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| Course: HMC213 First Term: 2020 Fall 1
Final Term: Current
Final Term: 2022 Summer
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Clock Hours: 206 Grading Basis: CLK |
| MCCCD Official Course Competencies | |||
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| 1. Identify the use and purpose of the current procedural terminology (CPT) and the healthcare common procedure coding system (HCPCS) coding systems. (I)
2. Describe the importance of CPT/HCPCS coding in the revenue cycle management process. (II) 3. Correlate the relationship among the international classification of diseases - clinical modification (ICD-CM), CPT, and HCPCS coding systems. (III) 4. Identify the levels of the HCPCS coding system. (III) 5. Outline the organization and content of the CPT manual. (IV) 6. Explain the purpose and use of CPT modifiers and HCPCS level II modifiers. (V) 7. Apply appropriate modifiers to codes for physicians and facilities. (VI) 8. Apply criteria for selecting and assigning evaluation and management service codes. (VII) 9. Assign CPT codes and modifiers for anesthesia services utilizing source documents. (VIII) 10. Apply CPT and HCPCS guidelines to accurately sequence and assign procedure codes for surgical services, pathology, radiology, laboratory, and medicine services. (VIII-XI) 11. Use technology for code assignment and reimbursement determination. (XI) 12. Apply principles of coding compliance and ethical coding when assigning codes. (XII) 13. Interpret and apply medical coding regulatory guidelines and standards at the federal, state, regional, and local levels. (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 | |||
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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 | |||
Clock Curriculum Committee Approval Date: 5-6-2020 | |||