Basic CPT Coding, Part I Course Description The purpose of this course is to provide students with the basic principles of CPT coding and classification systems, the sequencing of codes and impact on reimbursement, as well as the ability to distinguish between CPT basic coding and HCPCS Level II codes. The student will practice assigning codes for procedures in this course. Credit Hour Designation: 0.00 Total Course Hours: 127.55 Total Clock Hours: 38.80 Total Student Preparation Hours: 88.75 Time on Task Number Presentation Discussions Quizzes and Exams Clock Hours Reading and Review Assignments Student Preparation Time 1 1.50 1.50 1.00 4.00 1.75 0.00 1.75 5.75 2 1.00 1.50 0.50 3.00 2.00 2.00 4.00 7.00 Total 3 2.30 1.50 1.00 4.80 27.00 0.00 27.00 31.80 4 1.00 1.50 0.50 3.00 4.00 2.00 6.00 9.00 5 1.00 1.50 0.50 3.00 4.00 2.00 6.00 9.00 6 1.00 1.50 0.50 3.00 8.00 2.00 10.00 13.00 7 1.00 1.50 0.50 3.00 7.00 2.00 9.00 12.00 8 1.00 1.50 0.50 3.00 6.00 2.00 8.00 11.00 9 1.00 1.50 0.50 3.00 3.00 2.00 5.00 8.00 10 1.00 1.50 0.50 3.00 3.00 2.00 5.00 8.00 11 1.00 1.50 0.50 3.00 3.00 2.00 5.00 8.00 12 1.00 1.50 0.50 3.00 0.00 2.00 2.00 5.00 Total 13.80 18.00 7.00 38.80 68.75 20.00 88.75 127.55 46.56 *50-minute clock hour Title and Topics 1: CPT/HCPCS Overview Topics: Introduction to Clinical Coding / CPT / HCPCS, Application of System, Modifiers, CPT Guidelines and Index Course Outcomes and Objectives Explain the basic format of CPT codes Identify key concepts (for example, unlisted procedures) Interpret conventions and characteristics of CPT (for example, semicolon, bullet) Explain the basic format of CPT codes Distinguish between CPT and National codes Define CPT coding Use existing procedures to assign CPT codes Describe the general principles of medical record documentation Identify the official publication for CPT coding Explain the purpose of modifiers Basic CPT Coding, Part I Preview page 1 of 4
Append a CPT code with the correct modifier when given a scenario Identify the proper use of modifier 59 Differentiate between modifiers 73 and 74 Differentiate between modifiers for hospital outpatient use and the complete list of CPT modifiers 2: Evaluation and Management (E/M) Topics: Evaluation and Management (E/M) 3: Surgery Overview and Integumentary System Topics: Surgery Section Overview, Integumentary System Appropriately assign E/M codes on the basis of documentation Accurately assign E/M codes based on documentation in the health record List the classifications of E/M services Identify key components in Evaluation and Management (E/M) coding Apply basic guidelines for assigning CPT codes Apply general guidelines for CPT surgical coding List components of a surgical package Describe the organization of the Surgery section in CPT 4: Musculoskeletal and Respiratory Systems Topics: Musculoskeletal System, Respiratory System 5: Cardiovascular and Digestive Systems Topics: Cardiovascular System, Digestive System 6: Urinary, Male Genital, and Female Genital Systems, and Maternity Care and Delivery Topics: Urinary, Male Genital, and Female Genital Systems, Maternity Care and Delivery 7: Endocrine, Nervous, Eye, and Basic CPT Coding, Part I Preview page 2 of 4
Auditory Systems Topics: Endocrine System, Nervous System, Eye and Auditory Systems 8: Radiology and Anesthesia Topics: Radiology, Anesthesia 9: Pathology and Laboratory Topics: Pathology and Laboratory 10: Medicine Topics: Medicine 11: HCPCS Level II Codes and CPT Category II and III Codes Topics: HCPCS Level II, Category II and III CPT Codes Assign CPT codes for anesthesia services Apply HCPCS coding guidelines Apply HCPCS coding guidelines Identify HCPCS Level II codes Locate and review the list of HCPCS codes from CMS (Centers for Medicare & Medicaid Services) Define and list the components of HCPCS Assign Category II and III CPT codes Apply experience in coding for outpatient and physician medical records 12: Compliance Topics: Laws and Compliance, Fraud and Other Illegal Acts Assign codes according to stated guidelines to outpatient and physician medical records Given a procedure or operative report, correctly assign CPT codes Reference official coding guidelines (CPT Assistant) to support accurate CPT coding assignment Abstract CPT codes for clinical information successfully when given an operative report Assign code(s) for data collection and processing Research Medicare Transmittals and CPT Assistant pertaining to use of modifiers Abstract CPT codes for clinical information successfully when given an operative report Basic CPT Coding, Part I Preview page 3 of 4
Differentiate between CMS-1500 and UB-04 form Apply existing control procedures to ensure accuracy and completeness of coded information Successfully apply the general guidelines for accurate coding assignment Recognize the future use of Computer-Assisted Coding (CAC) software Suggested Textbooks Pearson Titles CPT 2015 Professional Edition ISBN: 0134138260 HCPCS 2015 Level II Professional Edition ISBN: 0134138295 Edition: CPT Case Studies: Examples of Procedures and Services 1st ISBN: 0134130502 Medical Law and Ethics Preview page 4 of 4
AHIMA Titles Basic Current Procedural Terminology and HCPCS Coding Gail Smith, MA, RHIA, CCS-P ISBN: 0134243374 Edition: Basic Current Procedural Terminology and HCPCS Coding Exercises 3rd Gail Smith, MA, RHIA, CCS-P ISBN: 0134244370 AHIMA-Pearson Partnership The AHIMA Pearson partnership is a result of both parties looking to advance the Health Information Management profession, taking advantage of both of our strengths, AHIMA on content and strategy and Pearson with the global power of development and delivery of high value content to a targeted audience. Standards and Certification The content adheres to Professional Certificate Approval Program (PCAP) Standards. Upon completion of the courses, a candidate can sit for the CCA Certification Exam to become a Certified Coding Associate. Medical Law and Ethics Preview page 4 of 4