Maricopa Community Colleges  HIT212   20016-20025 
Official Course Description: MCCCD Approval: 04/24/01
HIT212 20016-20025 L+L 3 Credit(s) 5 Period(s)
Current Procedural Terminology Coding (CPT)
Coding of medical and surgical procedures and services using the Current Procedural Terminology (CPT) coding system and other applicable classification systems for ambulatory care services. Development of critical coding skills in accordance with established guidelines for use in hospital-based and non- hospital settings. Prerequisites: (HCC145, or HCC145AA, HCC145AB and HCC145AC), or (HCC146 and HCC145AC), and (BIO160 or BIO202), or permission of instructor.
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MCCCD Official Course Competencies:
 
HIT212   20016-20025 Current Procedural Terminology Coding (CPT)
1. Identify the use and purpose of Current Procedural Terminology (CPT) coding. (I)
2. Explain the relationship between CPT and the Health Care Financing Administration (HCFA) Common Procedural Coding System (HCPCS). (II)
3. Describe the importance of CPT coding to health care reimbursement. (III)
4. Identify current coding compliance and fraud abuse issues. (III)
5. Describe the format and organization of the CPT classification system. (IV)
6. Describe the conventions and punctuations used in CPT coding and note the functions of each. (IV)
7. Read and interpret encounter forms and/or medical record documentation to identify all services and procedures delivered. (IV)
8. Assign appropriate CPT codes for surgical services and procedures. (V)
9. Code radiology services in accordance with current CPT guidelines. (VI)
10. Use CPT guidelines to accurately assign CPT codes for pathology, laboratory, medicine, and anesthesiology services. (VII, IX, X)
11. Describe the criteria used for evaluation and management service code selection. (VIII)
12. Attach modifiers to procedure or service codes when applicable. (XI)
13. Input data into an encoder to determine Ambulatory Payment Categories (APCs). (XII)
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MCCCD Official Course Outline:
 
HIT212   20016-20025 Current Procedural Terminology Coding (CPT)
    I. Introduction to Current Procedural Terminology (CPT)
        A. History
        B. Purpose
        C. Use in health care
      II. HCFA Common Procedural Coding System (HCPCS)
          A. Background
          B. Levels
        III. CPT and Reimbursement
            A. Resource-Based Relative Value Scale (RBRVS)
            B. Ambulatory Surgery Center (ASC) Groups
            C. Ambulatory Payment Categories (APCs)
            D. Coding compliance, fraud, and abuse
          IV. CPT Basics
              A. Format
              B. Indexing
              C. Conventions
              D. Source documents
            V. Surgery Coding
                A. Organization of code section
                B. Guidelines
                  1. Surgical package
                  2. Separate procedures
                  3. Unlisted procedures
                  4. Starred procedures
                C. General instructions
                D. Integumentary system
                  1. Skin lesions
                  2. Repairs (closure)
                  3. Grafts
                  4. Breast procedures
                E. Musculoskeletal system
                  1. General concepts
                  2. Fracture/dislocation treatment
                  3. Hand and foot procedures
                  4. Arthroscopy
                F. Respiratory system
                  1. General concepts
                  2. Endoscopy
                G. Cardiovascular system
                  1. Catheterizations
                  2. Atrioventricular fistula
                H. Digestive system
                  1. Endoscopy
                  2. Prostate surgery
                I. Urinary/male reproductive systems
                  1. Endoscopy
                  2. Prostate surgery
                J. Laparoscopy, peritoneoscopy, hysteroscopy
                K. Female reproductive system/maternity
                L. Nervous system
                  1. Carpal tunnel surgery
                  2. Nerve blocks/injections
                M. Ocular and auditory systems
                  1. Cataract extractions
                  2. Strabismus surgery
                  3. Middle ear surgery
              VI. Radiology Coding
                  A. Diagnostic radiology/diagnostic imaging
                  B. Diagnostic ultrasound
                  C. Radiation oncology
                  D. Nuclear medicine
                  E. Interventional radiology
                VII. Pathology and Laboratory Coding
                    A. Automated multichannel tests
                    B. Organ/disease oriented panels
                    C. Consultations
                    D. Chemistry and toxicology
                    E. Surgical pathology
                  VIII. Evaluation and Management Services
                      A. Organization of code section
                      B. Definitions
                        1. New versus established patients
                        2. Presenting problem
                        3. Components
                        4. Time
                      C. Selecting level of service
                    IX. Medicine Services
                        A. Organization of code section
                        B. Guidelines
                        C. Adjunct codes
                      X. Anesthesiology Services
                          A. Guidelines
                          B. Physical status modifiers
                          C. Qualifying circumstances
                        XI. Modifiers
                            A. Purpose
                            B. Application
                          XII. Computer Applications
                              A. Encoders
                              B. APCs
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