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The course introduces you to the study of Healthcare Common Procedure Coding System which is essential to healthcare reimbursement. The course is designed to provide you with the basic medical coding skills. The focus of the class is on CPT/HCPCS coding.
This is a five-semester hour course. This course is allotted ten weeks of time. You must complete all of the requirements for the course successfully by the end of the ten-week period. The first day of week one will begin the day that you register for the course, or the day which you notify me that your textbook has arrived and you are ready to begin your studies. Please be cognizant of the time frame. It is rare that extensions of time are permitted, unless you have good justification. Upon successful completion of this course, you will be awarded five-semester hours of credit.
The following books are required for this course.
Book 1: Health Information Management - 5TH 03, Skurka, Margaret A. (Eds), John Wiley & Sons, Publisher. ISBN: 0-7879-5977-4
Book 2: Q & A Review for Health Information Management / With CD- 8TH 05, Bailey, Susan Pritchard / Green, Michele / Ellison, Jennifer. Pearson Publisher. ISBN: 0-13-098257-1
Book 3: Supplemental material: None
You will complete each workbook exercise and view lecture notes before taking the designated Midterm or Final Examination.
Midterm Exam will be completed online.
Final Examination will be completed online.
• Each test has a set time 48-hour time before it is due.
• Once a test is opened, it must be completed or the grade will be forfeited. If the student opens the wrong test, the student must contact the instructor at that time. It is up to students to be sure they are ready to take a test before entering it.
• Both tests will have sections that require the use of the CPT or HCPCS coding book. For all questions that do not need a “code,” the student is not to use the CPT or HCPCS book.
The grading scale for this course is as follows:
90-100% = A
80-89% = B
70-79% = C
Below 70% = Fail
Points:
(Web-Board) Participation - 10 pts
Weekly Assignments - 0 pts (optional)
Journaling Project - 10 pts
Exam (2) - 80 pts (40 pts each)
TOTAL 100 pts
At the end of this course, the student will be able to:
- Have an understanding of the healthcare, health information management professions, and organizations.
- Apply accreditation, licensing, and certification standards for healthcare data in assembly, analysis and use of health records.
- Design or select proper forms to meet a specific need, utilizing forms design principles, including forms control process (i.e., Medical Record Committee functions).
- Understand the implementation and maintenance of valid (manual or computerized) master patient index (MPI) and/or number index, understanding the methods, supplies, and equipment needs, including implications such as space requirements of various data storage methods.
- State the recommended retention period for specific records.
- Have an understanding of basic functions and relationships of common software packages used in health information systems.
- Understand the implementation and maintenance of new/revised accurate manual or automated filing systems for active and inactive primary and secondary records, utilizing concepts of space management, filing methods, supplies, equipment needs and retention requirements.
- Maintain manual or automated record control system, including tracking record location.
- Understand difference between qualitative vs. quantitative analysis why each is used to evaluate compliance.
After successfully completing MA252 Insurance Coding Concepts, the student will be able to master the following Tasks as identified by the American Health Information Management Association (AHIMA) and (AAPC).
Upon completion of this course, you will be able to:
- Identify purposes and uses of health records.
- Identify basic health record forms and content.
- Assemble a chart in filing order and analyze for deficiencies.
- Define the Problem Oriented Medical Record (POMR).
- Identify and describe three admission numbering systems, advantages, and disadvantages of each.
- Identify and describe three filing systems, advantages, and disadvantages of each.
- List basic data on a master patient index card.
- Trace the development of a health record from the time a patient is admitted until is discharged.
- Define the role of the administrator, governing board, medical staff and medical record personnel.
- Define medical staff organization.
- Identify functions of various medical staff committees.
- List five categories of medical staff membership.
- Trace the development of the health information management profession from its beginning to the present day.
- Distinguish between the educational requirements and functions of RHIT’s and RHIA’s.
- Describe basic characteristics of the AHIMA’s Code of Ethics.
- Identify the organizational components of the AHIMA.
- State the purpose of the Foundation of Record Education (FORE) of AHIMA.
- State purposes of the health record.
- Define licensure, certification, and accreditation (JCAHO).
- Describe the problem-oriented, source-oriented, and integrated health record.
- Apply good forms design principles to the development of health record forms and recognize problems.
- Assemble and evaluate a record for deficiencies and prepare incomplete reports for staff purposes.
- Define master patient index (MPI).
- Describe the methods, supplies, and equipment commonly used for maintenance of a master patient index.
- Apply alphabetical and phonetic filing rules to a given situation.
- Describe serial, unit, and serial–unit numbering and compare the advantages and disadvantages of each system.
- Describe terminal digit, middle digit, and straight numeric filing and list advantages and disadvantages of each.
- Given a series of six-digit numbers, place the numbers in sequence according to straight numeric, middle digit, and terminal digit.
- Describe the physical characteristics and equipment necessary for a health record file area.
- Compare centralized and decentralized filing systems.
- Discuss various record tracking systems and procedures available to ensure record control in a HIM department including requisition slips, sign-out systems, out-guides, and locator files.
- Name three ways to locate misfiles.
- Discuss the role of color-coding.
- Describe how to handle the destruction of inactive records.
- Describe retention policies.
- Distinguish between the advantages and disadvantages of the source oriented, integrated and problem oriented formats of the paper-based medical record.
- Describe the users and uses of the patient record.
- List the attributes of the Computerized Patient Record (CPR).
- Distinguish between the Electronic Medical Record (EMR) and CPR.
- Describe the advantages of the CPR.
- Identify the standards development organizations involved in the development of the CPR.
- Identify new information technologies, which are increasing physician use of electronic medical records.
- Define commonly used insurance terms.
- Describe Medicare and Medicare eligibility.
- Distinguish between Medicare Part A and Medicare Part B.
- Define Prospective Payment System (PPS).
- Compare data versus information.
- Define data security and integrity.
- Recognize health care data sets.
- Discuss registries and indices.
- Delineate between primary and secondary records.
- Name payment and reimbursement systems.
- Discuss marketing of HIM services.
- Describe the prospective payment system (DRGs, APGs, and RBRVS).
- Compare various third party payers.
- Examine the duties of a Peer Review Organization.
- Describe a chargemaster system.
- Define and discuss managed care/capitation systems.
- Recognize the importance of health care ethics.
- Verify timeliness, completeness, accuracy, and appropriateness of data and data sources.
- Abstract records for department indices/databases/registries.
- Present data in verbal and written form.
- Collect and report data on incomplete records and timeliness of record completion.
- Manage special projects.
The following objectives should be met by the end of this module:
- Define the profession of health information management.
- Name and describe three numbering systems and cite the advantages and disadvantages of each one.
- Describe the nature and purpose of the Master Patient Index.
- Discuss the rationale for determining the amount of information maintained by the Master Patient Index on an individual patient.
- Differentiate between centralized and decentralized filing systems.
- Define and describe advantages and disadvantages of straight numerical and terminal digit filing methods.
- Discuss the functions of the health information department and its interrelationships with other areas of the hospital.
- Chart the flow of the medical record from admission to filing after discharge.
- Describe the main reasons for color-coding patient records.
- Given a group of numbers or names, accurately place them in correct order using straight numeric, alphabetic and terminal digit methods.
- Identify the basic medical record forms.
- Explain the process of record assembly and analysis.
- Discuss the role of information in a health care system.
Upon completion of this course you will be able to:
- Provide an overall, but general description of the medical office procedure office as it exists today.
- Understand medical office theory and methodology, focusing specific attention to systems theory, information theory, management concepts, and systems development methodologies.
- Have a good working knowledge of how RMA/ CMA are different and how they relate.
If you have any questions about the course please feel free to e-mail me at the address provided or contact Breyer State at admassistant@breyerstate.com
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