Course Outline. TERM EFFECTIVE: Fall 2014 CURRICULUM APPROVAL DATE: 03/10/2014

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1 5055 Santa Teresa Blvd Gilroy, CA Course Outline COURSE: BOT 183 DIVISION: 50 ALSO LISTED AS: TERM EFFECTIVE: Fall 2014 CURRICULUM APPROVAL DATE: 03/10/2014 SHORT TITLE: MEDICAL CODING LONG TITLE: Medical Coding Units Number of Weeks Type Contact Hours/Week Total Contact Hours 3 18 Lecture: 3 54 Lab: 0 0 Other: 0 0 Total: 3 54 COURSE DESCRIPTION: This course will introduce the student to the theory and procedure of coding for medical diagnoses, an increasingly essential and specialized healthcare communication system. The course is not a certification course. CPT coding is covered, with an overview of both ICD-9 and ICD-10 coding. This course has the option of a letter grade or pass/no pass. ADVISORY: BOT 180. PREREQUISITES: COREQUISITES: CREDIT STATUS: D - Credit - Degree Applicable GRADING MODES L - Standard Letter Grade P - Pass/No Pass REPEATABILITY: N - Course may not be repeated SCHEDULE TYPES: 02 - Lecture and/or discussion 03 - Lecture/Laboratory 04 - Laboratory/Studio/Activity STUDENT LEARNING OUTCOMES: 1. List the uses of the ICD-9-CM. Measure: Homework, quizzes, exams 3/17/2014 1

2 PLO: 1, 2, 3 2. List the uses of the ICD-10-CM. Measure: Homework, quizzes, exams PLO: 1, 2, 3 3. Explain the uses of coding conventions when assigning codes. Measure: Homework, quizzes, exams PLO: 1, 2, 3 4. Demonstrate use of ICD-9-CM Measure: Homework, quizzes, exams PLO: 1, 2, 3 5. Demonstrate use of ICD-10-CM Measure: Homework, quizzes, exams PLO: 1, 2, 3 6. Explain the uses of CPT coding and CPT modifiers Measure: PLO: PROGRAM LEARNING OUTCOMES: 1. Student will perform common tasks for the medical office. 2. Student will demonstrate competence in patient record management and billing 3. Student will explain the meaning of common medical terms. CONTENT, STUDENT PERFORMANCE OBJECTIVES, OUT-OF-CLASS ASSIGNMENTS Curriculum Approval Date: 03/10/2014 CONTENT: 3/17/2014 2

3 Reimbursement, HIPAA, and Compliance Basic structure of the Medicare Program Health Insurance Portability and Accountability Act Federal Register Outpatient Resource-Based Relative Value Scale Medicare Fraud and Abuse Managed Health Care An Overview of ICD-10-CM Development of the of ICD-10-CM ICD-10-CM Replaces the ICD-9-CM, Volumes 1 and 2 Improvements in the ICD-10-CM Structure of the System Mapping Index Tabular Official Instructional Notations in the ICD-10-CM ICD-10-CM Outpatient Coding and Reporting Guidelines First-Listed Diagnosis Unconfirmed Diagnosis Outpatient Surgery Additional Diagnoses Z Codes Observation Stay First-Listed Diagnosis and Coexisting Conditions Uncertain Diagnoses Chronic Diseases Documented Conditions Diagnostic Services Therapeutic Services Preoperative Evaluation Prenatal Visits Using ICD-10-CM Organization of the Guidelines Accurate Coding Alphabetic Index and Tabular List Level of Specificity Integral Conditions Multiple Coding Acute and Chronic Combination Codes Late Effects Reporting Same Diagnosis Code More Than Once Laterality 3/17/2014 3

4 Chapter-Specific Guidelines (ICD-10-CM Chapters 1-10) Certain Infections and Parasitic Diseases Neoplasms Diseases of the Blood and Blood-Forming Organs and Certain Disorders Involving the Immune Mechanism Endocrine, Nutritional, and Metabolic Diseases Mental and Behavioral Disorders Diseases of the Nervous System Diseases of the Eye and Adnexa Diseases of the Ear and Mastoid Process Diseases of the Circulatory System Diseases of the Respiratory System Chapter-Specific Guidelines (ICD-10-CM Chapters 11-14) Diseases of the Digestive System Diseases of the Skin and Subcutaneous Tissue Diseases of the Musculoskeletal System and Connective Tissue Chapter-Specific Guidelines (ICD-10-CM Chapters 15-21) Pregnancy, Childbirth, and the Puerperium Certain Conditions Originating in the Perinatal Period Congenital Malformations, Deformations and Chromosomal Abnormalities Symptoms, Signs, and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified Injury, Poisoning, and Certain Other Consequences of External Causes An Overview of ICD-9-CM ICD-10-CM-9-CM Tabular List, Volume 1 Appendices in the Tabular List, Volume 1 Alphabetic Index, Volume 2 Procedures, Volume 3 ICD-CM-9-CM Outpatient Coding and Reporting Guidelines First-Listed Diagnosis Additional Diagnoses V Codes Specificity Uncertain Diagnosis Chronic Diseases Diagnostic Services Therapeutic Services Surgery Prenatal Visits Using ICD-10-CM-9-CM Organization of the Guidelines Level of Specificity Integral Conditions Multiple Coding Acute and Chronic 3/17/2014 4

5 Combination Codes Late Effects Impending or Threatened Condition Chapter-Specific Guidelines (ICD-10-CM-9-CM Chapters 1-8) Infectious and Parasitic Diseases Neoplasms Endocrine, Nutritional, and Metabolic Diseases and Immunity Disorders Diseases of the Blood and Blood-Forming Organs Mental, Behavioral and Neurodevelopmental Disorders Diseases of the Nervous System and Sense Organs Disease of the Circulatory System Disease of the Respiratory System Chapter-Specific Guidelines (ICD-10-CM-9-CM Chapters 9-17) Diseases of the Digestive System Disease of the Genitourinary System Complications of Pregnancy, Childbirth, and the Puerperium Diseases of the Skin and Subcutaneous Tissue Disease of the Musculoskeletal System and Connective Tissue Congenital Anomalies and Certain Conditions Origination in the Perinatal Period Symptoms, Signs, and Ill-Defined Conditions Injury and Poisoning Introduction to the CPT and Level II National Codes (HCPCS) The Purpose of the CPT Manual Updating the CPT Manual CPT Manual Starting with the Index History of National Level Codes CPT Modifiers Evaluation of Management (E/M) Services Contents of the E/M Section Three Factors of E/M Codes Various Levels of E/M Service An E/M Code Example Using the E/M Codes Documentation Guidelines Anesthesia Types of Anesthesia Anesthesia Section Formula for Anesthesia Payment Concurrent Modifiers Unlisted Anesthesia Code Other Reporting 3/17/2014 5

6 Surgery Guidelines and General Surgery Introduction to the Surgery Section Notes and Guidelines Unlisted Procedures Special Reports Separate Procedure Surgical Package General Subsection Integumentary System Integumentary System Skin, Subcutaneous, and accessory Structures Nails Repair (Closure) Burns Destruction Breast Procedures Musculoskeletal System Fractures and Dislocations General Application of Casts and Strapping Endoscopy/Arthroscopy Homework: Read the chapters and work the assigned exercises Respiratory System Endoscopy Nose Accessory Sinuses Larynx Trachea/Bronchi Lungs and Pleura Cardiovascular System Coding Highlights Cardiovascular Coding in the Surgery Section Cardiovascular Coding in the Medicine Section Cardiovascular Coding in the Radiology Section Hemic, Lymphatic, Mediastinum, and Diaphragm Digestive System Lips Vestibule of Mouth Tongue and Floor of Mouth 3/17/2014 6

7 Dentoalveolar Structures Palate and Uvula Salivary Gland and Ducts Pharynx, Adenoids, and Tonsils Esophagus Stomach Intestines (Except Rectum) Meckel s Diverticulum and the Mesentery Appendix Rectum Anus Liver Biliary Tract Pancreas Abdomen, Peritoneum, and Omentum Urinary and Male Genital Systems Urinary System Male Genital System Reproductive, Intersex Surgery, Female Genital System and Maternity Care and Delivery Reproductive System Procedures Intersex Surgery Female Genital System Maternity Care and Delivery Endocrine and Nervous Systems Endocrine System Nervous System Eye, Ocular Adnexa, Auditory, and Operating Microscope Eye and Ocular Adnexa Auditory System Operating Microscope Radiology Radiology Terminology Terms Planes Guidelines Diagnostic Radiology Breast, Mammography Diagnostic Ultrasound Radiation Oncology Nuclear Medicine 3/17/2014 7

8 Pathology/Laboratory Organ of Disease Oriented Panels Drug Testing Therapeutic Drug Assays Evocative/Suppression Testing Consultations (Clinical Pathology) Urinalysis, Molecular Pathology, and Chemistry Molecular Pathology Procedures Hematology and coagulation Immunology Transfusion Medicine Microbiology Anatomic Pathology Cytopathology and Cytogenic Studies Surgical Pathology Other Procedures Medicine Introduction to Immunizations Psychiatry Biofeedback Dialysis Gastroenterology Ophthalmology Special Otorhinolaryngologic Services Cardiovascular Pulmonary Allergy and Clinical Immunology Endocrinology Neurology and Neuromuscular Procedures Central Nervous System Assessments/Tests Health and Behavior Assessment/Intervention Chemotherapy Administration Photodynamic Therapy Special Dermatological Procedures Physical Medicine and Rehabilitation Medical Nutritional Therapy Osteopathic Manipulative Treatment (OMT) Chiropractic Manipulative Treatment (CMT) Non-Face-to-Face Nonphysician Services Special Services, Procedures, and Reports Other Services and Procedures Home Health Procedures/Services Medication Therapy Management Services Inpatient Coding 3/17/2014 8

9 Differences between Inpatient and Outpatient Coding Selection of Principal Diagnosis Reporting Additional Diagnoses Present of Admission (POA) Development of the ICD-10-PCS (2 hours) Final METHODS OF INSTRUCTION: Lecture, discussion METHODS OF EVALUATION: Category 1 - The types of writing assignments required: Percent range of total grade: 5 % to 10 % Written Homework If this is a degree applicable course, but substantial writing assignments are not appropriate, indicate reason: Course primarily involves skill demonstration or problem solving Category 2 -The problem-solving assignments required: Percent range of total grade: 10 % to 60 % Homework Problems Quizzes Exams Category 3 -The types of skill demonstrations required: Percent range of total grade: 20 % to 50 % Performance Exams Category 4 - The types of objective examinations used in the course: Percent range of total grade: 10 % to 50 % Multiple Choice True/False Matching Items Completion REPRESENTATIVE TEXTBOOKS: Required: Carol Buck. Step-by-Step Medical Coding, 2014 Edition. Saunders, Year of Publication: Or other appropriate college level text. ISBN: Reading level of text, Grade: 12+ Verified by: E. Venable ARTICULATION and CERTIFICATE INFORMATION Associate Degree: 3/17/2014 9

10 CSU GE: IGETC: CSU TRANSFER: Transferable CSU, effective UC TRANSFER: Not Transferable SUPPLEMENTAL DATA: Basic Skills: N Classification: I Noncredit Category: Y Cooperative Education: Program Status: 2 Stand-alone Special Class Status: N CAN: CAN Sequence: CSU Crosswalk Course Department: BOT CSU Crosswalk Course Number: 183 Prior to College Level: Y Non Credit Enhanced Funding: N Funding Agency Code: Y In-Service: N Occupational Course: C Maximum Hours: Minimum Hours: Course Control Number: Sports/Physical Education Course: N Taxonomy of Program: /17/