Medical Coding I HITT1013

Transcription

1 HOUSTON COMMUNITY COLLEGE SOUTHWEST Medical Coding I HITT1013 Date and Time of class: Class CRN: Instructor s Name: School Site: Phone number:

2 HOUSTON COMMUNITY COLLEGE POWER CENTER COURSE SYLLABUS Medical Coding I HITT 1013 Provides skills and knowledge in the health information field for ICD and CPT coding of insurance forms for reimbursement of medical services. Prerequisite is Medical Terminology. COURSE OBJECTIVE: This course is designed to provide practical applications of the linkage of the coding systems ICD and CPT in completion of medical claims in a multiple health information setting. GOALS: Students will understand ICD and CPT terminology. Students will understand the life cycle of insurance claims. Students will demonstrate knowledge of ICD and CPT coding regarding reimbursement issues. Students will demonstrate knowledge of filing commercial and government claims and knowledge of Workers' Compensation. LEARNING OUTCOMES: Students will demonstrate mastery of course objectives by successfully completing "10" HCFA 1500 claim forms manually. PREREQUISITE: Medical Terminology. REQUIRED TEXTBOOK: 2005 ICD-9-CM, Vols 1 & 2, Office Edition indexed, PMIC 2005 CPT Plus!, PMIC 2004 Coding Workbook for the Physician s Office, Thomson Learning/Delmar Publisher COURSE REQUIREMENTS AND EXPECTATIONS This is a 32-hour instructor guided course. Students will complete the required chapter exercises within the textbook and practice the chapter exercises on the computer. -2- Revised Jan 11, 2005

3 ATTENDANCE: To fully benefit from the class, students are expected to attend all classes. REQUIREMENTS FOR COURSE COMPLETION CERTIFICATE: To receive a Certificate of Completion and Continuing Education Units, students must meet the following requirements: Attend at least 80% of scheduled class time Complete the course material demonstrating mastery of course concepts as determined by the instructor. CELL PHONES AND PAGERS: Cell phones and pagers are very disruptive during class. They must be turned off or set to mute while in the classroom or student lab. WITHDRAWAL AND REFUND POLICY: Please refer to the HCC catalog for withdrawal and refund policy. DISABILITY SERVICES: Any student with a documented disability (e.g. physical, learning, psychiatric, vision, hearing, etc.) who needs to arrange reasonable accommodations must contact the Disability Services Office at the respective college at the beginning of each semester. Faculty are authorized to provide only the accommodations requested by the Disability Support Services Office at DISCLAIMER: Medical Coding introduces students to document coding of health insurance claims. The Contract Training and Continuing Education department does not guarantee student job placement in hospitals or medical offices, or insurance claims offices, and the course does not prepare students for home/office coding businesses. Students should not expect to have experience necessary for employment in the hospital setting. The Medical Coding certificate program prepares a beginner student for entry-level skills in a doctor s office or billing department. Students should not expect enough experience to operate their own billing software service after two coding classes. ADDITIONAL LEARNING OPPORTUNITIES The Houston Community College System has outlined instructional goals in the strategic plan, Building a Learning College, This course complies with these goals in the following manner: Opportunities for Student-Faculty Interaction: Students are encouraged to ask questions and request clarification or guidance as needed during class. A question and answer period is always provided. -3- Revised Jan 11, 2005

4 Opportunities for Career Exploration: Topics relevant to future employment and career exploration opportunities will be presented to the students. Opportunities for Supplemental Instruction: Students are informed of instructional aids and resources, including books, other publications, and web sites relevant to the course. Speaker Forum: At the discretion of the instructor, speakers may be invited to address the class on pertinent topics. -4- Revised Jan 11, 2005

5 What's in Medical Coding? ACTIVITY SHEET/COURSE OUTLINE HITT 1013 This class is designed to abstract patient records and other source documents to accurately code all procedures and diagnoses using the International Classification of Diseases Clinical Modification (ICD-CM) for diagnoses, Current Procedural Terminology (CPT), and the HCFA 1500 (Health Care Financing Administration) Common Procedures Coding System-(HCPCS). Health Insurance Specialist (chapter 1) Employment Opportunities Basic Skill Requirements Health Insurance Specialist Responsibilities Legal Considerations (chapter 2) Breach of Confidentiality Claims Information Telephone Queries Insurance Fraud and Abuse Introduction to Health Insurance (chapter 3) Disability and Liability Insurance Third-Party Reimbursement Methods Managed Health Care (chapter 4) Six Managed Care Models HMO Accreditation Life Cycle of an Insurance Claim (chapter 5) Insurance Company Processing of a Claim Diagnosis Coding (chapter 6) CPT Procedure Coding (chapter 7) HCPCS Coding System (chapter 8) Coding From Source Documents (chapter 10) -5- Revised Jan 11, 2005

6 STUDENT COMPETENCY VALIDATION/EVALUATION PRE-COURSE EVALUATION MEDICAL CODING HITT 1013 This evaluation measures your current knowledge of Advanced Medical Transcription and helps determine if this course is appropriate for your current skill level. Please answer the following by placing a check mark in the appropriate column. Can you perform the following tasks? Can Can with help Cannot Apply optical scanning guidelines when completing Claim forms. Explain the function of the national Blue Cross and Blue Shield Association. Identify the typical services found in Major Medical coverage. Identify and explain the five HMO models. Identify the three levels of NCQA accreditation. Identify and explain the six managed care models. Explain an insurance company's claims review process. Identify and explain the seven steps in coding Diagnoses using the ICD-CM coding system. Explain the format of the CPT system. Name Date -6- Revised Jan 11, 2005

7 STUDENT COMPETENCY VALIDATION/EVALUATION POST-COURSE EVALUATION MEDICAL CODING HITT 1013 This evaluation measures your current knowledge of Advanced Medical Transcription and helps determine if this course is appropriate for your current skill level. Please answer the following by placing a check mark in the appropriate column. Can you perform the following tasks? Can Can with help Cannot Apply optical scanning guidelines when completing Claim forms. Explain the function of the national Blue Cross and Blue Shield Association. Identify the typical services found in Major Medical coverage. Identify and explain the five HMO models. Identify the three levels of NCQA accreditation. Identify and explain the six managed care models. Explain an insurance company's claims review Process. Identify and explain the seven steps in coding Diagnoses using the ICD-CM coding system. Explain the format of the CPT system. Name Date -7- Revised Jan 11, 2005