Medical Coding Preparatory

Transcription

1 2014 Prep Course Catalog Volume I Medical Coding Preparatory Page 1 of 17

2 2014 Prep Course Catalog Medical Coding Preparatory Visit: Mission: The Medical Coding Preparatory (MCP) was founded to facilitate continuing education (CEU) opportunities and certification preparatory training for medical professionals. Purpose: The Purpose of the Medical Coding Preparatory is to assist learners, through continuing education, to learn the practice of medical billing and coding so that they may pass the American Association of Professional Coders (AAPC), Certified Professional Coding (CPC) national certification exam, or the American Healthcare Information Management Association s (AHIMA), Certified Coding Specialist-Physician (CCS- P) or Certified Coding Specialists (CCS) national certification exam. For those with a coding background, they may opt to also take a course in Medical Record Auditing for coders, or update their skills in the new ICD-10-CM/PCS. Vision: We envision a healthcare administrative workforce that is highly trained and certified in all levels and specialties of medical coding, auditing, and analysis to better support the success of healthcare providers, facilities, public health, and communities through optimal medical abstraction, coding, and analysis. MCP Prep Course Curriculum: Developed by Nationally recognized coding curriculum authors, who have successfully trained thousands of medical billing, coding and healthcare professionals with a 97% pass rate in certification. Proven Curriculum that works! Medical Coding Preparatory 996 Lake Irene Road, Casselberry, FL Phone: , or Toll Free: , Fax: info@medicalcodingprep.com CPC Coding Prep Page 2 of 17 Our Goal: CCS Prep & ICD-10-CM/PCS Prep Your Successful Preparation, Certification and continuing education! Last Update: 01/24/2014

3 Table of Contents 1. FlexPrep Delivery Overview of Medical Coding Preparatory Tier I: Modules 1-5: CPC, CCS-P Prep, Physician & Outpatient Coding Tier II: Modules 1-3: CCS Prep, Hospital Coding Tier III: Physician, Outpatient Auditing and Hospital Auditing 9 6. ICD-10-CM/PCS Made Easy Course Objectives and hours License Agreement Disclosures Course fees, Process and Policies.17 Flexible Prep Course Delivery Options: Prepare for Medical Coding Certification in a way that works for you: Asynchronous Online Training. Self-Study CEU students have 180 days of access to complete the Prep classes. Instructor is available by and phone for content questions, M-F from 9am to 9pm. Overview: Build your career and increase your career opportunities: Convenient, online classes that meet your busy schedule, including o Tier I: Physician Coder! CPC, CCS-P PREP o Tier II: Hospital Coder! CCS PREP o Tier III: Medical Record Auditor/Analyst! o ICD-10-CM/PCS Training Page 3 of 17

4 Online Medical Coding Training: These classes are intended to provide learners the necessary education and coding experience to pass the national certification exams in medical coding and/or billing. They are continuing education and are not intended to be a replacement for college coursework, nor do they constitute college credit. Each course is a Module. All modules have the necessary topics containing 1) reference ebook chapters 2) learning objectives, 3) chapter Q & A, 4) medical cases for coding, 5) PowerPoint lectures and 6) a short competency quiz for each topic area. There is a pre and post-test to measure your progress. Tier I Program Description: Physician & Outpatient Coding Module 1: Medical Terminology Abstraction (CPC, CCS-P Prep). This module is specifically designed for the medical coder and is a refresher course in medical terminology, i.e., anatomy, physiology and pathology terms. The course covers all 12 organ systems and teaches the coder how to accurately do medical abstraction (identify and define) key terms for the purpose of diagnostic and procedure coding. Module 2: ICD-9 CM Outpatient Physician Coding (CPC, CCS-P Prep). This course covers the guidelines and conventions for ICD-9-CM diagnostic coding. This course will focus on professional (outpatient) diagnosis coding to prepare you for the American Academy of Professional Coders (AAPC) Certified Professional Coding (CPC, CPC-H, CPC-P ) Exams, or the American Health Information Management Association (AHIMA) Certified Coding Specialist-Physician (CCS- P ) Exam. Proper coding is based on abstracting the key information from the medical documentation to show medical necessity and then assigning and accurately sequencing the primary and secondary diagnoses codes to 3rd digit, 4th digit, and 5th digit specificity. Module 3: Current Procedure Terminology (CPT) and Modifiers (CPC, CCS-P Prep). This course covers the all of the guidelines and coding conventions for Current Procedure Terminology (CPT) Codes and Modifiers, and the corresponding National Correct Coding Initiatives (NCCI) for all sections of the CPT coding book, including E/M, Anesthesiology, Surgery, Radiology, Laboratory, Medicine and for Category II and III codes. This course will focus on professional (outpatient) coding to prepare you for the American Academy of Professional Coders (AAPC) Certified Professional Coding (CPC, CPC-H, CPC-P) Exams, or the American Health Information Management Page 4 of 17

5 Association (AHIMA) Certified Coding Specialist-Physician (CCS- P) Exam. Module 4: HCPCS Level II (DMEPOS) and Modifiers (CPC, CCS-P Prep) This course covers all of the guidelines and conventions for HCPCS Level II Codes and Modifiers. These codes are for DMEPOS, or Durable Medical Equipment Parenteral/Enteral Therapies, Orthotics and Supplies for medical billing. These codes are used in both the inpatient and outpatient setting and are being taught to prepare you for the American Academy of Professional Coders (AAPC) Certified Professional Coding (CPC, CPC-H, CPC-P) Exams, or the American Health Information Management Association (AHIMA) Certified Coding Specialist-Physician (CCS- P) Exam. This Tier (I) facilitated course covers 5 modules of study. It is a comprehensive 180 day curriculum review. It is a must for anyone who is either preparing to take the national coding certification exam through the American Association of Professional Coders (AAPC) for the CPC, CPC-H, CPC-P, or the American Health Information Management Association (AHIMA) CCS-P. It is also appropriate for those who need to be updated in the latest professional medical coding guidelines and conventions for outpatient coders. Course modules are filled with illustrations, Q & A, and medical record cases. In addition you will be facilitated by an instructor with expertise in the area of medical insurance billing and coding and also who has successfully completed the national certification examinations from both AAPC and AHIMA. Module 5: Medical Billing & Reimbursement (CPC, CCS-P Prep-Optional) This comprehensive course covers the 1) Revenue Cycle from Fee setting, to Medical Appeals, 2) Insurance 101 from Medicare to Managed Care to Private pay, 3) Front/back office processes, 4) medical computer systems and 5) medical records management. This course is recommended for those who need additional training in medical billing and payment systems, as well as, those who are preparing for the CPC and/or CCS exams, but do not have a strong billing background. The course has many tools for the biller, including a complete usable Medical Office Credit & Collection Policy template. After completing this comprehensive course and all assessment quizzes, you will have earned a medical billing certificate. Working in healthcare administration as an AAPC CPC certified medical coder and biller is rewarding. Page 5 of 17

6 Tier I Physician/Outpatient Coding Preparatory: Course Table of Contents Module 1: Medical Terminology/Abstraction Review of 12 body systems and learning how to identify and define main medical terms for medical coding. The The Human 12 Human Body Body Systems Skeletal Digestive Muscular Lymphatic Endocrine Nervous Cardiovascular Male Reproductive Female Reproductive Urinary Integument Respiratory Tier I: Module 2: ICD-9-CM Diagnostic Coding Introduction to ICD-9-CM ICD-9 Codes : Infectious and Parasitic Diseases ICD-9 Codes : Neoplasms (NCCI) ICD-9 Codes : Endocrine, Nutritional, and Anesthesia Codes Metabolic Diseases ICD-9 Codes : Diseases of the Blood and Blood-Forming Organs ICD-9 Codes : Mental Disorders ICD-9 Codes : Diseases of the Nervous System and Special Senses ICD-9 Codes : Diseases of the Circulatory System ICD-9 Codes : Diseases of the Respiratory System ICD-9 Codes : Diseases of the Digestive System ICD-9 Codes : Diseases of the Genitourinary System ICD-9 Codes : Complications of Pregnancy, Childbirth ICD-9 Codes : Diseases of the Skin and Subcutaneous Tissue ICD-9 Codes : Diseases of the Musculoskeletal System ICD-9 Codes : Congenital Anomalies ICD-9 Codes : Conditions Originating in the Perinatal Period ICD-9 Codes : Symptoms, Signs, ICD-9 Codes : Injury&Poisoning ICD-9 Supplementary Classification Codes (V-Codes and E-Codes) Tier I: Module 3: Current Procedural Terminology (CPT) Current Procedural Terminology (CPT) Commonly Used CPT/HCPCS Modifiers CPT National Correct Coding Initiative Surgery Codes ( ) Radiology Codes ( ) Pathology and Laboratory Codes ( ) Medicine Codes ( ) Evaluation & Management Codes ( ) EM Code Levels 1997 Evaluation and Management Guidelines, 1995 Documentation Guidelines for Evaluation and Management Servic es Tracking and New Technology Codes (Category II and III) Tier I: Module 4: HCPCS Level II Coding HCPCS Level II Codes and Modifiers HCPCS Processes and Coding HCPCS Level II Coding Conventions HCPCS Level II Modifiers and Policies HCPCS Modifiers and Long Descriptions HCPCS Glossary of Terms Tier I: Module 5: Medical Billing & Reimbursement Ch1: Organization & Revenue Cycle Ch2: Insurance 101 Ch3: Front Office Procedures Ch4: Back Office Billing Procedures Ch5: Medical Billing Computer Systems Ch6: Lecture ix. APPEALING MEDICAL CLAIMS Page 6 of 17

7 Tier II Program Description: Hospital, Inpatient Coding & Billing Module 1: Uniform Hospital Discharge Data Set (UHDDS) (CCS Prep) This course covers the Uniform Hospital Discharge Data Set (UHDDS), MS-DRGs, CMS Official Coding Guidelines, Present on Admission (POA) and Inpatient procedures. A UB 04 resource, IPPS Glossary and IPPS Acronyms are also available in the course. This is a necessary course for those preparing for the AHIMA CCS inpatient coding. Module 2: ICD-9-PCS, Inpatient Procedure Coding (CCS Prep) This course covers only ICD-9 CM Book Volume 3, inpatient procedure coding. This is one of the most comprehensive classes available for inpatient procedures used on the UB-04 for facility billing. The content also has extensive ICD-9-CM Diagnostic coding to compliment the procedure coding in order to understand the relationships necessary to show medical necessity. Finally, a DRG and discussion has been provided for each of the cases in each topic chapter. Module 3: MS-DRGs & APCs (CCS Prep) Hospital coding or Facility coding has its own unique coding systems and reimbursement (payment) systems referred to as the inpatient perspective payment system (IPPS). In this module you will cover all of the key aspects of the IPPS and medical severity - diagnostic related groups (MS- DRGs) and also the outpatient perspective payment system (OPPS) and ambulatory payment groups (APCs). Through understanding how your facility is paid you will understand how to evaluate accuracy in billing for payment. Page 7 of 17

8 Tier II: Hospital/Inpatient Coding Prep Course Table of Contents Tier II Module 1: UHDDS: CMS Guidelines for Coding & Reporting Chapter_1_ Intro_to_UHDDS Chapter_2_DRGs Chapter_3_Official Coding Guidelines Chapter_4_POA Rule Chapter_5_Inpatient Procedures Appendix A_UB_04 FORM INSTRUCTIONS Appendix B_EXEMPT POA DIAGNOSES CODES Appendix C_ACRONYMS I Appendix D GLOSSARY Tier II Module 2: Inpatient Diagnostic & Procedure Coding Chapter_0_ICD-9_Introduction to Inpatient case coding Chapter 1_ICD-9_Infection Chapter 2_ICD-9_Neoplasm Chapter 3_ICD-9_Endocrine Chapter 4_ICD-9_Blood Diseases Chapter 5_ICD-9_Mental Disorders Chapter 6_ICD-9_Nervous Chapter 7_ICD-9_Circulatory Chapter 8_ICD-9_Respiratory Chapter 9_ICD-9_Digestive Chapter 10_ICD-9_GU Chapter 11_ICD-9_Pregnanc Chapter 12_ICD-9_Integumentary Chapter 13_ICD-9_Musculoskeletal Chapter 14_ICD-9_Congenital Anomalies Chapter 15_ICD-9_Newborns Chapter 16_ICD-9_Signs and Symptoms Chapter 17_ICD-9_E-&V-Codes Appendix A_CC_ list Appendix B_MCC_List Earning my AHIMA Certified Coder Specialists Certification for hospital coding was one of the best things I ve done so far for my career as a medical coder. Tier II Module 3: The Complete Introduction to DRG and APC Chapter_1_Introduction to Inpatient Perspective Payment System (IPPS) Chapter_ 2_Introduction to Outpatient Perspective Payment System (OPPS) Chapter_ 3_Diganostic Related Groups (DRG) coding and reimbursement Chapter_ 4_Ambulatory Payment Classification (APC) coding and reimbursement Chapter_ 5: DRG and APC Survival Strategies Appendix A: APC-DRG Glossary Page 8 of 17

9 Tier III: Introduction to Physician & Outpatient Record Auditor Correct coding is critical to getting paid as physicians, outpatient facilities and ancillary care providers. Avoiding external audits by Medicare and other payers is desired. Appropriately optimizing revenue and quality assurance and staying in compliance is critical to survival in healthcare today. MCP has many resources and tools for the medical records auditor and analyst. In these modules, we focus on outpatient, and physician coding. Particular attention is given to the physician evaluation and management (E/M) coding frequently targeted by third party payers. Auditors are taught how to use auditing assessment tools, establish coding patterns and benchmark against industry standards. Tier III: Medical Record Auditor Brider, Deborah J. (2014). Medical Record Auditor. 3 rd Edition. American Medical Association. Supplements: EM ebook, Audit Forms Topic 1: Auditing assessment tools, processes establish coding patterns and benchmark against industry standards. Topic 2: Ethics, Laws and Evaluating Medical Records Topic 3: Audit Tools and Forms Topic 4: Physician evaluation and management (E/M) coding. Topic 5: Physician surgical coding Topic 6: Hospital/Inpatient Medical Record Auditing Topic 7: Report writing Tier III: Hospital/Inpatient Medical Record Auditor/Analyst Prep With the implementation of Medical Severity Diagnostic related groups (MS-DRG s), present on admission (POA), and revisions of the major and other comorbidity and complication lists (CC/MCC), inpatient hospital code auditing has become more complex than ever. This is an advance course important facilitated Diploma for any hospital auditor, or analyst, physician or nurse reviewer, or for quality assurance personnel responsible for compliance in all areas of health information management and/or healthcare finance for their facilities. It also goes over in detail all of the payer systems and methodologies. Page 9 of 17

10 ICD-10 CM/PCS Made Easy! Coding Course Schedule This continuing education course is designed to help train healthcare professionals in understanding the organization and structure of ICD-10-CM (diagnoses). It compares ICD-9, with ICD-10 diagnoses and teaching the use of General Equivalence Mappings (GEMS). It provides chapter-specific case coding, explaining the changes between the two coding conventions and guidelines for both outpatient and inpatient services. It also trains in the application of ICD-10 CM diagnoses coding. ICD-10 CM Diagnoses Coding 1) 8-Lessons (Lectures), 2) 16-Coder Learning Activities: 2- per Lesson, 3) 8- Assessments (Quizzes with unlimited attempts), 4) 1-Final Assessment Upon completion of this course, the healthcare professional will be able to: 1. Discover the organizational changes that exist between the two code schemes, i.e., ICD-9-CM and ICD-10-CM. 2. Identify the areas of similarities and differences between ICD-9-CM and ICD-10-CM. 3. Explore the ICD-10-CM coding conventions and rules. 4. Apply ICD-10-CM Official Coding Guidelines to determine the correct codes for ICD-10-CM diagnoses. 5. Determine what clinical information must be abstracted from the medical record in order to assign codes correctly. 6. Build an ICD-10-CM foundation with case coding scenarios for outpatient and inpatient coding. 7. Apply your knowledge of coding principles by assigning accurate and precise codes for the primary and secondary outpatient diagnoses and principal and other inpatient diagnoses using ICD-10-CM. 8. Define General Equivalency Mapping (GEM). 9. Assess the requirements and appropriate uses of the General Equivalency Mapping (GEM) Tables. 10. Complete all weekly and final assessments for successful ICD-10 CM learning. ICD-10 PCS Procedure Coding This continuing education course is designed to help train hospital and other facility healthcare professionals in understanding the organization and structure of ICD-10-PCS (procedure) inpatient coding. It compares ICD-9, with ICD-10 procedure codes and teaching how to cross-walk from the ICD-9 to the ICD-10 PCS codes using the General Equivalence Mappings (GEMS). It provides case coding, explaining the changes between the two procedure coding conventions and guidelines. It also trains in the application of ICD-10 PCS coding. Upon completion of this course, the healthcare professional will be able to: 1. Build on experience gained in coding scenarios using ICD-10-PCS. 2. Follow ICD-10-PCS multi-axial coding structure and conventions. 3. Apply definitions and guidelines to determine the correct code for the procedure(s). 4. Understand the importance of anatomy and laterality in ICD-10-PCS. 5. Identify the areas of similarities and differences between ICD-9 and ICD- 10-PCS. 6. Apply knowledge of procedure coding principles by assigning accurate and precise codes that matches the medical documentation. 7. Understand the requirements of the General Equivalency Mapping (GEM) Tables for ICD-10-PCS. 8. Understand how to code procedures using ICD-10-PCS references. Page 10 of 17

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16 Course Content and ebook Agreement: Online course content and ebooks contain copyrighted materials. Their use is subject to the following License Agreement, which essentially says that you mustn't copy, give away or sell copies of the content you have purchased for the purpose of Medical Coding education. Please read the License Agreement carefully: Medical Coding Preparatory (MCP) agrees to grant, and you (the person who has purchased an online course containing e- books) agree to accept, a non-exclusive, non-transferable license to use the course content and e-books under the following terms and conditions: 1. Installing: You may not download or install the course materials or e-books onto your computer. You may not make back-up copies of the e-books. You may not give copies of the e-book to others, or make the e-book available for others to copy or download. 2. Printing. You may not print the e-books for your personal use. You may not give printed pages from the e-book or the entire printed e-book to others. 3. Copyright, Use, and Resale Prohibitions. All content in the e-book is copyrighted under the US Copyright laws, and MCP owns the copyright and the e-books. As stated in this License Agreement, you may not copy, print, modify, remove, delete, augment, add to, publish, transmit, sell, resell, create derivative works from, or in any way exploit any of the e-book's content, in whole or in part, and you may not aid or permit others to do so. You shall not: (1) rent, assign, timeshare, distribute, or transfer all or part of the e-book or any rights granted by this license agreement to any other person; (2) duplicate the e-book, except for reasonable backup copies; (3) remove any proprietary notices, labels, or marks from the e-book; (4) transfer or sublicense title to the e-book to any other party. 4. Liability. The unauthorized use or distribution of copyrighted or other proprietary content is illegal and could subject the purchaser to substantial money damages. Purchaser will be liable for any damage resulting from any violation of this License Agreement, including any infringement of copyrights or proprietary rights. MCP e-book License Agreement. 5. Professional Services. This e-book is designed to provide accurate and authoritative information in regard to the subject matter covered. A license to use the e-book while taking the MCP course curriculum is with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional service. If legal advice or other expert assistance is required, the services of a competent professional should be sought. 6. Without Warranty MCP does not guarantee that the information in the course or e-books is error-free, or warrants that the courses or e-books will meet your personal requirements, or that the operation of the course or e-books will be uninterrupted or error-free. The course content and e-books are provided during the timed access to the purchased program "as is" without warranty of any kind, either express or implied or statutory, including, without limitation, implied warranties of merchantability and fitness for a particular purpose. If the courses and related e-books were purchased in the United States, the above exclusions may not apply, or may not apply in total to you as some states do not allow the exclusion of implied warranties. You may also have other rights that vary from state to state. 7. Risk. The entire risk as to the results and performance of the course and the e-books are assumed by you. In no event will MCP be liable for any damages, including, without limitation, incidental and consequential damages and damages for lost data or profits arising out of the use or inability to access or use the course or e-books. The entire liability of MCP shall be limited to the amount actually paid by you for the course or e-book license. 8. Your Agreement. Your use of the course and e-book constitutes your agreement to the above terms and conditions. By entering the MCP online classes, you are agreeing to these content terms. Page 16 of 17

17 Disclosures: Statement of Legal Control: Madeline Angela Meyer, is the Owner and Sole Proprietor, of the Medical Coding Preparatory, a US Registered Trademark, and Florida dba. Primary Contact and any further information regarding the Medical Coding Preparatory may be obtained from: Madeline Angela Meyer, Ower Medical Coding Preparatory 996 Lake Irene Road Casselberry, FL Toll Free: Phone: ameyer@medicalcodingprep.com For Licensure and further available information, contact: Commission for Independent Education Florida Department of Education 325 W. Gaines Street., #1414 Tallahassee, FL website: (850) phone (850) fax (888) Toll Free Placement: Medical Coding Preparatory does not do employment placement, nor do we guarantee employment after CEU training. Finding employment is the responsibility of the Learners. Learner Termination: Dr. Meyer retains the right to disenroll learners for actions that are unethical, illegal, or unprofessional. Owner/Instructor Madeline Angela Meyer, PhD, Public Health- Epidemiology, MSHA, MBA, CMPE, CCS-P, CPC, CCS, AHIMA Approved ICD-10 CM/PCS Certified Trainer Over 25 years working as a Healthcare Administrator in high level management positions. Over 10 years as a subject matter expert, course developer and college professor teaching Epidemiology, Community Health and Healthcare Administration. Credentials: PhD from Walden University, Minneapolis, MN. MBA from Nova Southeastern University School of Business. Master s of Science in Health Services Administration from Nova Southeastern University School of Business. B.A. in Business Administration from Metropolitan State University, Minneapolis, MN, Medical Laboratory Technologists, ASCP (American Society of Clinical Pathologists) registered, Lakeland Medical Academy, Minneapolis, MN, and attended St. Luke s School of Nursing, St. Louis, MO. Professional memberships and certifications include: American Public Health Association (APHA). American Medical Informatics Association (AMIA), American Health Information Management Association (AHIMA) and American Academy of Professional Coders (AAPC), Medical Group Management Association (MGMA), American College of Medical Practice Executives (ACMPE). I am a Certified Medical Practice Executive (CMPE), and certified in medical coding, as a Certified Medical Coder- Physician (CCS-P) and Certified Medical Coder-Hospital (CCS) from AHIMA, as well as a Certified Professional Coder from the AAPC. She is an AHIMA ICD-10-CM/PCS Trainer and Ambassador, and her dissertation was on the "Change Impact of Transitioning from ICD-9 CM to ICD-10 on Morbidity Statistics". Course Process and Policies: Registration: Upon receipt of payment, you will need to register your name and on the Website. Enrollment: Once you are registered, you will be enrolled in the course by Dr. Meyer. Begin Course of Study: Once you are enrolled you may sign-in to the course and begin reading the course instructions, lectures and complete the assessments until course content has been completed. CEU Certificate: You must notify Dr. Meyer that you have completed the final assessment in the course. She will then send you your certificate of completion which will indicate your CEUs earned. Refund Policy: Refunding is allowed within the first two weeks, or 14 days should the learner decide not to complete the course. Fees: Tier I: "Tier I CPC Review Course, Physician Coding Prep" (CPC, CCS-P) $600 (a $1,300+ value) (12 CEUs) Tier II: "Tier II CCS Review Course, Hospital Coding Prep" (CCS) $499 (a $1,000+ value) (12 CEUs) Tier III: "Tier III Introduction to Physician Medical Record Auditor/Analyst" $199 (a $600 value) (6 CEUs) ICD-10-CM/PCS: "ICD-10-CM/PCS Comprehensive Online Prep Course" $199 (16 CEUs) + a 3 Hour Live Webinar for Q & A ( $600+ value) Page 17 of 17