Health Information Technology
Intermediate Ambulatory Coding
This course includes theory and practice in coding medical/health records in the hospital/ambulatory setting using Current Procedural Terminology (CPT) and Healthcare Financing Administration Common Procedure Coding System (HCPCS). The student will use encoding software in the laboratory to code medical/health records. The student will analyze clinical data for the purpose of coding and reimbursement in the ambulatory setting including the physician office.
(A requirement that must be completed before taking this course.)
Upon successful completion of the course, the student should be able to:
- Use electronic applications and work processes to support clinical classification and coding.
- Apply procedure codes using CPT/HCPCS.
- Apply diagnosis/procedure codes using the ICD system.
- Ensure accuracy of diagnostic/procedural groupings such as APCs and so on.
- 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.
- Use specialized software in the completion of HIM processes such as record tracking, release of information, coding, grouping, registries, billing, quality improvement and imaging.
- Monitor coding and revenue cycle processes.
- Apply policies and procedures for the use of clinical data required in reimbursement and prospective payment systems 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.