Official Course Description: MCCCD Approval: 11/23/04
HIT212 20056-20065	L+L	2 Credit(s)	3 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. Introduction to computerized encoders. Ethical coding and compliance issues highlighted. Prerequisites: [HCC145 and (BIO160 or BIO202)], or permission of Program Director.

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MCCCD Official Course Competencies:
HIT212   20056-20065	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 Ambulatory Surgery Center (ASC) payment groups. (III)
4.	Explain the role of CPT in Ambulatory Patient Categories (APCs). (III)
5.	Explain the relationship between CPT and the Healthcare Common Procedural Coding System (HCPCS). (IV)
6.	Identify the levels of the HCPCS Coding System. (IV)
7.	Describe the organization and content of the CPT manual. (V)
8.	Describe the use of CPT conventions. (V)
9.	Define key terms used in the CPT coding system. (V)
10.	Locate procedural terms in the CPT index. (VI)
11.	List the steps in assigning a CPT code. (VI)
12.	Read and interpret source documents to identify all services and procedures to be coded. (VI)
13.	Identify the purpose of CPT and HCPCS Level II modifiers. (VII)
14.	Apply modifiers to physician procedures and services. (VII)
15.	Attach modifiers to facility procedures and services. (VII)
16.	Describe the criteria used for evaluation and management service code selection. (VIII)
17.	Use CPT guidelines to accurately assign CPT codes for anesthesiology, pathology, laboratory, and medicine services. (IX, XII, XIII)
18.	Assign appropriate CPT codes for surgical services. (X)
19.	Code radiology services in accordance with current CPT guidelines. (XI)
20.	Use surgical, radiology, pathology/laboratory, and medicine services terminology. (XI-XIII)
21.	Describe the importance of coding compliance and ethical coding. (XIV)
22.	Apply Correct Coding Initiative (CCI) principles to CPT coding. (XIV)
23.	Describe legislative regulations that impact CPT coding. (XIV)
24.	Appropriately use software programs for code and APC assignment. (XV)

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MCCCD Official Course Outline:
HIT212   20056-20065	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 Payment Methodologies A. Resource Based Relative Value System (RBRVS) B. Ambulatory Surgery Center (ASC) payment groups C. Ambulatory Patient Categories (APCs) IV. CPT and the Healthcare Common Procedural Coding System (HCPCS) A. Background B. Levels V. CPT Basics A. Organization and content B. Conventions C. Definitions of key terms VI. General Guidelines A. Using the index B. Assigning a code C. Reading a source document D. Using references VII. Modifiers A. Purpose B. CPT C. HCPCS Level II D. Physician versus facility applications VIII. Evaluation and Management Services A. Overview B. Definitions C. Levels of service D. Modifier applications IX. Coding Anesthesiology Services A. Format B. Definitions C. Guidelines D. Modifier applications X. Coding Surgical Services A. Overview B. Terminology C. General instructions D. Guidelines E. Modifier applications XI. Coding Radiology Services A. Format B. Terminology C. Guidelines XII. Coding Pathology and Laboratory Services A. Format B. Terminology C. Guidelines XIII. Coding Medicine Services A. Format B. Terminology C. Guidelines D. Modifier applications XIV. 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 XV. Computer Applications

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