of ICD-9-CM
Volume 2.
D. Identify the characteristics of ICD-9-CM
Volume 1.
E. Identify the characteristics of ICD-9-CM
Volume 3.
F. List the developers of the ICD-9-CM
Official Coding Guidelines.
G. Understand the application of the
ICD-9-CM Official Coding Guidelines.
H. Define the steps to ICD-9-CM diagnosis
coding.
I. Assign ICD-9-CM codes to various
diagnosis statements.
J. Understand the format of the ICD-10-CM.
AHIMA DOMAINS
Domain 1: Health Data Management.
Subdomain A: Health Data Structure,
Content and Standards
3. Apply clinical
vocabularies and terminologies used in the organization’s health
information systems.
5. Very
timeliness, completeness, accuracy, and appropriateness of data and data
sources
(e.g., patient care;
management; billing reports and/or databases)
Subdomain C: Clinical Classification Systems
1.
Use and monitor
applications and work processes to support clinical classification and coding
2.
Apply
diagnosis/procedure codes using ICD-9-CM
3.
Apply procedure
codes using CPT/HCPCS
4.
Ensure accuracy
of diagnostic/procedural groupings (e.g., APC; DRG/IPF)
5.
Adhere to current
regulations and established guidelines in code assignment
6.
Validate coding
accuracy using clinical information found in the health record
7.
Identify
discrepancies between coding data and supporting documentation
Subdomain D: Reimbursement Methodologies
1. Apply policies
and procedures for the use of clinical data required in reimbursement and
prospective payment systems (PPS) in healthcare delivery (e.g., APC,; DRG; RVU;
RBRVS)
2. Support accurate revenue cycle through:
a. Coding
3. Use established guidelines to comply with
reimbursement and reporting requirements (e.g., National Correct coding
Initiative [NCCI]; Local Medical Review Policies[LMRP])
Domain 2: Health Statistics,
Biomedical Research and Quality Management
Subdomain A: healthcare Statistics and
Research
1. Abstract and maintain data for clinical
indices/databases/registries
Domain 3: Health Services
Organization and Delivery
2. Apply policies
and procedures to comply with the changing regulations among various payment
systems for healthcare services such as Centers for Medicare and Medicaid
Services (CMS), managed care
Domain 4: Information
Technology Systems
Subdomain A: Information and Communication
Technologies
3. Use specialized
software in the completion of HIM processes (e.g., chart management; coding;
release of information)
Domain 5: Organizational
Resources
Subdomain B: Financial and Physical
Resources
3. Monitor coding
and revenue cycle processes
A. Introduction
to the CPT Manual
B. Evaluation
and Management (E/M) Section
C. Anesthesia
Section and Modifiers
D. Introduction
to the Surgery Section and Integumentary System
E.
Musculoskeletal System
F. Respiratory
System
G.
Cardiovascular System
H. Female
Genital System and Maternity Care and Delivery
I. General
Surgery I
J. General Surgery II
K. Radiology
Section
L.
Pathology/Laboratory
M. Medicine
Section and the Level II National Codes
II. International Classification
of Diseases, 9th Revision, Clinical Modification (ICD-9-CM)
A. An Overview of the ICD-9-CM
B. Using the ICD-9-CM
SCHEDULE
This class meets online for
weekly learning units. The class materials
for each unit will be available for a minimum of eight days, starting
___________________ and ending _____________________.
|
Week |
Topic/Exam |
Readings/Activities |
|
1 |
Introduction to the CPT
Manual |
Assignments |
|
2 |
Evaluation
and Management (E/M) Section |
Assignments |
|
3 |
Anesthesia
Section and Modifiers |
Assignments |
|
4 |
Introduction
to the Surgery Section and Integumentary System |
Assignments |
|
5 |
Musculoskeletal
System |
Assignments |
|
6 |
Respiratory
System |
Assignments |
|
7 |
Cardiovascular System |
Assignments |
|
8 |
Female Genital System and
Maternity Care and Delivery |
Assignments |
|
9 |
General Surgery I |
Assignments |
|
10 |
General
Surgery II |
Assignments |
|
11 |
Radiology
Section |
Assignments |
|
12 |
Pathology/Laboratory |
Assignments |
|
13 |
Medicine Section and the
Level II National Codes |
Assignments |
|
14 |
An Overview of the ICD-9-CM
& Using the ICD-9-CM |
Assignments |
|
15 |
Final |
Final |
The instructional methods used include internet lecture, CD Activities, workbook completion, group assignments, and collaborative projects. Students will be required to complete reading assignments, chapter reviews, case studies, participate in threaded discussions with other classmates on topics determined by instructor, complete assignments and examinations of knowledge, and demonstrate skill competency using a specific internet platform. Students must participate in all activities, as well as accurately complete assignments and examinations within the internet platform in a timely manner. Therefore it is imperative that students have a reliable internet provider, computer hardware, and email address to succeed in this course.
Evaluation
is directly related to the performance objectives.
Performance
is measured by examination, assignments, and/or quizzes.
The
letter grade is based on the percentage of the total weighted points earned
throughout the semester based on the following scale:
A = 90
to 100%
B = 80
to 89%
C = 70
to 79%
D = 60
to 69%
F = 59%
and below
Seventy-five
percent of the final grade is based on chapter tests that evaluate knowledge of
the text information and ability to code patient services. Ten percent or five
points (which is the greater) will be deducted from each examination score that
is not completed by its due date. This rule reinforces the need for on-time
performance. Any make-up examination must be completed within 7 days of the
scheduled examination or no points will be awarded for the examination.
Twenty-five percent of the final grade is based on comprehensive final examination
scheduled during the semester’s designated finals week. Further details and information will be
provided closer to time of exam.
ATTENDANCE POLICY
Absences that occur due to students participating in official
college activities are excused except in those cases where outside bodies, such
as the State Board of Nursing, have requirements for minimum class minutes for
each student. Students who are excused will be given reasonable opportunity to
make up any missed work or receive substitute assignments from the instructor
and should not be penalized for the absence.
Proper procedure should be followed in notifying faculty in advance of
the student’s planned participation in the event. Ultimately it is the student’s responsibility
to notify the instructor in advance of the planned absence.
Unless students are participating in a school activity or are excused by the instructor,
they are expected to attend class. If a
student’s absences exceed one-hundred (100) minutes per credit hour for the
course or, in the case of on-line or other non-traditional courses, the student
is inactive for one-eighth of the total course duration, the instructor has the
right, but is not required, to withdraw a student from the course. Once the student has been dropped for
excessive absences, the registrar’s office will send a letter to the student,
stating that he or she has been dropped.
A student may petition the chief academic officer for reinstatement by
submitting a letter stating valid reasons for the absences within one week of
the registrar’s notification. If the
student is reinstated into the class, the instructor and the registrar will be
notified.
ASSESSMENT OF STUDENT GAIN
Student
gain will be determined by student improvement in each of the areas of student
competencies.
ACADEMIC INTEGRITY
NCCC expects every student to demonstrate ethical behavior with regard to
academic pursuits. Academic integrity in
coursework is a specific requirement.
Definitions, examples, and possible consequences for violations of
Academic Integrity, as well as the appeals process, can be found in the College
Catalog, Student Handbook, and/or Code of Student Conduct and Discipline.
CELL PHONE POLICY
Student cell phones and
pagers must be turned off during class times. Faculty may approve an exception
for special circumstances.
·
NOTE: If you are a student with a disability
who may need accommodation(s) under the Americans with Disabilities Act (ADA),
please notify the Director of Advising
and Counseling, Chanute Campus, Student Union, 620-431-2820 ext 280
or the Dean, Ottawa Campus,
785-242-2607 ext 312, as soon as possible.
You will need to bring your documentation for review in order to
determine reasonable accommodations, and then we can assist you in arranging
any necessary accommodations.
· The Director of Advising and Counseling in now located in the Student Union on the Chanute Campus.
· The Assistant Dean’s phone extension on the Ottawa campus is 305.
Note: Information
and statements in this document are subject to change at the discretion of
NCCC. Changes will be published in
writing and made available to students.