Dec 10, 2023
MR 212 - Coding Seminar
Credit Hours: 3
This course offers a practical medical coding opportunity using both manual and computerized systems. An advanced application with integration of ICD-9-CM and CPT classification systems will be used to code hospital, physician inpatient and outpatient diagnoses and services. Reimbursement methodologies for a variety of health care providers from various settings will also be applied to include the financial impact analysis and case mix reporting. Systems used to meet medical coding compliance guidelines, fraud and abuse prevention and regulatory compliance will be studied.
Upon completion of this course, the student will be able to:
- accurately assign and sequence ICD-9-CM and HCPCS codes for ambulatory and inpatient services (both hospital and physician components);
- interpret ICD-9-CM and HCPCS coding guidelines published in Coding Clinic, CPT Assistant, and other nationally recognized publications;
- research and apply medical necessity criteria for a variety of health care services and providers;
- conductICD-9-CM and HCPCS coding audits based on appropriate sampling techniques and official coding guideline;
- research national coding benchmarks, salaries, and credentials;
- write coding policies and procedures for the variety of healthcare providers and settings;
- utilize and compare computerized encoders;
- calculate reimbursement for inpatient and outpatient services to include APC’s, DRG’s, and RBRVS payments;
- utilize coding and reimbursement data for management purposes (forecasting, planning etc); and
- write a coding compliance plan utilizing the Office of the Inspector General (OIG) model.
Prerequisites: BI 150, BI 151, BI 152, BI 153, MA 115, MR 105, MR 106, MR 203, MR 204, MR 250