HITT 2106 - CPT/HCPCS & Outpatient Coding

Prerequisite: Admission into Health Information Technology Program and HITT-1201 with grade C or better

Prerequisite: Admission into Health Information Technology Program and HITT-1209 with grade C or better

Prerequisite: Admission into Health Information Technology Program and HITT-1210 with grade C or better

Prerequisite: Admission into Health Information Technology Program and HITT-1211 with grade C or better

Corequisite: HITT-2105
Corequisite: HITT-2108

Objectives:

1. Use and maintain electronic applications and work processes to support clinical classification and coding.
2. Apply procedure codes using Current Procedural Terminology CPT/Healthcare Common Procedure Coding System (HCPCS).
3. Adhere to current regulations and established guidelines in code assignment.
4. Use and maintain applications and processes to support other clinical classification and nomenclature systems (such as ICD‐10‐ CM, SNOMED, and so on).
5. Validate coding accuracy using clinical information found in the health record.
6. Resolve discrepancies between coded data and supporting documentation.
7. Apply and promote ethical standards of practice.
8. Support accurate billing through coding, charge master, claims management, and bill reconciliation process.

Outcome 2: Upon completion of this course, students will be able to differentiate different reimbursement methodologies.

Objectives:

1. Apply policies and procedures for the use of clinical data required in reimbursement and prospective payment systems (PPS) in healthcare delivery.
2. Define and apply classification systems, such as DRGs, as required.
3. Support accurate billing through coding, charge master, claims management, and bill reconciliation process.
4. Use established guidelines to comply with reimbursement and reporting requirements such as the National Correct Coding Initiative.
5. Compile patient data and perform data quality reviews to validate code assignment and compliance with reporting requirements such as outpatient prospective payment systems.

Outcome 3: Upon completion of this course, students will be able utilize information and communication technologies.

Objectives:

1. Use specialized software in the completion of HIM processes such as record tracking, release of information, coding, grouping, registries, billing, quality improvement, and imaging.
2. Use technology, including hardware and so ware, to ensure data collection, storage, analysis, and reporting of information.

1. Application to CPT Coding
2. Application of the CPT System
3. Modifiers
4. Surgery - Integumentary
5. Surgery - Musculoskeletal
6. Surgery - Respiratory, Cardiovascular
7. Surgery - Digestive
8. Surgery - Urinary, Male Genital, Female Genital
9. Surgery - Endocrine, Nervous, Eye, Auditory
10. Radiology
11. Pathology and Laboratory Services
12. Evaluation and Management
13. Medicine
14. Anesthesia
15. HCPCS Level II
16. Reimbursement in the Ambulatory Setting