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.
5. Placement Tests Required:
Accuplacer (specify test): |
No placement tests required |
Score: |
|
6. Prerequisite Courses:
HINS 1150 - Introduction to Diagnosis & Procedure Coding
All Course(s) from the following...
Course Code | Course Title | Credits |
HINS 1360 | Medical Terminology | 3 cr. |
A total of 1 Course(s) from...
Course Code | Course Title | Credits |
BIOL 1404 | Human Biology | 3 cr. |
BIOL 1510 | Essentials of Human Anatomy | 3 cr. |
9. Co-requisite Courses:
HINS 1150 - Introduction to Diagnosis & Procedure Coding
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:
College of St. Scholastica, June 2014 (CSS course equivalent HIM 3211 Classification of Health Data)
III. Course Purpose
1. Program-Applicable Courses – This course is required 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 wayst 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
- Reimbursement and Compliance
- Avoiding fraud and abuse
- Coding regulations
- Compliance plan
- Strategies for coding compliance
- HIPAA
- Basic structure of the Medicare program
- Managed healthcare
- Outpatient Resource-Based Relative Value Scale (RBRVS)
- 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
- 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
- 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
- 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
- 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
- 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
- Introduction to the CPT and Level II National Codes (HCPCS)
- Purpose of the CPT manual
- CPT manual format
- HCPCS manual format
- Index
- Modifiers
- 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