Health Information Technology
Basic Ambulatory Coding
This course is an introduction to basic coding theory and computer laboratory practice applying CPT to ambulatory medical/health records. This course is designed to prepare a student to code in the ambulatory setting using Current Procedural Terminology (CPT). The course will emphasize the reporting requirements for codes and rules that apply to the reimbursement systems used by government payers and other health plans. The student will be introduced to computerized coding systems utilized in healthcare. The emphasis of the course will be coding for facility services and procedures.
(A requirement that must be completed before taking this course.)
Upon successful completion of the course, the student should be able to:
- Conduct analysis to ensure documentation in the health record supports the procedure/service and reflects the patient's progress, clinical findings and discharge status.
- Use electronic applications and work processes to support clinical classification and coding. Apply knowledge of current diagnostic coding and reporting guidelines for outpatient services.
- Apply procedure codes using CPT/HCPCS.
- Ensure accuracy of diagnostic/procedural groupings such as APC.
- Adhere to current regulations and established guidelines in code assignment.
- Validate coding accuracy using clinical information found in the health record.
- Resolve discrepancies between coded data and supporting documentation.
- Apply policies and procedures for the use of clinical data required in reimbursement and prospective payment systems (PPS) in healthcare delivery.
- Apply policies and procedures to comply with the changing regulations among various payment systems for healthcare services such as Medicare, Medicaid, managed care and so forth.
- Support accurate billing through coding, chargemaster, claims management and bill reconciliation processes.
- Use established guidelines to comply with reimbursement and reporting requirements such as the National Correct Coding Initiative.
- Compile patient data and perform data quality reviews to validate code assignment and compliance with reporting requirements such as outpatient prospective payment systems.
Currently no sections of this class are being offered.