Catalog Description
- Transfer Status
- CSU
- Unit(s)
- 3.00
- Lecture: 51.00 Contact hours/102.00 Out of class hours/153.00 Total hours/3.00 Unit(s)
- Total: 51.00 Contact hours/102.00 Out of class hours/153.00 Total hours/3.00 Unit(s)
Course Description: This course introduces students to the medical coding classification systems used in the United States healthcare industry: International Classification of Diseases 10 Clinical Modification (ICD-10-CM) and Current Procedural Terminology (CPT). Through analysis of case histories and surgical reports, students will learn to distinguish between primary and secondary diagnoses codes, to assign the proper procedural codes, and to explain the importance of accurate medical documentation and clinical records.
Objectives
Upon successful completion of this course, the student should be able to:
- Examine Health Insurance Portability and Accountability Act's (HIPAA) role in determining reimbursement and compliance in the medical office.
- Identify and describe the main components of medical coding.
- Identify and describe CPT and the Healthcare Common Procedure Coding System (HCPCS) and the part each plays in medical office coding.
- Explain the differences in the skills needed to work with Outpatient Coding (for doctors' offices, clinics, outpatient care facilities) and with Inpatient Coding (for hospitals who admit patients for an extended stay).
- Code patient diagnoses and treatments using ICD-10-CM, CPT, and HCPCS codes.
Course Content
Topic Titles / Suggested Time Topic
Lecture
| Topics | Lec Hrs |
|---|---|
Overview of Reimbursement, HIPAA, and Compliance | 3.00 |
Introduction to ICD-10-CM Outpatient Coding and Reporting Guidelines | 9.00 |
CPT Coding, HCPCS, and Evaluation & Management (E & M) | 9.00 |
Introduction to Inpatient Coding | 3.00 |
Anesthesia, Surgery, Integumentary, Musculoskeletal, and Respiratory Coding | 6.00 |
Cardiovascular, Hemic, Lymphatic, Mediastinum, Diaphragm, and Digestive Systems Coding | 6.00 |
Male and Female Genital Systems, Reproductive/Maternity, and Endocrine Systems Coding | 6.00 |
Radiology, Pathology/Laboratory, and medicine coding | 6.00 |
Other non-surgical services coding | 3.00 |
| Total Hours: | 51.00 |
Methods of Instruction
- Collaborative Group Work
- Homework: Students are required to complete two hours of outside-of-class homework for each hour of lecture
- Lecture
- Problem-Solving Sessions
Methods of Evaluation
- Exams/Tests
- Quizzes
- Projects
- Practical Evaluations
Examples of Assignments
Reading Assignments
- Read "ICD-10-CM Outpatient Coding and Reporting Guidelines". Using the ICD-10-CM, identify the correct code for a list of 10 diagnoses provided by the instructor. Be prepared to discuss the justification for your answer with your instructor.
- Read an operative report on a patient. Identify the appropriate codes for the primary surgery portion. Write a one-page summary describing how you determined the codes you used.
Writing Assignments
- Using a problem-focused patient's history and examination, determine the diagnosis and management options, the risks if left untreated, the level of decision-making complexity, and the correct CPT code for the case. Write a one-page paper explaining your answers.
- In a one-page paper describe how inpatient coding differs from outpatient coding.
Out-of-Class Assignments
- Interview a medical coder employed in either an Inpatient or Outpatient environment. Write a one-page paper describing a typical day and include any recommendations the coder offers about being successful in the field. Share your findings with your class.
- Do an online search to find out what testing programs are available and how much training is needed to become a certified medical coder. Be prepared to share your findings in class.
Recommended Materials of Instruction
Buck, Carol. (2016). Step-By-Step Medical Coding. Elsevier Saunders, 2016.
Minimum Qualifications
Health Information Technology