Revenue Cycle, Coding & Compliance Content Audience

Transcription

1 Curriculum Purpose # of Revenue Cycle, Coding & Compliance Content EduCode Coding Curriculum EduCode Competency Exams Inpatient Coding Exams Outpatient Coding Exams Clinical Documentation Improvement (CDI) Exams Online training program covering inpatient and outpatient coding topics and coding guidelines. Organized by body system and structured to be suitable for all levels of coders with basic to advanced expertise. It includes complete libraries of ICD-9-CM, ICD-10-CM and ICD-10-PCS and CPT education by specialty. Also included are lessons on MS-DRGs and hospital outpatient coding and coverage issues. These are online validated competency exams for inpatient coding, outpatient coding, and Clinical Documentation Improvement. Each competency is based on a comprehensive job analysis, with questions written and peer reviewed by appropriately credentialed subject matter experts. Each question was selected for inclusion in the unique tests by an industryrecognized validation company. Questions are divided into six categories and are leveled as recall, application, or problem solving. The goal of each competency to assess job role proficiency and competence by demonstrating that the learner is knowledgeable and can apply their knowledge well enough to complete tasks and activities as identified in the specific job analysis. Reports allow the employer to ascertain the status of all their staff and how they compare to each other and benchmarks. As an added benefit we do recommend or assign training to address any weak areas identified by the competency. 491lessons 6 exams total two per type of exam All levels of coders; billing staff; compliance staff/auditors; CDI professionals; consultants Inpatient coders; outpatient coders; CDI professionals; compliance auditors; consultants 327 AHIMA AAPC n/a 1

2 Curriculum Purpose # of ICD-10 This online tool assesses staff readiness for the 150 Readiness migration to ICD-10-CM and ICD-10-PCS coding systems. questions Assessment This consists of 150 randomized, multiple choice questions with rationale, identified by core knowledge categories (anatomy and physiology; pathophysiology, medical terminology, documentation, procedure terminology, ICD-10 information, pharmacology). The tool can be used by a learner to pinpoint specific individual knowledge gaps, and by management, to assess and plan staff educational needs for the ICD-10 transition. Auto-assignment of education is available. EduCode ICD-10-CM and ICD-10-PCS Essentials This curriculum is designed to provide an understanding of basic coding knowledge within each of the ICD-10-CM and ICD-10-PCS coding systems. The content provides an overview of General Equivalence Mappings. The ICD-10 Orientation course offers ICD-10-CM/PCS awareness education for physicians, managers, and non-coders. An introduction to pharmacology lesson is included. Revenue Cycle, Coding & Compliance Content 5 courses 35 lessons All levels of coders; compliance staff, CDI professionals; consultants Coding, Billing, Compliance Staff, Cancer Registrars, Research Dept., PFS, Consultants, Auditors n/a 18 AHIMA 8 AAPC Mosby s Human Body Essentials Anatomy & Physiology Pathophysiology Extensive online courses designed to teach human anatomy and physiology and the pathophysiology of certain diseases and conditions. The course also can be used as a refresher for nursing and allied health professionals returning to practice. 41 lessons total 16 lessons 25 lessons HIM/Coding professionals. All health professionals and assistive personnel working in the healthcare setting 18AHIMA, 9 AAPC 22 AHIMA, 17.5 AAPC 2

3 Curriculum Purpose # of Medical Terminology 2.0 Curriculum Self-paced online instruction that enables learners to better understand specifics about medical terms and comprehend how clinical information can be abstracted. This curriculum allows learners to develop an understanding of basic medical word structure and medical abbreviations. Audio teaches correct pronunciation. 54 lessons All levels of coders; billing staff; compliance staff; PFS staff; persons new to healthcare industry 15 AHIMA 7.5 AAPC EduCode Clinical Documentation Improvement Curriculum EduCode Clinical Documentation Improvement is a three-course curriculum that provides education to clinical staff, coders, and CDI specialists. Content covers what and how to document in a patient s health record for each type of entry by place and type of service; Medicare s COP and The Joint Commission s health record completion standards, the physician query process, and CMS evaluation and management (E/M) Guidelines; information on anatomy, physiology, medical terminology, diagnostic workup, treatments, ICD-9-CM, ICD-10-CM and ICD-10-PCS coding guidelines; and associated documentation issues for selected conditions. 3 courses 22 lessons HIM coding staff; Case Managers, CDI specialists; medical students; residents for onboarding 25 AHIMA 19 CME Elsevier/Mosby contact hours 3

4 Curriculum Purpose # of EduCode Doc Briefs EduCode Doc Briefs are concise, compressed online lessons 32 Briefs Physicians; non-physician for physicians and clinicians that are differentiated by topic, practitioners; CDI staff enhanced with audio, and designed to demonstrate necessary (optional- for use as a documentation elements for high-risk, high-cost, audit-related reference) or ICD-10 related conditions. They pinpoint key documentation elements BY TOPIC needed to support an admission; justify diagnostic work-up, treatments and services; and accurately reflect a patient s severity of illness. Each brief is approximately 12 screens and will carry CME as an incentive for physicians to participate. Elements such as acuity, clinical indicators, synonyms, associated conditions, complications, treatments, and manifestations are covered for each topic. ICD-9-CM Inpatient Coder s Knowledge Inventory Tool with Lesson Assignment ICD-9-CM Inpatient Coder s Knowledge Inventory Tool without Lesson Assignment Outpatient Coder s Knowledge Inventory Tool with Lesson Assignment Outpatient Coder s Knowledge Inventory Tool without Lesson Assignment Elsevier s ICD-9-CM Hospital Inpatient and Hospital Outpatient Coder Knowledge Inventory Tools (KITs) are evaluative tools used in conjunction with the EduCode Coding Curriculum to identify knowledge gaps that may affect a coder s performance and the impact on the hospital's revenue cycle. They may be considered curriculum pre-tests which are comprised of multiple choice questions related to coding guidelines and the critical areas of related knowledge such as medical terminology and anatomy and physiology as well as code assignment. Each question is mapped to one or more lessons related to the particular body system or guideline covered in the KIT question. Questions are designed to test knowledge of material covered in the EduCode Coding Curriculum. It provides automated scoring and immediate feedback to the learner at the completion of the KIT, and creates an individualized prescriptive training plan by automatically assigning lessons to the learner s lesson plan. 4 KITs All levels of coders and other staff wishing to evaluate their coding knowledge 16 CME 4

5 Curriculum Purpose # of EduCode Reimbursement 5 Courses Essentials 39 EduCode Regulatory Essentials Interventional Radiology This content offers education on the fundamentals of reimbursement systems for inpatient and outpatient services. This detailed education defines the systems themselves and associated edits and challenges within the system. Also included are courses on the hospital HAC and Hospital Quality Initiative (HQI) programs that affect reimbursement, along with lessons on the various CMS auditing (RAC and RTS) and medical review programs. The Revenue Cycle is presented in an easy to understand format and includes an orientation course for those who are unfamiliar with the revenue cycle. This content presents HIPAA and compliance training in a compact curriculum and is appropriate for hospital-wide use. HIPAA content focuses on privacy, and compliance content focuses on Medicarespecific hot topics including fraud and abuse. A comprehensive online training program that provides specialty coders with in-depth information on the most frequently performed interventional radiology procedures. Each course targets a specific area that requires proficiency to ensure accurate procedure coding. Exams at both curriculum and course levels will assist in measuring coding specialty knowledge 2 Courses 22 6 courses 37 modules Consulting Firms, Acute Hospitals, Medical Billing Companies, Finance Dept., PFS, Compliance Officers, Revenue Cycle Managers, Quality Improvement Managers, Hospital data and business analysts All hospital staff for HIPAA; HIM, PFS, Billing and Compliance for the compliance course 16 AHIMA 3 AAPC 11 AHIMA 32 AHIMA 16 AAPC 30 RCCB 5

6 Curriculum Purpose # of Invasive Cardiology Radiation Oncology Diagnostic Radiology A comprehensive online training program that covers the guidelines for traditional diagnostic and therapeutic interventional cardiology procedures. Cardiac anatomy is reviewed in detail and procedure techniques are explained. Exams are provided at both curriculum and course levels. A comprehensive online training program that targets specific training for Standard Radiation Services, Brachytherapy, IMRT, Stereotactic Procedures and Radiopharmaceutical Procedures and Diagnosis Coding, tailored to address challenges found in coding for Radiation Oncology. Exams are provided at both curriculum and course levels. A comprehensive online training program that will familiarize users with imaging modalities and diagnostic radiology coding conventions. Courses cover coding guidelines for the various imaging modalities, including plain films, ultrasound, CT/CTA, MRI/MRA, PET, nuclear medicine and breast procedures. Exams at both curriculum and course levels will assist in measuring coding specialty knowledge. 5 courses 25 modules 8 courses 23 modules 10 courses 47 modules 25 AHIMA 33 AHIMA 16 AAPC 48 AHIMA 23 AAPC 45 RCCB 6

7 Curriculum Purpose # of Infusions and Injections This course covers complex coding guidelines for chemotherapy and non-chemotherapy infusions, injections, and related services. Topics include but are not limited to: Drug administration documentation; How Medicare pays for drugs and drug administration; Use of modifier 59; Chemotherapy and non-chemotherapy drug administration; Hydration; Billing for wasted drugs; Implanted infusion ports; and Transfusion services. The course discusses coding guidelines, documentation requirements, modifier use, and bundling issues. It includes exercises with real-life scenarios for hands-on learning. At the completion of the course, a scored assessment tests the learner s comprehension of the material. 1 module, billers 6 AHIMA Pain Management Nuance/JATA CDI A comprehensive course designed to provide learners with in-depth information on the most frequently performed pain management procedures and services, including basic principles and key terms. Exams at both curriculum and course levels will assist in measuring coding specialty knowledge. A comprehensive online learning program that describes the clinical presentation by physician specialty using clinical terminology and then explains how the clinical terminology is interpreted in the coding classification system, helping physicians with insight into why certain diagnoses codes are selected. This curriculum is comprised of 6 awareness lessons and 52 specialty and subspecialty lessons. 8 courses 30 modules 58 Total Physicians, Nonphysician Practitioners; CDI specialists and Coders (for reference) 42 AHIMA 1.5 AAPC N/A 7