Place in College Curriculum: This course is required for the Medical Coding Certificate.

Transcription

1 Section I Course Title: CPT Coding II Course Code: HSC102 Lecture Hours: 3 Lab Hours: 0 Credits: 3 Course Description: This is a continuation of CPT Coding I. This course will focus not only on the aspects of procedural coding, but also will delve into diagnostic coding. Coding standards, guidelines, regulatory requirements, along with the regulatory agencies will also be discussed. The link between medical record documentation and reimbursement will also be explored. Prerequisite: HSC101 Place in College Curriculum: This course is required for the Medical Coding Certificate. Date of Last Revision: March 2008

2 Course Content Outline: I. Cardiovascular System A. Coding in the surgery section B. Coding in the medicine section C. Coding in the radiology section II. III. IV. Female Genital System and Maternity Care A. Female genital system B. Maternity care General Surgery I A. Urinary system B. Digestive system General Surgery II A. Lymphatic system B. Endocrine system C. Nervous system D. Eye and auditory system V. Radiology Section A. Planes B. Four radiology subsections VI. VII. VIII. IX. Pathology/Laboratory section Level II National Codes A. Diagnostic and therapeutic services International Classification of Diseases A. Alphabetic index B. Tabular lists C. Procedures Overview of Reimbursement A. Medicare B. Managed health care C. Resource based relative value scale D. Inpatient/Outpatient reimbursement

3 Section III Course Performance Objectives: Performance Objective 1: The student will understand the coding of the cardiovascular system. 1. Define the terms associated with the cardiovascular system. 2. Read operative notes, reports and identify the key procedures. 3. Relate the key terms and procedures to CPT codes. 4. Complete a CMS-1500 form using the correct coding procedures. Performance Objective 2: The student will understand the correct coding procedures for the female genital system and maternity care. 1. Define terms associated with the female genital and maternity. 2. Read patient charts and be able to locate the services provided. 3. Relate the procedures and services to CPT coding. 4. Correctly complete CMS-1500 form. Performance Objective 3: The student will be able to understand the correct selection of CPT codes in relationship to the urinary and digestive systems. 1. Correctly identify services and procedures from patients notes in regards to the urinary and digestive system. 2. Correctly identify the corresponding codes to services and procedures. 3. Insert the codes correctly into a CMS-1500 form. Performance Objective 4: The student will be able to identify services and procedures from a set of patient s notes in regards to the lymphatic, endocrine, eye, auditory and the nervous system. 1. Identify services and procedures provided through the patient s record. 2. Correlate the services and procedures to CPT codes. Performance Objective 5: The student will be able to identify services and procedures in regards to radiology. 1. Identify the terms associated with radiology. 2. Explain the different planes used in radiology. 3. Identify the service and procedures from patient s notes. 4. Correlate the services and procedures to CPT codes.

4 Performance Objective 6: The student will be able to utilize codes regarding pathology and laboratory studies. 1. Identify services and procedures from a patient s health chart in regards to laboratory tests. 2. Correlate the tests with the correct CPT codes. Performance Objective 7: The student will be able to understand the role of Level II National Codes in correct medical billing and coding. 1. Explain the format of the Level II National Codes 2. Choose correct Level II codes for a variety of patient scenarios. 3. Explain the correct usage of Level II modifiers. Performance Objective 8: The student will be able to understand and use the ICD manual. 1. Explain the format of the ICD manual. 2. Select correct codes from the ICD manual for patient scenarios. 3. Properly place the ICD codes into a CMS-1500 form. Performance Objective 9: The student will be able to submit various types of claims for reimbursement. 1. Explain how the Medicare/Medicaid system functions. 2. Explain how PCPs, HMOs, Workman s Comp, CHAMPUS and private insurance work. 3. Correctly identify the type of insurance a patient has from medical records. 4. Explain the correct coding procedures for each type of insurance. 5. Explain an EOB.

5 Outcomes Assessment: A college-wide outcomes assessment program has been put into place to enhance the quality and effectiveness of the curriculum and programs at Salem Community College. As part of this assessment program, the learning outcomes for this course will be assessed. Assessment methods may include tests, quizzes, papers, reports, projects and other instruments. Copies of all outcomes assessments are available in an electronic assessment bank maintained by the Institutional Research and Planning Office. Section VI Course Activities: Lecture and class participation as well as in class assignments stressing cooperative learning are the major means of instruction. Power Points, charts, videos and computer usage are incorporated into the lecture portions of the class. Course Requirements and Means of Evaluation: Please refer to the instructor s syllabus addendum (to be distributed in class) for specific information regarding the course requirements and means of evaluation. Attendance Policy: Regular and prompt attendance in all classes is expected of students. Students absent from class for any reason are responsible for making up any missed work. Faculty members establish an attendance policy for each course and it is the student s responsibility to honor and comply with that policy. Academic Honesty Policy: Students found to have committed an act of academic dishonesty may be subject to failure of this course, academic probation, and / or suspension from the college. See the Student Handbook for additional details. ADA Statement: If you have a 504 Accommodation Plan, please discuss it with your instructor. If you have any disability but have not documented it with the Disability Support coordinator at Salem Community college, you must do so to be eligible for accommodations. To contact the Disability Support Coordinator, call , visit DON108, or disabilitysupport@salemcc.edu to set up an appointment. To find out more information about disability support services at Salem Community College, visit

6 Section VII Required Text(s): Bookstore Website. Optional Text(s): For textbook information, please see the Salem Community College None Materials / Supplies: None Additional Costs: None