Official Course Description: MCCCD Approval:  5-26-09
HIM212  2009 Fall – 2010 Summer II	L+L  2.0 Credit(s)  4.0 Period(s)  3.4 Load  Occ
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 BIO201)], or permission of Program Director. Prerequisites or Corequisites: BIO202, or permission of Program Director.

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MCCCD Official Course Competencies:
HIM212  2009 Fall – 2010 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, International Classification of Diseases 9th Revision Clinical Modification (ICD-9-CM), 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 anesthesiology, pathology, radiology, laboratory, and medicine services. (VIII, IX, X)

14.       Assign appropriate CPT codes for surgical services in accordance with CPT guidelines. (IX)

15.       Describe the importance of coding compliance and ethical coding. (XI)

16.       Describe the principles of National Correct Coding Initiative (NCCI) as they apply to CPT coding. (XI)

17.       Describe legislative regulations that impact CPT coding. (XI)

 

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MCCCD Official Course Outline:
HIM212  2009 Fall – 2010 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, HCPCS and ICD-9-CM

            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 – 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.       Governmental Impact on CPT Coding

            A.        Fraud and abuse

            B.        Coding compliance

            C.        National Correct Coding Initiative (NCCI)

            D.        Medicare edits

            E.         Legislative regulations