HITT 2208 - CPT/HCPCS, Outpatient Coding-Intermediate

Credit Hours: 2.00

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).
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, chargemaster, claims management, and bill reconciliation process.

 
OUTCOME 2: Upon completion of this course, students will be able to explain different reimbursement methodologies.
 
OBJECTIVES:

1. Apply policies and procedures for the use of clinical data required in reimbursement and prospective payment systems (PPS) in outpatient healthcare delivery.
2. Define and apply classification systems, such as APC’s, as required.
3. Support accurate billing through coding, chargemaster, 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 software, to ensure data collection, storage, analysis, and reporting of information.

1. Review of Modifiers
2. Case scenario practice for the following body systems
   1. Surgery - Integumentary
   2. Surgery - Musculoskeletal
   3. Surgery - Respiratory, Cardiovascular
   4. Surgery - Digestive
   5. Surgery - Urinary, Male Genital, Female Genital
   6. Surgery - Endocrine, Nervous, Eye, Auditory
   7. Radiology
   8. Pathology and Laboratory Services
   9. Evaluation and Management
   10. Medicine
   11. Anesthesia
3. HCPCS Level II
4. Reimbursement in the Ambulatory Setting
5. Charging