MCCCD Program Description

CPT Coding I

Course: HIM212

First Term: 2018 Fall

Lec + Lab 2 Credit(s) 4 Period(s) 4 Load
Subject Type: Occupational
Load Formula: T Lab Load

Description: Introduction to Current Procedural Terminology (CPT) from both facility and physician perspectives. General content, coding guidelines, and the role in healthcare reimbursement. Coding of basic medical and surgical services including use of modifiers. Ethical coding and compliance issues.

MCCCD Official Course Competencies
1. Identify the use and purpose of Current Procedural Terminology (CPT) coding. (I) 2. Describe the importance of CPT coding to health care reimbursement. (II) 3. Explain the relationship between CPT, International Classification of Diseases (ICD) and the Healthcare Common Procedural Coding System (HCPCS). (III) 4. Identify the levels of the HCPCS Coding System. (III) 5. Describe the organization and content of the CPT manual. (IV) 6. Describe the use of CPT conventions. (IV) 7. Define key terms used in the CPT coding system. (IV) 8. Locate procedural terms in the CPT index. (V) 9. List the steps in assigning a CPT code. (V) 10. Explain the purpose of CPT modifiers and HCPCS Level II modifiers. (VI) 11. Describe appropriate use of CPT and HCPCS Level II modifiers. (VI) 12. Describe the criteria used for evaluation and management service code selection. (VII) 13. Use CPT guidelines to accurately assign CPT codes for surgical services, anesthesiology, pathology, radiology, laboratory, and medicine services. (VIII, IX, X, XI) 14. Describe the importance of coding compliance and ethical coding. (XII) 15. Describe and apply the principles of National Correct Coding Initiative (NCCI) to CPT coding. (XII) 16. Describe legislative regulations that impact CPT coding. (XII)
MCCCD Official Course Competencies must be coordinated with the content outline so that each major point in the outline serves one or more competencies. MCCCD faculty retains authority in determining the pedagogical approach, methodology, content sequencing, and assessment metrics for student work. Please see individual course syllabi for additional information, including specific course requirements.

MCCCD Official Course Outline
I. Introduction to Current Procedural Terminology (CPT) A. Background B. Purpose II. CPT and Health Care Reimbursement A. Inpatient versus outpatient B. Ambulatory care settings III. CPT, HCPCS and ICD A. Levels B. Relationships IV. CPT Basics A. Organization and content B. Format and conventions C. Definitions of key terms V. General Guidelines A. Using the index B. Assigning a code C. Using references VI. Modifiers in CPT, HCPCS Level II A. Purpose B. Definitions C. Application of anatomic modifiers D. Physician versus facility VII. Evaluation and Management Services A. Overview B. Definitions C. Levels of service D. Categories, subcategories E. Modifier applications VIII. Coding Anesthesiology Services A. Format B. Definitions C. Guidelines D. Modifier applications IX. Coding Surgical Services A. Overview B. Terminology C. General instructions D. Specialty specific guidelines E. Anatomic modifier applications X. Coding Radiology, Pathology, Laboratory, Medicine Services A. Format B. Terminology C. Guidelines XI. Coding Tools A. Encoders B. Automated Code Book Software C. Other XII. Governmental Impact on CPT Coding A. Fraud and abuse B. Coding compliance 1. American Health Information Management Association (AHIMA) standard of ethical coding 2. Internal and external audits C. National Correct Coding Initiative (NCCI) D. Medicare edits E. Legislative regulations

MCCCD Governing Board Approval Date: November 22, 2016

All information published is subject to change without notice. Every effort has been made to ensure the accuracy of information presented, but based on the dynamic nature of the curricular process, course and program information is subject to change in order to reflect the most current information available.