Official Course Description: MCCCD Approval:  12-13-05
HIM212  2006 Fall – 2009 Summer II	L+L	2.0 Credit(s)	3.0 Period(s)
CPT Coding I
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. Prerequisites: [HCC145 and (BIO160 or BIO202) and HIM185], or permission of Program Director.

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MCCCD Official Course Competencies:
HIM212  2006 Fall – 2009 Summer II	CPT Coding I

 

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, 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.       Read and interpret source documents to identify all services and procedures to be coded. (V)

11.       Identify the purpose of CPT modifiers and HCPCS Level II modifiers. (VI)

12.       Apply modifiers to physician procedures and services. (VI))

13.       Attach modifiers to facility procedures and services. (VI)

14.       Describe the criteria used for evaluation and management service code selection. (VII)

15.       Use CPT guidelines to accurately assign CPT codes for anesthesiology, pathology, laboratory, and medicine services. (VIII, XI, XII)

16.       Assign appropriate CPT codes for surgical services. (IX)

17.       Code radiology services in accordance with current CPT guidelines. (X)

18.       Use surgical, radiology, pathology/laboratory, and medicine services terminology. (IX-XII)

19.       Describe the importance of coding compliance and ethical coding. (XIII)

20.       Apply Correct Coding Initiative (CCI) principles to CPT coding. (XIII)

21.       Describe legislative regulations that impact CPT coding. (XIII)

 

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MCCCD Official Course Outline:
HIM212  2006 Fall – 2009 Summer II	CPT Coding I

 

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, and the Healthcare Common Procedural Coding System (HCPCS)

            A.        Background  

            B.        Levels  

IV.       CPT Basics

            A.        Manual  organization and content

            B.        C conventions

            C.        Definitions of key terms

V.        General Guidelines

            A.        Using the index

            B.        Assigning a code

            C.        Reading a source document

            D.        Using references

VI.       Modifiers –

            A.        Purpose

            B.        CPT  

            C.        HCPCS Level II  

            D.        Physician versus facility applications

VII.     Evaluation and Management Services

            A.        Overview

            B.        Definitions

            C.        Levels of service

            D.        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.        Guidelines

            E.         applications

X.        Coding Radiology Services

            A.        Format

            B.        Terminology

            C.        Guidelines

XI.       Coding Pathology and Laboratory Services

            A.        Format

            B.        Terminology

            C.        Guidelines

XII.     Coding Medicine Services

            A.        Format

            B.        Terminology

            C.        Guidelines

            D.        Modifier applications

XIII.    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.        Correct Coding Initiative (CCI)

            D.        Medicare edits

            E.         Legislative regulations