Syllabus: Medical Coding Specialist Education... · Syllabus: Medical Coding Specialist ... 11.00 Demonstrate a working knowledge of Hemic, Lymphatic, Mediastinum and Diaphragm

Syllabus:

Medical Coding Specialist

Subject Code: 70911

Course Number: HC13201

CIP Code: 51.0713

SOC Code: 29-2071

C-TEC of Licking County

Newark, Ohio

CTPD 055

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Instructors: Debra Graham BS, CCS, CPC, CEMC

Michelle W. Miller CPC, CEDC, COSC, CEMC

Instructor Contact: C-TEC 150 Price Road Newark, Ohio 43055

Appointments as scheduled

Office Telephone (740) 364-2282

C-TEC Telephone (740) 364-2280

Class Meeting Times: M&TH 5:30 p.m.-9:30 p.m. January 9 – June 8, 2017

Class Location: C-TEC 1005

Minimum Hours: 182

Course Prerequisites:

WorkKeys pretesting, High School Diploma or GED

Program Requirements Prior to Externship:

None

Required and Recommended Texts and Resources:

American Medical Association. Current procedural terminology. (2017) Chicago:

American Medical Association. ISBN: 9781622022045

Buck, C.J. HCPCS level II. (2017) Philadelphia: Saunders. ISBN: 9780323430760

Buck, C.J. (2017). Step-by-step medical coding. Philadelphia: Saunders.

ISBN: 9780323430821

Buck, C.J. (2017). Workbook for step-by-step medical coding. Philadelphia: Saunders.

ISBN: 9780323430807

Buck, C.S. (2017). ICD-10 CM for hospitals (Vols. 1-3, Professional Edition).

Philadelphia: Saunders. ISBN: 9780323431217

Lovaasen, K. (2017). ICD-10-CM coding: Theory and practice with ICD-10.

Philadelphia: Saunders. ISBN: 978-0-323-47805-2

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Lovaasen, K. (2017). Workbook for ICD-10-CM/PCS coding: Theory and practice with.

Philadelphia: Saunders. ISBN: 978-0-323-47799-4

Official CPC certification study guide (2017 ISBN # not yet available).

CPC online practice exam. (2017 info not yet available)

Medical Dictionary

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Websites for Gathering Information and Research:

www.icd10data.com

www.findacode.com

www.medilexicon.com

www.askamedicalbiller.com

Required and Recommended Materials: None

Course Description: This course teaches fundamental coding skills for outpatient physician settings and

prepares the student to take the AAPC CPC exam for a career in medical coding. It

provides the most up-to-date information relating to CPT, HCPCS, and ICD-10 diagnosis

coding and assures a broad, encompassing knowledge and expertise in reviewing and

selecting the correct procedure and diagnosis codes for physician services. Successful

completion of the Medical Coding course sequence indicates that the student is eligible to

sit for the American Academy of Professional Coders Examination. AAPC CPC

examination fees are approximately $370.00, not included in the cost of the course.

Course Objectives/Outcomes:

The course objectives include:

Preparing students for post-program success, both in the work force and in their

educational pursuits.

Preparing students to process information using higher order thinking skills and to

engage in sound decision-making.

Providing a rich learning environment utilizing research-based methods of

instruction, state-of-the-art technology, and current resources and materials.

Maintaining high expectations for all students regardless of educational needs and

providing support necessary for achievement.

Providing a challenging, worthwhile curriculum based on current

industry/academic expectations. Specifically, and upon successful completion of

the program/course for Medical Coding Specialist the students will be able to:

http://www.icd10data.com/

http://www.findacode.com/

http://www.medilexicon.com/

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Required Topics: CPT I and II

CPT coding

Medical Coding guidelines

Coding of medical services

CPT, ICD-10 and level II (HCPCS) coding systems

Medicare regulations

Medicare Fraud/Abuse

HMO

Level II National Codes (HCPCS)

Pathology and Laboratory coding

Medical Coding guidelines

Coding of medical services

CPC certification exam

Competencies 1.00 Explain Reimbursement, HIPAA, and Compliance (Ch. 1)

1.01 Distinguish among Medicare Part A, B, C, and D. 1.02 Interpret rules of the Health Insurance Portability and Accountability Act (HIPAA). 1.03 Locate information in the Federal Register. 1.04 Explain the RBRVS system. 1.05 Understand the framework of Medicare Fraud and Abuse. 1.06 Identify the major components of Managed Health Care.

2.00 Demonstrate a working knowledge of CPT classification structure and function (Ch.8)

2.01 Identify the uses of the CPT manual. 2.02 Name the developers of the CPT manual. 2.03 Identify placement of CPT codes on the CMS-1500 insurance form. 2.04 Know the importance of using the current-year CPT manual. 2.05 Recognize the symbols used in the CPT manual. 2.06 Identify the content of the CPT appendices. 2.07 Locate the major sections found in the CPT manual. 2.08 Interpret the information contained in the section Guidelines and notes. 2.09 Describe the CPT code format. 2.10 Recognize modifiers. 2.11 Describe what is meant by unlisted procedures/services. 2.12 Review Category II and III CPT Codes. 2.13 State the purposes of a special report. 2.14 Locate terms in the CPT index.

3.00 Classify Coding Modifiers (Ch. 10)

3.01 Recognize modifiers. 3.02 Understand the purpose of modifiers. 3.03 Select Increased Procedural Services modifier 3.04 Select Unusual Anesthesia modifier 3.05 Select Unrelated E/M Services by the Same Physician During a Postoperative

Period modifier 3.06 Select Significant Separately Identifiable E/M Service by the Same Physician on

the same day of the Procedure or other Service modifier

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3.07 Select the Professional Component modifier 3.08 Select Mandated Services modifier 3.09 Select Anesthesia by Surgeon modifier 3.10 Select preventative services modifier 3.11 Select Bilateral Procedure modifier 3.12 Select Multiple Procedures modifier 3.13 Select Reduced Services modifier 3.14 Select Discontinued Procedure modifier 3.15 Select Surgical Care Only modifier 3.16 Select Postoperative Management Only modifier 3.17 Select Preoperative Management Only modifier 3.18 Select Decision for Surgery modifier 3.19 Select Staged or Related Procedure or Service by the Same Physician during the

Postoperative period modifier. 3.20 Select Distinct Procedural Service modifier 3.21 Select Two Surgeons modifier 3.22 Select Procedure Performed on Infants Less than 4 kg modifier 3.23 Select Surgical Team modifier 3.24 Select Repeat Procedure or Service by Same Physician modifier 3.25 Select Repeat Procedure by Another Physician modifier 3.26 Select Unplanned Return to the Operating/Procedure Room by the Same

Physician following Initial procedure for a Related Procedure During the Postoperative Period modifier

3.27 Select Unrelated Procedure or Service by the Same Physician During the 14. 3.28 Select Assistant Surgeon modifier 3.29 Select Minimum Assistant Surgeon modifier 3.30 Select Assistant Surgeon (When Qualified Resident Surgeon Not Available)

modifier 3.31 Select Reference (Outside) Laboratory modifier 3.32 Select Repeat Clinical Diagnostic Laboratory Test modifier 3.33 Select Alternative Laboratory Platform Testing modifier 3.34 Select Multiple Modifiers modifier

4.00 Analyze Evaluation and Management Services (Ch. 11)

4.01 Explain the three factors of E/M code Assignment. 4.02 Differentiate between a new and an established patient. 4.03 Differentiate between an inpatient and an outpatient. 4.04 Explain the levels of E/M service. 4.05 Review the key components. 4.06 Analyze the key component history. 4.07 Analyze the key component examination. 4.08 Analyze the key component in medical decision making. 4.09 List contributory factors. 4.10 Analyze code information. 4.11 Analyze the types of E/M codes. 4.12 Demonstrate the ability to code E/M services. 4.13 Identify CMS Documentation Guidelines.

5.00 Demonstrate a working knowledge of Anesthesia Coding (Ch.12)

5.01 Define types of anesthesia. 5.02 Explain the format of the Anesthesia section and subsections. 5.03 Understand the anesthesia formula. 5.04 Identify other reporting issues. 5.05 Demonstrate ability to report anesthesia services. 5.06 Identify use of other modifiers with anesthesia codes.

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6.00 Demonstrate a working knowledge of Surgery and General Surgery Coding (Ch. 13)

6.01 Understand the Surgery section format. 6.02 Locate notes and Guidelines in the Surgery section. 6.03 State the uses of the unlisted procedure codes. 6.04 Interpret elements of a special report. 6.05 Examine the separate procedure designation. 6.06 Analyze the contents of a surgical package. 6.07 Determine the contents of the General subsection.

7.00 Demonstrate a working knowledge of Integumentary System Coding (Ch. 14)

7.01 Describe the format of the Integumentary System in the CPT manual. 7.02 Identify the elements of coding Skin, Subcutaneous, and Accessory Structures

services. 7.03 Review the main services in Nails, Pilonidal Cyst, and Introduction. 7.04 Identify the major factors in Repair. 7.05 State the important coding considerations in destruction, Mohs micrographic

surgery and breast procedures 7.06 Demonstrate the ability to code integumentary services and procedures.

8.00 Demonstrate a working knowledge of Musculoskeletal System Coding (Ch. 15)

8.01 Differentiate between fracture and dislocation treatment types. 8.02 Understand types of traction. 8.03 Identify services/procedures included in the General subheading. 8.04 Analyze cast application and strapping procedures. 8.05 Understand elements of arthroscopic procedures. 8.06 Demonstrate the ability to code musculoskeletal services and procedures.

9.00 Demonstrate a working knowledge of Respiratory System Coding (Ch. 16)

9.01 Differentiate between services reported with codes from the Respiratory subsection and those reported with codes from other subsections.

9.02 Explain the effects of extent and approach when reporting endoscopy respiratory procedures.

9.03 Identify highlights of nasal procedure coding. 9.04 Analyze the codes to report services to the accessory sinuses. 9.05 Categorize the codes in the Larynx subheading. 9.06 Explain the structure of the trachea/bronchi codes. 9.07 Distinguish the difference between the codes Selected to report lungs and pleura

services and procedures. 9.08 Demonstrate the ability to code respiratory services and procedures.

10.00 Demonstrate a working knowledge of Cardiovascular System Coding (Ch. 17)

10.01 Understand cardiovascular services across three sections—Surgery, Medicine, and Radiology.

10.02 Review cardiovascular coding terminology. 10.03 Recognize the major differences in the subheadings of the cardiovascular

subsection. 10.04 Define rules of coding cardiovascular services when codes from the Medicine

section are used. 10.05 Identify the major rules of coding cardiovascular services using the Radiology

section codes.

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10.06 Demonstrate the ability to report cardiovascular services. 11.00 Demonstrate a working knowledge of Hemic, Lymphatic, Mediastinum and Diaphragm Coding (Ch. 18)

11.01 Review the Hemic and Lymphatic Systems subsection format. 11.02 Understand the Hemic and Lymphatic Systems subheadings. 11.03 Demonstrate the ability to code Hemic and Lymphatic Systems services. 11.04 Review the format of the Mediastinum and Diaphragm subsection codes. 11.05 Understand the Mediastinum and Diaphragm information. 11.06 Demonstrate the ability to code Mediastinum and Diaphragm services.

12.00 Demonstrate a working knowledge of Digestive System Coding (Ch. 19)

12.01 Understand the format and codes of the Digestive System subsection. 12.02 Report procedures of the lips. 12.03 Report procedures of the vestibule of the mouth. 12.04 Report procedures of the tongue and floor of the mouth. 12.05 Report procedures of the dentoalveolar structures. 12.06 Report procedures of the palate and uvula. 12.07 Report procedures of the salivary gland and ducts. 12.08 Report procedures of the pharynx, adenoids, and tonsils. 12.09 Report procedures of the esophagus. 12.10 Report procedures of the stomach. 12.11 Report procedures of the intestines (except rectum). 12.12 Report procedures of the Meckel’s diverticulum and mesentry. 12.13 Report procedures of the appendix. 12.14 Report procedures of the rectum and colon. 12.15 Report procedures of the anus. 12.16 Report procedures of the liver. 12.17 Report procedures of the biliary tract. 12.18 Report procedures of the pancreas. 12.19 Report procedures of the abdomen, peritoneum, and omentum.

13.00 Demonstrate a working knowledge of Urinary and Male Genital System Coding (Ch.20)

13.01 Understand the format and codes of the Urinary System subsection. 13.02 Review the subheadings and categories of the Urinary System subsection. 13.03 Report services with Urinary System codes. 13.04 Understand the format and codes of the Male Genital System subsection. 13.05 Review the subheadings and categories of the Male Genital System subsection. 13.06 Report services with Male Genital System codes.

14.00 Demonstrate a working knowledge of Reproductive, Intersex Surgery, Female Genital

System and Maternity Care and Delivery Coding (Ch.21)

14.01 Describe reproductive services. 14.02 Report reproductive services. 14.03 Report intersex surgery services. 14.04 Understand the format of the Female Genital System subsection. 14.05 Identify elements of component coding with Female Genital System codes. 14.06 Define the critical terms in maternity and delivery services. 14.07 Define services in the global maternity and delivery package. 14.08 Understand the format of Maternity Care and Delivery subsection services. 14.09 Demonstrate the ability to code Female Genital and Maternity Care and Delivery

subsection.

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15.00 Demonstrate a working knowledge of Endocrine and Nervous System Coding (Ch.22)

15.01 Review the Endocrine System subsection format. 15.02 Understand the Endocrine System subheadings. 15.03 Demonstrate the ability to code Endocrine System services. 15.04 Review the Nervous System subsection format. 15.05 Understand the Nervous System subheadings. 15.06 Demonstrate the ability to code Nervous System services.

16.00 Demonstrate a working knowledge of Eye, Ocular Adnexa, Auditory, & Operating

Microscope Coding (Ch.23)

16.01 Review the Eye and Ocular Adnexa subsection format. 16.02 Understand the Eye and Ocular Adnexa subheadings. 16.03 Demonstrate the ability to code Eye and Ocular Adnexa services. 16.04 Review the Auditory System subsection format. 16.05 Understand the Auditory System subheadings. 16.06 Demonstrate the ability to code Auditory System services. 16.07 Review reporting use of an operating microscope. 16.08 Demonstrate the ability to report the use of an operating microscope.

17.00 Demonstrate a working knowledge of Radiology Coding

17.01 Demonstrate an understanding of Radiology terminology. 17.02 Analyze the elements of component coding in the reporting of radiology services. 17.03 Identify the elements of the global procedure. 17.04 State the appropriate coding of contrast material. 17.05 Explain the format of the Radiology section. 17.06 Demonstrate the ability to code Radiology services and procedures.

1.00 Demonstrate ability to assign Level II National Codes (HCPCS) (Ch. 9)

1.01 List the major features of Level II National Codes, HCPCS.

1.02 Recognize the code groupings within HCPCS.

1.03 Review Temporary Procedure and Professional Services.

1.04 Describe the HCPCS code format. 1.05 Understand the Table of Drugs.

2.00 Demonstrate a working knowledge of Pathology and laboratory Coding (Ch. 25)

2.01 Explain the format of the Pathology and Laboratory section. 2.02 Understand the information in the Pathology and Laboratory Guidelines. 2.03 Demonstrate an understanding of Pathology and Laboratory terminology. 2.04 Differentiate amongst the Organ or Disease Oriented Panels codes. 2.05 Recognize Drug Testing codes. 2.06 Identify Therapeutic Drug Assays codes. 2.07 Classify Evocative/Suppression Testing codes. 2.08 Explain Consultations (Clinical Pathology) codes. 2.09 Interpret Urinalysis and Chemistry codes. 2.10 Evaluate Hematology and Coagulation codes. 2.11 Describe Immunology codes. 2.12 Discriminate amongst Transfusion Medicine codes.

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2.13 Interpret Microbiology codes. 2.14 Evaluate Anatomic Pathology codes. 2.15 Summarize Cytopathology and Cytogenic Studies codes. 2.16 Explain Surgical Pathology codes. 2.17 Choose Other Procedures codes. 2.18 Demonstrate the ability to code Pathology and Laboratory services.

3.00 Demonstrate a working knowledge of Medicine Coding (Ch. 26)

3.01 Analyze the format of the Medicine section. 3.02 Report psychiatric services. 3.03 Identify biofeedback services. 3.04 List components of dialysis reporting. 3.05 Demonstrate ability to report gastrointestinal services. 3.06 Understand ophthalmology and otorhinolaryngologic reporting. 3.07 Report cardiovascular services. 3.09 List the important elements of coding allergy and clinical immunology services. 3.10 Report endocrine services. 3.11 Define neurology and neuromuscular services. 3.12 Demonstrate an understanding of central nerves assessment and intervention. 3.13 Analyze chemotherapy services. 3.14 Report special services and dermatologic procedures. 3.15 Code physical medicine and rehabilitation services. 3.16 Report active wound management. 3.17 Define osteopathic and chiropractic services. 3.18 Understand non-face-to-face services. 3.19 Code special services, procedures, and reports. 3.20 Report medical services using Medicine section codes.

4.00 Demonstrate an understanding of the focus of the CPC Certification Exam

4.01 Understand the concept of business medicine and explain how the coder fits in to the office setting.

4.02 Review anatomy as applied to the ICD-10, CPT and HCPCS coding guidelines. 4.03 Apply knowledge of coding guidelines to real life coding examples. 4.04 Identify test parameters and testing techniques necessary for successful

completion of certification exam. 4.05 Utilize review questions and practice exams to identify deficiencies and reinforce

key competencies. necessary to pass CPC certification examination.

Required Topics: Medical ICD-10 CM Diagnosis Coding I and II

ICD-10 CM coding

ICD-10 CM coding section guidelines Competencies 1.00 Determine the rationale for and history of coding.

1.01 Describe the application of coding. 1.02 Define nomenclature and classifications. 1.03 Identify the historical timeline of coding. 1.04 Delineate coder training needs for transitioning to ICD-10-CM. 1.05 Describe different coding organizations and credentials.

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1.06 Recognize the importance of the Standards of Ethical Coding. 1.07 Define compliance as it relates to coding. 1.08 Explain confidentiality as it applies to coding.

2.00 Explore the health record as the foundation of coding.

2.01 Explain the purpose of the various forms or reports found in a health record. 2.02 Define “principal diagnosis”. 2.03 Define “principal procedure”. 2.04 Identify reasons for assigning codes for other diagnoses. 2.05 List the basic guidelines for reporting diagnoses/procedures. 2.06 Identify types of documentation acceptable for assigning codes. 2.07 Explain the query process.

3.00 Identify the ICD-10-CM format and conventions.

3.01 Identify the format of the ICD-10-CM code book. 3.02 Explain and apply the conventions and guidelines.

4.00 Examine the basic steps of coding.

4.01 Assign a diagnosis or procedure from the Alphabetic Index using main terms, sub terms, and Essential modifiers.

4.02 Explain the necessity of referencing the Alphabetic Index and the Tabular List. 4.03 Describe basic steps of coding. 4.04 Explain how to use both the Alphabetic Index and the Tabular List.

5.00 Apply the general coding guidelines for diagnosis.

5.01 Apply ICD-10-CM Official Guidelines for Coding and Reporting. 5.02 Sequence ICD-10-CM diagnosis codes as directed by coding guidelines or ICD-

10-CM conventions. 5.03 Determine whether signs, symptoms, or manifestations require separate code

assignments. 5.04 Assign ICD-10-CM diagnosis codes for sequelae.

6.00 Identify symptoms, signs, and abnormal clinical and laboratory findings (Ch.8).

6.01 Apply and assign the correct ICD-10-CM codes in accordance with Official guidelines for Coding and Reporting.

6.02 Determine when to assign signs and symptoms codes. 6.03 Assign the correct Z codes. 6.04 Explain the importance of documentation in relation to MS-DRGs for

reimbursement. 7.00 Characterize infectious and parasitic disease codes (Ch.9).

7.01 Apply and assign the correct Guidelines for Coding and Reporting. 7.02 Recognize infectious and parasitic diseases. 7.03 Assign the correct Z codes related to infectious and parasitic diseases. 7.04 Identify common treatments, medications, laboratory values and diagnostic tests. 7.05 Explain the importance of documentation as it relates to MS-DRGs for

reimbursement. 8.00 Identify neoplasm codes (Ch.10).

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8.01 Apply and assign the correct ICD-10-CM codes in accordance with Guidelines for Coding and Reporting.

8.02 Identify pertinent anatomy and physiology for neoplasm. 8.03 Assign the correct Z codes related to neoplasms. 8.04 Identify common treatments, medications, laboratory values and diagnostic tests. 8.05 Explain the importance of documentation in relation to MS-DRGs for

reimbursement. 8.06 Identify neoplastic diseases.

9.00 Categorize codes for diseases of the blood and blood- forming organs (Ch.11).

9.01 Apply and assign the correct ICD-10-CM codes in accordance with Official Guidelines for Coding and Reporting.

9.02 Identify pertinent anatomy and physiology of the blood and blood-forming organs. 9.03 Identify diseases of the blood and blood-forming organs. 9.04 Assign the correct Z codes and procedure codes related to the blood-forming

organs. 9.05 Identify laboratory values and diagnostic tests. 9.06 Explain the importance of documentation in relation to MS-DRGs for

reimbursement. 10.00 Identify codes for endocrine, nutritional, metabolic diseases, and immunity disorders (Ch.12)


10.02 Identify pertinent anatomy and physiology of the endocrine, nutritional, and metabolic diseases and immunity disorders.

10.04 Identify endocrine, nutritional, and metabolic diseases and immunity disorders. 10.04 Assign correct Z codes related to endocrine, nutritional, and metabolic diseases. 10.05 Identify common treatments, medications, laboratory values, and diagnostic

tests. 10.06 Explain the importance of documentation in relation to MS-DRGs for

reimbursement. 11.00 Apply codes for mental, behavioral, and neurodevelopmental disorders (Ch.13)

11.01 Apply and assign the correct ICD-10-CM codes in accordance with Official Guidelines for Coding and Reporting

11.02 Identify pertinent anatomy and physiology of mental, behavioral, and neurodevelopmental disorders.

11.04 Identify various mental, behavioral, and neurodevelopmental disorders. 11.05 Assign the correct Z codes and related to mental, behavioral, and

neurodevelopmental disorders. 11.06 Identify common treatments and medications. 11.07 Explain the importance of documentation in relation to MS-DRGs for

reimbursement. 12.00 Characterize codes for diseases of the nervous system and sense organs (Ch.14).


12.02 Identify pertinent anatomy and physiology of the nervous system and sense organs.

12.03 Identify disease of the nervous system and sense organs. 12.04 Assign the correct Z codes related to the nervous system and sense organs.

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12.05 Identify common treatments, medication, laboratory values, and diagnostic tests. 12.06 Explain the importance of documentation in relation to MS-DRGs for

reimbursement. 13.00 Identify codes for diseases of the circulatory system (Ch.15).


13.02 Identify pertinent anatomy and physiology of the circulatory system. 13.03 Identify disease of the circulatory system. 13.04 Assign the correct Z codes related to the circulatory system. 13.05 Identify common treatments, medication, laboratory values, and diagnostic tests. 13.06 Explain the importance of documentation in relation to MS-DRGs for

reimbursement. 14.00 Identify codes for the respiratory system (Ch.16).

14.01 Apply and assign the correct ICD-9-CM and ICD-10-CM codes in accordance with Official Guidelines for Coding and Reporting.

14.02 Identify pertinent anatomy and physiology of the respiratory system. 14.03 Identify disease of the respiratory system. 14.04 Assign the correct Z codes related to the respiratory system. 14.05 Identify common treatments, medications, laboratory values, and diagnostic

tests. 14.06 Explain the importance of documentation in relation to MS-DRGs for

reimbursement. 15.00 Categorize codes for the digestive system (Ch.17).


15.02 Identify pertinent anatomy and physiology of the digestive system. 15.03 Identify disease of the digestive system. 15.04 Assign the correct V/Z codes and procedure codes related to the digestive

system. 15.05 Identify common treatments, medication, laboratory values, and diagnostic tests. 15.06 Explain the importance of documentation in relation to MS-DRGs for

reimbursement. 16.00 Identify codes for the diseases of the skin and subcutaneous tissue (Ch.18).

16.01 Assign the correct ICD-10-CM codes in accordance with Official Guidelines for Coding and Reporting.

16.02 Identify pertinent anatomy and physiology of the skin and subcutaneous tissue. 16.03 Identify disease of the skin and subcutaneous tissue. 16.04 Assign the correct Z codes and procedure codes related to the skin and

subcutaneous tissue. 16.05 Identify common treatments, medication, laboratory values, and diagnostic tests. 16.06 Explain the importance of documentation in relation to MS-DRGs for

reimbursement. 17.00 Identify codes for the musculoskeletal system and connective tissue (Ch.19).


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17.02 Identify pertinent anatomy and physiology of the musculoskeletal system and connective tissue.

17.03 Identify diseases of the musculoskeletal system and connective tissue. 17.04 Assign the correct Z codes related to the musculoskeletal system and connective

tissue. 17.05 Identify common treatments, medications, laboratory values and diagnostic tests. 17.06 Explain the importance of documentation as it relates to MS-DRGs for

reimbursement. 18.00 Identify codes for the diseases of the genitourinary system (Ch.20).


18.02 Identify pertinent anatomy and physiology of the genitourinary system. 18.03 Identify diseases of the genitourinary system. 18.04 Assign the correct Z codes related to the genitourinary system. 18.05 Identify common treatments, medications, laboratory values and diagnostic tests. 18.06 Explain the importance of documentation as it relates to MS-DRGs for

reimbursement. 19.00 Identify codes for the complications of pregnancy, childbirth, and puerperium (Ch. 21).


19.02 Identify pertinent anatomy and physiology of pregnancy, childbirth, and the puerperium.

19.03 Recognize conditions and complications of pregnancy, childbirth, and the puerperium.

19.04 Assign the correct Z codes related to pregnancy, childbirth, and the puerperium. 19.05 Identify common treatments, medications, laboratory values and diagnostic tests. 19.06 Explain the importance of documentation as it relates to MS-DRGs for

reimbursement. 20.00 Identify codes for congenital anomalies and perinatal conditions (Ch. 22).


20.02 Identify congenital anomalies and perinatal conditions. 20.03 Assign the correct Z codes to congenital anomalies and perinatal conditions. 20.04 Identify common treatments, medications, laboratory values, and diagnostic

tests. 20.05 Explain the importance of documentation as it relates to MS-DRGs for

reimbursement. 21.00 Identify codes for injuries and external cause codes (Ch.23).


21.02 Identify the various types of injuries. 21.03 Assign the correct Z codes and external cause codes related to injuries. 21.04 Identify common treatments, medications, laboratory values and diagnostic tests. 21.05 Explain the importance of documentation as it relates to MS-DRGs for

reimbursement. 24.00 Identify codes for burns, adverse effects, and poisonings (Ch. 24)

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24.02 Identify the various types of burns. 24.03 Differentiate between an adverse effect and a poisoning. 24.04 Assign the correct Z codes, External cause codes related to burns, adverse

effects, and poisonings. 24.05 Identify common treatments, medications, laboratory values and diagnostic tests. 24.06 Explain the importance of documentation I relation to MS-DRGs for

reimbursement. 25.00 Identify codes for complications of surgical and medical care (Ch. 25)


25.02 Identify complications of surgical and medical care. 25.03 Assign the correct Z codes related to complications of surgical and medical care. 25.04 Explain the importance of documentation in relation to MS-DRGs for

reimbursement.

26.00 Examine reimbursement methodologies (Ch. 26)

26.01 Describe the complexities of MS-DRGs and hospital reimbursement. 26.02 Explain the difference between optimization and maximization. 26.03 Identify key elements of a UB-04. 26.04 Describe the elements and purpose of the charge description master (CDM). 26.05 Explain medical necessity. 26.06 Calculate case-mix index (CMI). 26.07 Explain the role of Quality Improvement Organizations (QIOs). 26.08 Explain the purpose of PEPPER and Recovery Audit Contract (RAC). 26.09 Describe the purpose of a clinical documentation improvement program.

27.00 Examine outpatient coding (Ch. 27)

27.01 Explain terminology as related to the outpatient setting. 27.02 Describe the difference between inpatient coding guidelines and outpatient

coding guidelines. 27.04 Describe what CPT coding is, when it is used, and the official guideline source. 27.05 Apply Diagnostic Coding and Reporting Guidelines of Outpatient Services. 27.06 Assign ICD-10-CM codes for outpatient services and explain the purpose and

use of APCs. 28.00 Demonstrate an understanding of key concepts and focus of CPC

28.01 Understand the concept of business medicine and explain how coder fits into the office setting

28.02 Review Anatomy and Medical Terminology as applied in ICD-10-CM, CPT and

HCPCS coding guidelines

28.03 Identify testing parameters, formats and techniques necessary for successful

completion of CPC® exam

28.04 Identify common format(s) used for CPC certification questions

28.05 Identify, review and apply chapter specific coding concepts and guidelines for all

body system chapters in ICD-10-CM, CPT and HCPCS

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28.06 Identify, review and apply chapter specific coding concepts and guidelines for

evaluation and management codes (E/M)

28.07 Identify, review and apply chapter specific coding concepts and guidelines for

radiology, pathology/laboratory and anesthesia

28.08 Identify, review and apply appropriate use of modifiers

28.09 Apply knowledge of coding guidelines to real life coding examples

28.10 Utilize workbook and on-line practice resources to identify deficiencies, and

reinforce and improve key competencies necessary to pass the CPC certification

examination

Grading: Evaluation of student performance is based upon pupil performance objectives relating to

course competencies study. The number of competencies mastered and the degree of

mastery is translated into appropriate grades consistent with the C-TEC Board of

Education policy on grading guidelines, practices, and procedures.

In the process of evaluation, instructors obtain several grades for each student within the

time frame of the program/course. These grades may include, but are not limited to,

performance on tests, quizzes, homework, assignments, special research projects,

classroom participation, lab competency mastery and/or improvement and the

demonstration of positive employability traits.

Evaluation and Grading:

The student is evaluated based on class performance, and must complete the course with

a grade of “c” or higher.

Evaluation is directly related to the performance objectives.

Performance is measured by examination, Assignments,

and/or quizzes.

The letter grade is based on the percentage of the total points

earned

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Grades will be based on the following:

Instructor will provide specifics for grading related to each section

of the course.

Late Assignments: No late Assignments will be accepted. No exceptions. All

Assignments are due on date indicated.

Journal Reflection: A journal reflection should begin with an introductory paragraph that

introduces the main topic of the article and summarizes its content.

Following the introduction, a few paragraphs should be written

detailing insights, implications, and how the information might be

applied in your career. In addition, the reflection should include your

personal thoughts and opinions concerning the content of the article.

Reflections should be approximately 1 1/2 to 2 pages in length.

Make Up Quizzes: May be made up only in the event of unique and unusual

circumstances, on a case by case basis.

Course Policies: Exams cannot be made up during class time. The missed exam

must be made up prior to that instructor’s next scheduled class.

Exceptions will only be allowed in an extreme emergency. Cell

phones, Blackberries, iPods, PDA’s or other electronic devices are

to be placed on silent mode in the classroom. Please allow calls to

go to voicemail. In the event of an emergency; calls should be

taken in the hallway. Academic dishonesty cases will be handled

in accordance with C-TEC’s policies.

Grading Scale

90-100% - A

80-89% - B

70-79% - C

60-69% - D

59% or below – F

Credentialing: Upon successful completion of the program the student will be able to apply for

the examination of the American Academy of Professional Coders. Fee $370.00,

not included in the cost of the course.

xviii

Course Policies: Disruptive Behavior – Disruptive behavior of any type is NOT permitted and

may result in dismissal from the program. Sleeping during class, tardiness to

class, excessive talking during class and disrespectful behavior are examples of

disruptive behavior.

Plagiarism – Submitting plagiarized work for an academic requirement is

considered academic misconduct. Plagiarism is the representation of another’s

work or ideas as one’s own; it includes the unacknowledged word-for-word use

and/or paraphrasing of another person’s work, and/or inappropriate

unacknowledged use of another person’s ideas.

Diversity - It is the responsibility of the instructor and the students to foster and

maintain a harmonious, non-threatening and non-discriminating environment in

the classroom. Therefore, all individuals are to be respected as equal and

contributing partners of our society.

xix

Total Classroom Hours: 80 CPT (Current Procedural Terminology) Mondays 5:30-9:30pm

Instructor: Michelle W. Miller CPC,CEDC, COSC, CEMC

740-815-8535 [email protected]

Class Date Chapter Review/Lecture Classroom Activity Quiz Homework Assignment Quiz Points HW Points Hours

COTC Spring Semester MCDE 104

1/9/2017 Anatomy & Medical Terninology Assessment Read Chapter 1,8, 10 0 75 4

Study Habits Assessment: Christine Greetham

Chapter 1-Reimbursement Discussion Chapt 1 WB Questions 1-25

Chapter 8- Intro to CPT Review Preface/Intro to CPT Chapt 8 WB Questions 1-28

Chapter 10-Modifier Chapt 10 WB Questions 1-22

1/16/2017 MARTIN LUTHER KING DAY NO CLASSES

1/23/2017 Review WB Chapt 1,8,10 Quiz Chapt 1,8,10 Read Chapter 11 100 36 4

Chapter 11-Eval and Mgmt Chapter 11 overview Chapt 11 WB Questions 1-73 evens

1/30/2017

Chapter 11- E/M part 2 Practice E/M coding No quiz Prep for quiz over E/M Chapter 11 0 0 4

Go over WB questions

2/6/2017 Review WB Chapter 11 Quiz Chapt 11 Read Chapter 12 100 30 4

Chapter 12-Anesthesia Chapter 12 overview Chapter 12 WB Questions 1-30

Turn In Group Study Excercises 4

2/13/2017 Review WB Chapter 12 Quiz Chapt 12 Read Chapter 13 100 30 4

Chapter 13-Surgery Chapter 13 overview Chapter 13 WB Questions 1-30

2/20/2017 Review WB Chapter 13 Quiz Chapt 13 Read Chapter 14 and 20 100 64 4

Chapter 14-Integumentary Chapter 14 and 20 Overview Chapter 14 WB Questions 1-51 evens

Chapter 20-Urinary/Male Genital System Chapter 20 WB Questions 1-78 evens

2/27/2017 Review WB Chapt 14 and 20 Quiz Chapt 14, 20 Read Chapter 15 100 59 4

Chapter 15-Musculoskeletal Chapter 15 Overview Chapter 15 WB Questions 1-59

3/6/2017 Review WB Chapt 15 Quiz Chapter 15 Read Chapter 16 100 29 4

Chapter 16-Respiratory Chapter 16 Overview Chapter 16 WB questions 1-58 evens

3/13/2017 SPRING BREAK SPRING BREAK SPRING BREAK SPRING BREAK SPRING BREAK SPRING BREAK SPRING BREAK

3/20/2017 Review WB Chapter 16 100 100 4

Midterm CPT Exam covering Chapters 1, 8, 10-16, 20

3/27/2017 Chapter 17 overview Read Chapter 17 100 61 4

Chapter 17-Cardiovascular Chapter 17 WB questions 1-61

4/3/2017 Continue Chapter 17 no quiz Study for Chapter 17 Cardio quiz 0 0 4

Chapter 17-Cardiovascular-part 2 Roll-out CPC On-Line Exam B & C Assignments Due 5/1

4/10/2016 Review WB Chapter 17 Quiz Chapter 17 Read Chapters 18, 19 100 43 4

Chapter 18- Hem/Lymph Chapter 18 and 19 overview Chapter 18 WB questions 1-46 evens

Chapter 19- Digestive Chapter 19 WB questions 1-41 evens

4/17/2017 Review WB Chapter 18, 19 Quiz Chapter 18, 19 Read Chapter 21 100 34 4

Chapter 21-Reproduction/ Female Genital Chapter 21 overview Chapter 21 WB questions 1-69 evens

Intersex, Maternity, Delivery

4/24/2017 Review WB Chapter 21 Quiz Chapter 21 Read Chapter 22, 23 100 53 4

Chapter 22- Endocrine and Nervous Chapter 22, 23 overview Chapter 22 WB questions 1-31

Chapter 23- Eye and Ear Chapter 23 WB questions 1-44 evens

5/1/2017 Review WB Chapter 22,23 Quiz Chapter 22, 23 Read Chapter 24 100 28 4

Chapter 24- Radiology Chapter 24 overview CPC B & C Exams Due Chapter 24 WB questions 1-56 evens 8

5/8/2017 START MCDE 106 COTCNew Semester COTC

COTC Semester Break No Classes May 6-145/15/2017 Review WB Chapter 24 Quiz Chapter 24 Read Chapter 25 100 13 4

Chapter 25-Pathology/Lab Chapter 25 overview Chapter 25 WB questions 1-13

Resume: Draft Due 6/1

5/22/2017 Review WB Chapter 25 Quiz Chapter 25 Read Chapter 9, 26 100 81 4

Chapter 9- HCPCS (Level 2 codes) Chapter 9 WB questions 1-32

Chapter 26-Medicine Chapter 26 WB questions 1-49

5/29/2017 MEMORIAL DAY-NO CLASSES

6/5/2017 Chapter 9 and 26 continued Review WB Chapter 9, 26 4

6/12/2017 CPC Exam Prep Review WB Chapter 9, 26 Quiz Ch. 9 & 26 Study for Final Exam 100 0 4

Review for Final Exam

6/15/2017 FINAL EXAM COMBINED ICD10 AND CPT 100

TOTAL 1600 636 88

Calendar changes may occur per instructor.

xx

11/2/2016 Debra Graham, BS, CCS, CPC, CEMC

cell: 740-819-4844

[email protected]

Class Date 2017 Chapter Reviews/Lectures Classroom Activity Quiz Homework Assignment for Next Class

1/12/2017

Introduction to Medical Coding

Chapters 1,2,3

Read Chapters 1,2,3 & review guidelines in ICD-

10 CM pg. x-page 8 and pg. 39-43

Textbook Chapter 1 Workbook Questions ALL

Chapter 2 Workbook Questions ALL

Chapter 3 Workbook Questions ALL

1/19/2017 Chapters 4,5 Review WB Ch. 1,2,3 Chapters 1,2,3 Read Chapters 4,5 & Review Guidelines

Basic Steps of Coding Book exercises in class Chapter 4 Workbook Questions- ALL

General Coding Guidelines for Dx Chapter 5 Workbook Questions ALL

Rollout Group Study Exercise Due 2/6

1/26/2017 Chapters 8, 9 Review WB Ch. 4 & 5 Chapters 4, 5

Ch. 8 Symptoms, Signs, and Ill

Defined Conditions

Book exercises in class Chapter 8 Workbook Questions Abbev/Glossary

ALL, Coding -Case Scenarios odds only, Case

Study: 8.1 & 8.3 (a,c,d)

Ch. 11 Infectious and Parasitic

Diseases

Book exercises in class Chapter 9 Workbook Questions Abbrev/Glossary

ALL, Coding & Case Scenarios odds only, Case

Study: 9.1 & 9.3 (a,c,d)

2/2/2017 Ch. 10 11 Review WB Ch. 8 & 9 Chapters 8 & 9

Ch. 10 Neoplasms Book exercises in class Chapter 10 Workbook Questions Abbrev/Glossary:

ALL, Coding & Case Scenarios odds only,Case

Study: 10.1 & 10.3 (a,c,d)

Ch. 11: Blood and Blood Forming

Organs



Study: 11.1 & 11.2 (a,c,d)

2/9/2017 Chapter 12 Review WB Ch. 10 & 11 Chapter 10 & 11 Read Chapters 12 & review guidelines

Ch. 12: Endocrine, Nutritional,

Metabolic Diseases, and Immunity



Study: 12.1 & 12.3 (a,c,d)

10/30/2016 Debra Graham, CCS, CPC, CEMC

cell: 740-819-4844 [email protected]


2/16/2017 Ch. 13, 14 Review WB Ch. 12 Chapter 12

Ch. 13: Mental, Behavioral, and

Neurodevelopmental Disorders



Study: 13.1 & 13.2 (a,c,d)

Ch. 14: Nervous System, Eye &

Adnexa and Ear & Mastoid Process



Study: 14.1 & 14.3 (a,c,d)

2/23/2017 Chapter 15 Review WB Ch. 13 & 14 Chapters 13 & 14 Read Chapter 15 & review guidelines

Cardiovascular Book exercises in class Chapter 15 Workbook Questions Abbrev/Glossary


Study: 15.1 & 15.3 (a,c,d)

3/2/2017 Chapter 16 Review WB Ch. 15 Chapter 15 Read Chapter 16 & review guidelines

Diseases of the Respiratory System Book exercises in class Chapter 16 Workbook Questions Abbrev/Glossary


Study: 16.1 & 16.3 (a,c,d)

Review of Guidelines from Chapters

1-5, 8-16

Chapter 16 Study for Midterm to include Chapters 1-5, 8-16

Give CPC Practice exam A to groups: Due

3/23

3/9/2017 Review WB Ch. 16

ICD-10 MIDTERM ICD-10 MIDTERM Ch. 1-5, 8-16

3/13/2017 SPRING BREAK OBSERVED NO CLASSES




3/23/2017 Introduce On-Line CPC Exam Sign-up for On-line Exams CREDIT CARDS***

Chapter 17 Group Exam A Due Read Chapter 17 & Review Guidelines

Diseases of the Digestive System Chapter 17 Workbook Questions Abbrev/Glossary


Study: 17.1 & 17.3 (a,c,d)

3/30/2017 Chapter 18 Review WB Ch. 17 Chapter 17

Ch. 18: Diseases of the Skin &

Subcutaneous Tissue

Book exercises in class Chapter 18 Workbook Questions Abbrev ALL,

Coding & Case Scenarios odds only, Case Study:

18.1 & 18.2 (a,c,d)CEMC and/or AAPC Meeting

4/6/2017 Chapter 19 Review WB Ch. 18 Chapter 18 Read Chapter 19 & review guidelines

Ch. 19: Diseases of Musculoskeletal

and Connective Tissue

Book exercises in class Chapter 19 Workbook Questions AbbrevALL,

Coding & Case Scenarios odds only, Case Study:

19.1 & 19.3 (a,c,d,)

4/13/2017 Encoder Introdcution (TruCode) TruCode Assessment Due TBD

Ch. 20 Review WB Ch. 19 Chapter 19

Ch. 20: Diseases of the Genitourinary

System

Book exercises in class Chapter 20 Workbook Questions

Abbrev/Glossary/Coding ALL, Case Scenarios

odds only, Case Study: 20.1 only

4/20/2017 Chapters 21, 22 Review WB Ch. 20 Chapter 20 Read Chapters 21, 22 & review guidelines

Ch. 21 Complications of Pregnancy,

Childbirth, and Puerperium


ALL, Coding & Case Scenarios: odds only,Case

Study: 21.1 & 21.3 (a,c,d)

Ch. 22 Congenital Anomalies and

Perinatal

Book exercises in class Chapter 22 Workbook Questions Abbre/Glossary


Study: 22.1 & 22.3 (a.c.d)

4/27/2017 Ch. 23 Review WB Ch. 21, 22 Chapters 21, 22

Ch. 23 Injuries and V Codes, Z

Codes

Book exercises in class Chapter 23 Workbook Questions Abbrev/Glossary:

ALL, Coding -Case Scenario: odds only, Case

Study: 23.1 & 23.3 (a,c,d)




5/4/2017 Ch. 24 Review WB Ch. 23 Chapter 23

Ch. 24 Burns,Adverse Effects, and

Poisonings



Study: 24.1 24.3 (a,c,d)

5/11/2017 COTC SEMESTER BREAK OBSERVED NO CLASSES May 6-145/18/2017 Chapter 25 Review WB Ch. 24 Chapters 24 Read Chapters 25 & review guidelines

Complications Surgical & Medical

Care



Study: 25.1 & 25.3 (a,c,d)

5/25/2017 Chapters 26, 27 Review WB Ch. 25 Chapter 25 Read Chapters 26, 27 & review guidelines

Ch. 26 Reimbursement Methodologies Book exercises in class Chapter 26 Workbook Questions

Abbrev/Glossary/Multiple Choice/Short Answer

ALL

Ch. 27 Outpatient Coding Book exercises in class Chapter 27 Workbook Questions Abbrev/Glossary

ALL, Coding & Case Scenarios odds only

6/1/2017 Draft Resume Due

Review WB Chapters 26, 27 Chapters 26, 27

6/8/2017

Thursday, June 15 ICD-10 & CPT COMBINED FINAL EXAM

Resumes, Job Search, and Interviewing: Anne Bowman

CPC Study Guide Practice Exam & ICD-10 Guideline Review

ICD-10-CM CODING THEORY AND PRACTICE CLASS

MEDICAL CODING SPECIALIST COURSE







Ch. 1: The Rationale for and Hx of Coding

Ch. 2: The Health Record as the Foundaton of Coding

Ch. 3: ICD-10-CM Format and Conventions

Review Study Habits Assessment: Christine Greetham

xxi

Documents

Syllabus: Medical Coding Specialist Education... · Syllabus: Medical Coding Specialist ... 11.00 Demonstrate a working knowledge of Hemic, Lymphatic, Mediastinum and Diaphragm