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Official Course
Description: MCCCD Approval:
5-26-2009 |
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HIM216 2009
Fall – 2011 Fall |
LAB 1.0 Credit(s) 5.0 Period(s) 0.0 Load Occ |
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Professional Practice in Physician-Based Billing and
Coding |
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Practical application of billing and coding guidelines for the physician- based setting. Use of the International Classification of Diseases and Current Procedural Terminology systems to code ambulatory patient diagnoses and treatment. Process medical claims for patient care services. Prerequisites: HCC204, HIM209, HIM212, and permission of Program Director. Corequisites: HIM214 and HIM215, or permission of Program Director. |
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Go to Competencies Go to Outline
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MCCCD Official Course Competencies: |
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HIM216 2009 Fall – 2011 Fall |
Professional Practice
in Physician-Based Billing and Coding |
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1. |
Follow professional practice guidelines as outlined by the Medical Billing and Coding: Physician-Based Program. (I) |
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Complete professional practice documentation including practice summaries and evaluations. (I) |
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Initiate the billing process following practice guidelines. (II) |
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Complete medical claims manually and electronically. (II) |
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Follow policies and procedures for managing insurance claims. (II) |
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Identify and submit documentation as needed for proper claims processing. (II) |
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Code ambulatory patient diagnoses using the International Classification of Diseases (ICD) guidelines. (III) |
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Code physician-based services using Current Procedural Terminology (CPT) guidelines. (III) |
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Attach modifiers to ambulatory codes when applicable. (III) |
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Attach evaluation and management codes when applicable. (III) |
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Attach Healthcare Common Procedure Coding System (HCPCS) codes when appropriate. (III) |
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Describe the flow of patient documentation within an ambulatory setting. (IV) |
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Describe the use of coded information from initial patient visit through the billing process. (IV) |
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Describe the techniques used to ensure billing and coding quality of a compliance program. (V) |
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Go to Description Go to top of
Competencies
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MCCCD Official Course Outline: |
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HIM216 2009 Fall – 2011 Fall |
Professional Practice
in Physician-Based Billing and Coding |
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I. Professional Practice A. Guidelines B. Summaries C. Evaluations II. Billing Practice A. Completion of claims B. Submission of claims C. Claims follow-up III. Coding Practice A. ICD codes B. CPT codes C. Modifiers D. Evaluation and management codes IV. Data Development A. Patient record B. Billing information C. Coded information V. Billing and Coding Quality Compliance |
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