I. General Information

1. Course Title:
Introduction to Diagnosis & Procedure Coding

2. Course Prefix & Number:
HINS 1150

3. Course Credits and Contact Hours:

Credits: 3

Lecture Hours: 3

4. Course Description:

This course will introduce students to the basic medical coding principles and conventions of ICD-10-CM/PCS, CPT, and HCPCS coding. Students will learn the application of coding principles using examples and hands-on exercises. The course will require students to apply their knowledge of medical terminology and human biology. Students will need to have completed HINS 1360, HINS 1122 (or BIOL 1404) before taking this course. Students planning on taking HINS 2140 will be required to have completed BIOL 1404 before taking the course.

5. Placement Tests Required:

Accuplacer (specify test):

No placement tests required

Score:

6. Prerequisite Courses:

There are no prerequisites for this course.

7. Other Prerequisites
Students will need to have completed HINS 1360, HINS 1122 (or BIOL 1404) before taking this course. Students planning on taking HINS 2140 will be required to have completed BIOL 1404 before taking the course.

9. Co-requisite Courses:

There are no corequisites for this course.

II. Transfer and Articulation

1. Course Equivalency - similar course from other regional institutions:

Alexandria Technical College, MEDS 1626 Intro to ICD Coding, 2 credits
Alexandria Technical College, MEDS 1633 Intro to CPT Coding, 2 credits

2. Transfer - regional institutions with which this course has a written articulation agreement:

MSU - Moorhead, Articulation agreement signed Spring 2019 (MSU-M Electives)

III. Course Purpose

1. Program-Applicable Courses – This course fulfills a requirement for the following program(s):

Healthcare Administrative Specialist, AAS
Healthcare Administrative Specialist, Diploma
Medical Assistant, AAS
Healthcare Accounting, AAS

IV. Learning Outcomes

1. College-Wide Outcomes

College-Wide Outcomes/Competencies	Students will be able to:
Analyze and follow a sequence of operations	Select correct codes using approved coding books and/or computerized coding program.
Apply ethical principles in decision-making	Code for accuracy, not for reimbursement.

2. Course Specific Outcomes - Students will be able to achieve the following measurable goals upon completion of the course:

• Demonstrate professionalism;
• Demonstrate different ways to locate CPT & ICD codes through the use of the codebook's index;
• Identify ways to ensure accurate code assignment through the application of coding guidelines from the AMA and CMS;
• Interpret information in the medical documentation to apply correct codes;
• Maintain confidentiality according to HIPAA (Health Insurance Portability and Accountability Act);
• Assess and apply regulatory and legal process when coding documents;
• Analyze and determine the need for requesting additional clarification when coding;
• Assess whether information is reported within legal, ethical, and regulatory guidelines;
• Manage the accuracy, effectiveness, and timeliness of medical information within regulatory guidelines;
• Choose correct coding references; and
• Demonstrate an understanding of the revenue cycle and how coding plays a key role in it.

V. Topical Outline

Listed below are major areas of content typically covered in this course.

1. Lecture Sessions

1. Reimbursement and Compliance
• Avoiding fraud and abuse
• Coding regulations
• Federal Register
• Compliance plan
• Strategies for coding compliance
• HIPAA
• Basic structure of the Medicare program
• Medicare fraud and abuse
• Managed healthcare
• Outpatient Resource-Based Relative Value Scale (RBRVS)
2. Overview of ICD-10-CM
• Development
• ICD-10-CM outpatient coding and reporting guidelines
• Structure of the system
• Mapping
• Index
• Tabular
• Instructional notations in the ICD-10-CM
3. ICD-10-CM Outpatient Coding and Reporting Guidelines
• First-listed diagnosis
• Unconfirmed diagnosis
• Outpatient surgery
• Additional diagnoses
• Z codes
• Observation stay
• First-listed diagnosis and coexisting conditions
• Uncertain diagnoses
• Documented conditions
• Diagnostic services
• Therapeutic services
• Preoperative evaluations
• Prenatal visits
4. Using ICD-10-CM
• Organization of the guidelines
• Accurate coding
• Alphabetic index and tabular list
• Level of specificity
• Integral conditions
• Multiple coding
• Acute and chronic
• Combination codes
• Late effects
• Reporting same diagnosis code more than once
• Laterality
5. ICD-10-CM Chapters 1-10
• Certain infectious and parasitic diseases
• Neoplasms
• Diseases of the blood and blood-forming organs
• Disorders involving the immune mechanism
• Endocrine, nutritional, and metabolic diseases
• Mental and behavioral disorders
• Disease of the nervous system
• Diseases of the eye and adnexa
• Diseases of the ear and mastoid process
• Diseases of the circulatory system
• Diseases of the respiratory system
6. ICD-10-CM Chapters 11-14
• Diseases of the digestive system
• Diseases of the skin and subcutaneous tissue
• Diseases of the musculoskeletal system and connective tissue
7. ICD-10-CM Chapters 15-21
• Pregnancy, childbirth, and puerperium
• Certain conditions originating in the perinatal period
• Congenital malformations, deformations, and chromosomal abnormalities
• Symptoms, signs, and abnormal clinical and laboratory findings, NEC
• Injury, poisoning, and certain consequences of external causes
8. Introduction to the CPT and Level II National Codes (HCPCS)
• Purpose of the CPT manual
• CPT manual format
• HCPCS manual format
• Index
9. Modifiers
• CPT modifiers
10. Evaluation and Management (E/M) Services
• Contents of the E/M section
• Three factors of E/M coding
• Using the E/M codes
• Documentation guidelines
• Inpatient Coding
• Differences between inpatient and outpatient coding
• Selection of principal diagnosis
• Reporting additional diagnoses
• Present on admission (POA)
• Development of ICD-10-PCS