MAP 150 - Adv. Medical Billing/Coding

Credits: 3
Lecture Hours: 2
Lab Hours: 2
Practicum Hours: 0
Work Experience: 0
Course Type: Voc/Tech

This course provides students with advanced knowledge of accurately reporting diagnoses and procedure codes through the application of official coding guidelines. The student will apply prior learning of CPT, HCPCS, and ICD concepts to accurately code patient medical records and reports. Coding applications are considered by specialty and body system, utilizing medical terminology, anatomy and physiology, and pathologies. Complex cases will be presented within the course to provide the student with the opportunity to coordinate the classification systems needed to code visits to the applicable healthcare setting.
Prerequisite: MAP 141, HIT 233 and HIT 280 with a “C” or better
Competencies

Apply coding guidelines of ICD
1. Identify the characteristics and conventions of ICD CM/PCS
2. Understand how to code to the highest level of specificity and why this is important
3. Select the primary diagnosis, condition, problem or reason for the medical service or procedure
4. Assign the highest code level of specificity to describe the diagnosis, symptom, complaint, condition, or other reason for the patient encounter
Apply coding guidelines of CPT and HCPCS
1. Demonstrate knowledge of the proper use of the CPT manual
2. Discuss the use of CPT guidelines format, symbols, index, and terminology
3. Apply appropriate procedure code(s) to medical records
4. Utilize modifiers appropriately
Evaluate the accuracy of diagnostic and procedural coding
1. Apply the principles of diagnostic grouping
2. Apply the principles of procedural groupings
Analyze current regulations and established guidelines in clinical classification systems
1. Interpret severity of illness systems and present on admission codes
2. Apply UHDDS guidelines
Analyze the documentation in the health record to ensure it supports the diagnosis and reflects the patient’s progress, clinical findings, and discharge status
1. Apply medical knowledge when reviewing patient medical records to validate medical necessity of services
2. Identify discrepancies between supporting documentation and coded data
3. Discuss clinical outcome measurement tools
4. Develop appropriate physician queries to resolve data and coding discrepancies
5. Review the AHIMA CDI toolbox
6. Demonstrate professional communication skills
Assess accuracy of computer assisted coding assignment and corrective action
1. Demonstrate application of coding specialty systems
2. Demonstrate use of automated encoder and grouper software
3. Define common coding terminology
Comply with ethical standards of practice
1. Demonstrate an understanding of AHIMA’s Code of Ethics
2. Explain professionalism as a medical coder
3. Demonstrate integrity during the coding process
4. Discuss compliance with state and federal regulations

Competencies Revised Date: 2019