MEA 131 MEDICAL CODING II (CPT/HCPCS)

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1 MEA 131 MEDICAL CODING II (CPT/HCPCS) PRESENTED FEBRUARY 3, 2012 EFFECTIVE FALL

2 Prefix & Number MEA 131 Course Title: Medical Coding II- CPT/HCPCS Purpose of this submission: New Change/Updated Retire If this is a change, what is being changed? Update Prefix Course Description Splitting the current MEA 140 into two classes. Title Course Number Currently students need to complete 31 chapters Format Change Credits in a 16 week course. This will not be possible with Prerequisite Competencies the new ICD CM conversion. Textbook/Reviewed Competencies-no changes needed Does this course require additional fees? No Yes If so, please explain. Is there a similar course in the course bank? No Yes (Please identify) Articulation: Is this course or an equivalent offered at other two and four-year universities in Arizona? No Yes (Identify the college, subject, prefix, number and title: Is this course identified as a Writing Across the Curriculum course? No Yes Course Textbook, Materials and Equipment Textbook(s) Current edition Title Author(s) Publisher Title Author(s) Publisher Step by Step Medical Coding Carol Buck Saunders Step by Step Medical Coding Workbook Carol Buck Saunders Software/ Equipment Current edition of CPT-4, HCPCS, ICD-10 (9)-CM manuals Course Assessments Description of Possible Course Assessments (Essays, multiple choice, etc.) Exams standardized for this course? Midterm Final Other (Please specify): Where can faculty members locate or access the required standardized exams for this course? (Contact Person and Location) Example: NCK Academic Chair Office Student Outcomes: Identify the general education goals for student learning that is a component of this course. Frequent quizzes and/or exams are highly encouraged to assess the student s comprehension. Quizzes and exams may be given in any format, while keeping in mind that the certification exam is in a multiple choice format. Practical exams are also encouraged to assess the student s ability to perform skills required to function within the medical facility. Are exams required by the department? No Yes If Yes, please specify: Instructors may write their own quizzes and/or exams which assess the student s mastery of the competencies for this course

3 Check all that apply: 1. Communicate effectively. a. Read and comprehend at a college level. b. Write effectively in a college setting. 2. Demonstrate effective quantitative reasoning and problem solving skills. Method of Assessment Selection of proper codes Homework, exams, CMS-1500 work 3. Demonstrate effective qualitative reasoning skills. Homework, exams, CMS-1500 work 4. Apply effective methods of inquiry. a. Generate research paper by gathering information from varied sources, analyzing data and organizing information into a coherent structure. b. Employ the scientific method. 5. Demonstrate sensitivity to diversity a. Experience the creative products of humanity. b. Describe alternate historical, cultural, global perspectives. Office of Instruction Use only: CIP Code: ONET Code: Minimum Qualifications:

4 COURSE INFORMATION Initiator: Lori Hogue, Lori Howell, Carol Elledge Date of proposal to Curriculum Sub-Committee: February 3, 2012 Effective Semester/Year Fall 2012 Spring Summer Prefix & Number: MEA 131 Full Title: (100 character limit) Medical Coding II Short Title: (30 character limit) Catalog Course Description: Provides a continuation of the MEA 140 course of medical coding using CPT-4, ICD-10 (9)-CM and HCPCS manuals and insurance reports as applied to the medical office. This course emphasizes the CPT-4 and HCPCS codes used for procedure coding within the medical facility. SUN Course Number: Credit Hours: 3.0 Lecture Hours: 3.0 Lab Hours: 0.0 Prerequisite(s) HES 113, HES 129, MEA 140, TRE 089, PCS 021 or Appropriate COMPASS score Co-requisite(s) MEA 130 Intended Course Goals By the end of the semester, students will be able to: 1. Apply basic anatomy and physiology to coding procedures in the medical office 2. Recognize the purpose and roles of the coding process in the medical field 3. Properly identify the different purpose of the CPT-4, ICD-10 (9)-CM, and the HCPCS codebooks 4. Apply appropriate codes to corresponding documents

5 Course Competencies and Objectives By the end of the semester, students will be able to: Competency 1 Discuss the purpose and organization of the CPT manual Objective 1.1 Identify the uses of the CPT manual Objective 1.2 Articulate the importance of using the current year CPT-4 manual Objective 1.3 Recognize the symbols used in the CPT-4 manual Objective 1.4 List the major sections found in the CPT Manual Objective 1.5 Interpret the information contained in the section guidelines and notes. Objective 1.6 Identify placement of CPT codes on the CMS-1500 forms Objective 1.7 Identify and describe the text change symbols used in the CPT manual Objective 1.8 Distinguish between professional and facility services. Objective 1.9 Describe what is meant by unlisted procedures/services Objective 1.10 state the purposes of a special report Objective 1.11 Review Category II and III CPT codes. Objective 1.12 Locate the terms in the CPT index. Objective 1.13 List the major features of Level II National Codes, HCPCS Objective 1.14 Demonstrate the ability to assign HCPCS codes Competency 2 Demonstrate an understanding of the coding process using Modifiers Objective 2.1 Recognize and understand the purpose of Modifiers Objective 2.2 Assign Increased Procedural Services modifier-22 Objective 2.3 Assign Unusual anesthesia modifier-23 Objective 2.4 Assign Unrelated E/M Services by the Same Physician During a Postoperative Period modifier-24 Objective 2.5 Assign Significant Separately Identifiable E/M Service by the Same Physician on the Same Day of the Procedure of Other Service modifier-25 Objective 2.6 Assign Professional Component modifier-26 Objective 2.7 Assign Mandated Services modifier-32 Objective 2.8 Assign Anesthesia by Surgeon modifier-47 Objective 2.9 Assign Bilateral Procedures modifier-50 Objective 2.10 Assign Multiple Procedures modifier-51 Objective 2.11 Assign Reduced Services modifier-52 Objective 2.12 Assign Discontinued Procedure modifier-53 Objective 2.13 Assign Surgical Care Only modifier-54 Objective 2.14 Assign Postoperative Management Only modifier-55 and Preoperative Management Only modifier-56 Objective 2.15 Assign Decision for Surgery modifier-57 Objective 2.16 Assign Staged or Related Procedure or Service by the Same Physician during the Postoperative Period modivier-58 Objective 2.17 Assign Distinct Procedural Service modinier-59 Objective 2.18 Assign Two Surgeons modifier-62 Competency 3 Identify and explain the three factors of E/M code assignment Objective 3.1Differentiate between a new and an established patient Objective 3.2 Differentiate between and inpatient and an outpatient Objective 3.3 Explain levels of E/M service Objective 3.4 Review the Key Components and Analyze the Key Component history and examination Objective 3.5 Analyze the Key Component medical decision making Objective 3.6 List contributory factors Objective 3.7 Analyze code information and the types of E/M codes Objective 3.8 Identify CMS Documentation Guidelines Objective 3.9 Demonstrate the ability to code E/M services Competency 4 Demonstrate ability to report anesthesia services Objective 4.1 Define types of anesthesia Objective 4.2. Explain the format of the Anesthesia section and subsections Objective 4.3 Understand the anesthesia formula. Objective 4.4 Identify other reporting issues

6 Competency 5 Accurately Understand the Surgery section format Objective 5.1 Locate notes and Guidelines in the Surgery section Objective 5.2 State the use of the unlisted procedure codes Objective 5.3 Interpret elements of a special report Objective 5.4 Examine the separate procedure designation Objective 5.5 Analyze the contents of a surgical package Objective 5.6 Determine the contents of the General subsection Competency 6 Describe the formant of the Integumentary System in the CPT manual Objective 6.1 Identify the elements of coding Skin, Subcutaneous, and Accessory Structures services Objective 6.2 Review the main services in Nails, Pilonidal Cyst and Introduction Objective 6.3 Identify the major factors in Repair Objective 6.4 State the important coding considerations in destruction and breast procedures Objective 6.5 Demonstrate the ability to code integumentary services and procedures Competencies 7 Accurately demonstrate the ability to code musculoskeletal services and procedures. Objective 7.1 Understand types of traction Objective 7.2 Identify services/procedures included in the General subheading Objective 7.3 Analyze cast application and strapping procedures Objective 7.4 Understand elements of arthroscopic procedures Competency 8 Differentiate between services reported with codes from the Respiratory subsection and those reported with codes from other subsections Objective 8.1 Explain the effects of extent and approach when reporting endoscopy respiratory procedures Objective 8.2 Identify highlights of nasal procedure coding Objective 8.3 Analyze the codes to report services to the accessory sinuses Objective 8.4 Categorize the codes in the Larynx subheading Objective 8.5 Explain the structure of the trachea/bronchi codes Objective 8.6 Distinguish the difference amongst the codes assigned to report lungs and pleura services, and procedures Objective 8.7 Demonstrate the ability to code respiratory services and procedures Competency 9 Accurately apply cardiovascular services reported with codes from the Surgery, Medicine, and Radiology sections Objective 9.1 Review cardiovascular coding terminology. Objective 9.2 Recognize the major differences in the subheadings of the Cardiovascular subsection Objective 9.3 Define rules of coding cardiovascular services when using codes from the Medicine section Objective 9.4 Identify the major rules of coding cardiovascular services using the Radiology section codes. Objective 9.5 Demonstrate ability to code Cardiovascular services Competency 10 Demonstrate the ability to code Hemic and Lymphatic System services Objective 10.1 Review the Hemic and Lymphatic Systems subsection format Objective 10.2 Understand the Hemic and Lymphatic Systems subheadings Objective 10.3 Review the format of the Mediastinum and Diaphragm subsection codes. Objective 10.4 Understand the Mediastinum and Diaphragm information Objective 10.5 Demonstrate the ability to code Mediastinum and diaphragm services Competency 11 Accurately report procedures of the abdomen, peritoneum, and omentum Objective 11.1 Understand the format of the Digestive System subsection Objective 11.2 Report procedures of the lips Objective 11.3 Report procedures of the vestibule of the mouth Objective 11.4 Report procedures of the tongue and floor of the mouth Objective 11.5 Report procedures of the dentoalveolar structures Objective 11.6 Report procedures of the palate and uvula Objective 11.7 Report procedures of the salivary gland and ducts Objective 11.8 Report procedures of the pharynx, adenoids, and tonsils Objective 11.9 Report procedures of the esophagus, stomach, and intestines (except rectum) Objective report procedures of the Meckel s diverticulum and mesentery Objective Report procedures of the appendix, rectum, anus, liver, biliary tract and pancreas Competency 12 Understand the format and codes of the Urinary System subsection Objective 12.1 Review the subheadings and categories of the Urinary System subsection

7 Objective 12.2Report services with Urinary System codes Objective 12.3 Understand the format and codes of the Male Genital System subsection Objective 12.4 Review the subheadings and categories of the Male Genital System subsection Objective 12.5 Report services with Make Genital System codes Competency 13 Accurately demonstrate the ability to code the Female Genital and Maternity Care and Delivery subsection Objective 13.1 Describe reproductive services Objective 13.2 Report intersex surgery services Objective 13.3 Identify elements of component coding with Female Genital System codes Objective 13.4 define the critical terms in maternity and delivery services Objective 13.5 Define services in the global maternity and delivery package Objective 13.6 Understand the format of the Maternity Care and Delivery subsection services Competency 14 Accurately demonstrate the ability to code Endocrine and Nervous System services Objective 14.1 Review the Endocrine System subsection format Objective 14.2 Understand the Endocrine System subheadings Objective 14 3 Review the Nervous System subheadings Objective 14.4 Understand the Nervous System subheadings Competency 15 Accurately demonstrate the ability to code Eye and Ocular Adnexa, and Auditory System services Objective 15.1 Review the Eye and Ocular Adnexa subsection Objective 15.2 Understand the Eye and Ocular Adnexa subheadings Objective 15.3 Review the Auditory System subsection format Objective 15.4 Understand the Auditory system services Objective 15.5 Review reporting use of an operating microscope Objective 15.6 Demonstrate the ability to report the use of an operating microscope Competency 16 Accurately demonstrate the ability to code Radiology services and procedures Objective 16.1 Demonstrate an understanding of Radiology terminology Objective 16.2 Analyze the elements of component coding in reporting Radiology services Objective 16.3 Identify elements of the global procedure Objective 16.4 State the appropriate coding of contrast material Objective 16.5 Explain the format of the Radiology section Competency 17 Accurately demonstrate the ability to code Pathology and Laboratory services Objective 17.1 Explain the format of the Pathology and Laboratory section Objective 17.2 Understand the information in the Pathology and Laboratory Guidelines Objective 17.3 Demonstrate an understanding of Pathology and Laboratory terminology Objective 17.4 Differentiate amongst the Organ or Disease Oriented Panels codes Objective 17.5 Recognize Drug Testing codes Objective 17.6 Identify Therapeutic Drug Assays codes Objective 17.7 Classify Evocative/Suppression Testing codes Objective 17.8 Explain Consultations (Clinical Pathology) codes Objective 17.9 Interpret Urinalysis and Chemistry codes Objective Evaluate Hematology and Coagulation codes Objective Describe Immunology codes Objective Discriminate amongst Transfusion Medicine codes Objective Interpret Microbiology codes Objective Evaluate Anatomic Pathology codes Objective Summarize Cytopathology and Cytogenic Studies codes Objective Explain surgical Pathology codes Objective Choose Other Procedures codes Competency 18 Accurately report medical services using Medicine section codes Objective 18.1 Analyze the format of the Medicine section Objective 18.2 Report Psychiatric services Objective 18.3 Identify biofeedback services Objective 18.4 List components of dialysis reporting Objective 18.5 demonstrate ability to report gastrointestinal services Objective 18.6 Understand ophthalmology and otorhinolaryngologic reporting Objective 18.7 Report cardiovascular services

8 Objective 18.8 Identify services reported with pulmonary codes Objective 18.9 List the important elements of coding allergy and clinical immunology services Objective Report endocrine services Objective Define neurology and neuromuscular services Objective Demonstrate an understanding of central nervous system assessment and intervention Objective Analyze chemotherapy services Objective Report special services and dermatologic procedures Objective Code physical medicine and rehabilitation services Objective Report active wound management Objective Define osteopathic and chiropractic services Objective Understand non-face-to-face services Objective Code special services, procedures and reports. Competency 19 Explain the differences between inpatient and outpatient coding Objective 19.1 Define principal diagnosis and procedure Objective 19.2 Examine the Official Guidelines for Coding and Reporting Objective 19.3 Review the Guidelines for Selection of a Principal Diagnosis Objective 19.4 Determine when a condition should be reported as an additional diagnosis Objective 19.5 Explain the purpose of the present on admission indicators Objective 19.6 Examine the ICD-10-PCS system

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