Print

Syllabus

CPT Coding
HR210

YEAR:

2023-2024

CREDIT HOURS:

2.00

PREREQUISITES:

HR105 Medical Terminology, or Departmental Consent.

COREQUISITES:

None

COURSE NOTES:

None

CATALOG COURSE DESCRIPTION:

Current Procedural Terminology (CPT) Coding, ICD Coding for outpatient surgery and the physician's office and reimbursement issues involved in ambulatory care.

HutchCC INSTITUTION-WIDE OUTCOMES:

  1. Demonstrate the ability to think critically and make reasonable judgments by acquiring, analyzing, combining, and evaluating information.
  2. Demonstrate the skills necessary to access and manipulate information through various technological and traditional methods.
  3. Demonstrate effective communication through reading, writing, listening, and speaking.
  4. Demonstrate effective interpersonal and collaborative skills.
  5. Demonstrate effective quantitative-reasoning and computational skills.

AREA OR PROGRAM OUTCOMES

  1. Demonstrate the Hutchinson Community College institutional outcomes.
  2. Display entry-level knowledge and skills fundamental to the health information management profession.
  3. Demonstrate good communications skills.
  4. Demonstrate skills in technology.
  5. Demonstrate problem-solving and critical-thinking skills.
  6. Comply with AHIMA Code of Ethics and maintain professional conduct.

COURSE OUTCOMES AND COMPETENCIES:

  1. Discover the use of HCPCS including terminology.
    1. Define coding.
    2. Discuss the purpose and future of coding.
    3. Identify the purpose and uses of CPT.
    4. State the official publication for CPT coding.
    5. Define and list the components of HCPCS.
    6. Distinguish between CPT and National Codes.
    7. Describe the general principles of medical record documentation.
    8. Given a list of services, identify what cannot be coded with CPT.
    9. Compare and contrast CPT with ICD-10-CM.
    10. Identify the ICD-10-CM/HCPCS Coding assignment necessary for physician services, hospital inpatients, and hospital ambulatory patients.
    11. Differentiate between CMS-1500 and UB-04 forms.
    12. Define key words.
    13. Identify abbreviations.
    14. Specify the conditions that must be met before a procedure or service is included in the CPT manual.
    15. Describe the contents of CPT: sections, subsections, subcategory heading, procedure, appendices, and index.
    16. Interpret conventions and characteristics of CPT including semicolon, Bullet, Triangle, Facing triangles, Plus sign, Null Symbol, Circled bullet, pending FDA Approval Symbol.
    17. Describe Category I, II, and III CPT Codes.
    18. Successfully apply the general rules/guidelines for coding assignment.
    19. Define key concepts: Unlisted procedures, "See", Stand alone.
    20. Given an operative report, successfully abstract pertinent clinical information.
    21. Reference official coding guidelines (CPT Assistant) to support accurate coding assignment.
  2. Assign HCPCS codes and modifiers for ambulatory coding.
    1. Identify the purpose of modifiers.
    2. State the uses of modifiers for surgical procedures.
    3. Differentiate between the modifiers identified for Hospital Outpatient Use and the complete list of CPT modifiers.
    4. Differentiate between modifiers 73 (procedures discontinued prior to anesthesia) and 74 (procedures discontinued after anesthesia administration or after procedure begins).
    5. Identify the proper use of modifier 59 (distinct procedural service).
    6. Research Medicare Transmittals and CPT Assistant pertaining to use of modifiers.
    7. Given a scenario, append a CPT code with the correct modifier.
    8. Examine rules for Surgery Coding.
    9. Explain the Integumentary System.
    10. Identify the rules pertaining to the Musculoskeletal System.
    11. Examine the Respiratory System.
    12. Explain the Cardiovascular System.
    13. Determine the rule guiding the Digestive System Subsection.
    14. Examine the Urinary System.
    15. Examine the rules pertaining to the Male Genital System.
    16. Explain common procedures in the Laparoscopy and Hysteroscopy.
    17. Distinguish among the common procedures in the Nervous System.
    18. Examine the rules concerning the Eye and Ocular Adnexa.
    19. Distinguish among the common procedures in the Auditory System.
  3. Assign HCPCS codes for Radiology, Pathology and Laboratory, Medicine, and Anesthesia Services.
    1. Apply modifiers associated with radiological procedures (26, TC).
    2. State the meaning of the phrase "supervision and interpretation" as it applies to radiological procedures.
    3. Apply physician-billing guidelines for coding laboratory services.
    4. Select pathology level codes associated with pahological examination and diagnosis.
    5. State the appropriate use of organ or disease-oriented panels.
    6. Assign codes to report the administration of vaccines or toxoids.
    7. Apply guidelines to identify injections and infusions.
    8. Apply "qualifying circumstances" and "physical status" codes to anesthesiology services.
    9. Given a procedure/service successfully assign CPT code(s) for the above listed services (radiology, pathology/laboratory, medicine, and anesthesia).
  4. Assign Evaluation and Management codes for outpatient services.
    1. Describe the contents of the Evaluation and Management (E/M) Services section.
    2. Differentiate between a new and established patient.
    3. Identify the seven components included in the descriptors for the levels of E/M services.
    4. List the three key components for levels of E/M services.
    5. Describe the documentation requirements for E/M key components.
    6. State the circumstances when "time" is a key factor in determining E/M level of service.
    7. Given a scenario, assign the appropriate E/M code.
  5. Differentiate between HCPCS Level I and HCPCS Level II.
    1. Determine when to use HCPCS Level I codes versus HCPCS Level II codes.
    2. Identify the structure of HCPCS Level II codes.
    3. Successfully apply general guidelines for HCPCS Level II coding assignment.
    4. Describe the use of HCPCS Level II modifiers.
    5. Identify the HCPCS Level II modifiers required for hospital outpatient services.
  6. Identify current reimbursement methodology used in the ambulatory setting.
    1. Explain the prospective payment system utilized for Medicare reimbursement for ambulatory surgery procedures.
    2. Identify the characteristics of the resource-based relative value scale (RBRVS) for Medicare reimbursement for physicians.
    3. Identify the characteristics of ambulatory patient classification (APC) groups.
    4. Describe the purpose of the Medicare outpatient code editor.
    5. Define unbundling.
    6. Apply coding skills to detect errors in submitted data.

COURSE ASSESSMENT AND EVALUATION:

1. Examinations 2. Coding assignments

ACCOMMODATIONS STATEMENT:

Any student who has a documented disability and wishes to access academic accommodations (per the 1973 Rehabilitation Act and Americans with Disability Act) must contact the HCC Coordinator of Disability Services, at 620-665-3554, or the Student Success Center, Parker Student Union. The student must have appropriate documentation on file before accommodations can be provided.

ACADEMIC HONESTY:

Education requires integrity and respect for HutchCC's institutional values. HutchCC students are required to maintain honesty through a "responsible acquisition, discovery, and application of knowledge" in all academic pursuits. Preserving and upholding academic honesty is the responsibility of Hut chCC students, faculty, administrators and staff.

I. Student Responsibilities

All HutchCC students are required to:

  • Submit all work in all courses without cheating, fabrication, plagiarism, dissimulation, forgery, sabotage, or academic dishonesty as defined below.
  • Provide all academic records such as transcripts and test scores that are free of forgery.
  • Refrain from participating in the academic dishonesty of any person.
  • Use only authorized notes and student aids.
  • Use technology appropriately, including refraining from submitting AI (Artificial Intelligence)-generated work without express written consent from your instructor.
  • Protect the security of passwords/login/privacy/electronic files, and maintain sole individual access for any online course information.

II. Definition of Academic Dishonesty

  • Academic dishonesty is any intentional act, or attempted act, of cheating, fabrication, plagiarism, dissimulation, forgery, or sabotage in academic work.
  • Cheating includes using unauthorized materials of any kind, whether hard copies, online, or electronic, such as unapproved study aids in any academic work, copying another student's work, using an unauthorized "cheat sheet" or device, or purchasing or acquiring an essay online or from another student.
  • Fabrica tion is the invention or falsification of any information or citation in any academic work, such as making up a source, providing an incorrect citation, or misquoting a source.
  • Plagiarism is the representation of words, ideas and other works that are not the student's own as being original to the student. A no n-inclusive list of examples includes work completed by someone else, work generated by an external entity (such as AI), omitting a citation for work used from another source, or borrowing the sequence of ideas, arrangement of material, and/or pattern of thought of work not produced by the student, even though it may be expressed in the student's own words.
  • Dissimulation is the obscuring of a student's own actions with the intention of deceiving others in any academic work, such as fabricating excuses for absences or missed assignments, or feigning attendance.
  • Forgery of academic documents is the unauthorized altering, falsification, misrepresentation, or construction of any academic document, such as changing transcripts, changing grades on papers or on exams which have been returned, forging signatures, manipulating a digital file of academic work, or plagiarizing a translation.
  • Sabotage is any obstruction or attempted obstruction of the academic work of another student, such as impersonating another student, stealing or ruining another student's academic work.
  • Aiding and abetting academic dishonesty is considered as knowingly facilitating any act defined above.
  • Academic honesty violations can also include the omission or falsification of any information on an application for any HutchCC academic program.

III. Sanctions for Academic Dishonesty

Students who violate the Academic Honesty Policy may be subject to academic or administrative consequences.

Instructor Sanctions for Violation:

Students suspected of violating the Academic Honesty Policy may be charged in writing by their instructor and any of the following may apply:

  • Assign Avoiding Plagiarism Bridge Module
  • Receiving written warning that could lead to more severe sanction if a second offense occurs
  • Revising the assignment/work in question for partial credit
  • Voiding work in question without opportunity for make-up
  • Reducing the grade for work in question
  • Lowering the final course grade
  • Failing the work in question

Institutional Sanctions for Violation:

Students charged with academic dishonesty, particularly in instances of repeated violations, may further be subjected to an investigation and any of the following may apply:

  • Instructor recommendation to the Vice President of Academic Affairs (VPAA) to dismiss the student from the course in which the dishonesty occurs
  • Instructor recommendation to the VPAA to dismiss student from the course in which the dishonesty occurs with a grade of 'F." Student will not be allowed to take a 'W' for the course
  • Instructor recommendation to the VPAA that the student be suspended and/or dismissed from the program
  • Student barred from course/program for a set period of time or permanently
  • May be recommended by the instructor (after documented repeated offenses) to the VP AA that the student be placed on probation, suspended and/or dismissed from the institution.

IV. Procedure

  • Instructor will communicate in writing via the student's HutchCC email account and/or LearningZone email account to the student suspected of violating the Academic Honesty Policy.  That communication may include sanction(s). Department Chair will notify the student's academic advisor upon receipt of the Academic Honesty Violation Form.
  • For each violation, the instructor will submit a completed Academic Honesty Violation Form to the Department Chair. Department Chair will notify the student's academic advisor upon receipt of the Academic Honesty Violation form.
  • Should the instructor choose to pursue institutional sanctions, the instruct or shall notify the student in writing via the student's HutchCC email account.  Instructor shall also submit a completed Academic Honesty Violation Form and all prior completed forms regarding said student to the Department Chair and the office of the VPAA with recommendation to proceed with specific Institutional Sanctions. Department Chair will notify the student's academic advisor upon receipt of the Academic Honesty Violation Form.
  • The decision of the VPAA on Institutional Sanction is final. The VPAA will notify the student's academic advisor of any institutional sanctions.

V. Due Process Rights

Students charged with violations of academic honesty have the right of appeal and are assured of due process through the Academic Honesty Appeal process.

Academic Honesty Appeal Process

I. Due Process Rights: Students charged with violations of academic honesty have the right of appeal and are assured of due process through the Academic Honesty Appeal process.

  • If an instructor has recommended course or program dismissal, the student may continue in coursework (provi ding there are no threatening or security behavioral issues) until appeal processes are concluded. However, if an issue has been documented at a partnership location (e.g., clinical sites, secondary institutions, correctional or military facilities), then the student is no longer eligible to continue participation in internships, apprenticeships, and/or clinical-based practice. For clinical sites, this sanction is immediate.

II. Process

If the student disagrees with the charge of a violation of academic honesty, the student has the right to due process as described in the Academic Honesty Appeal process below:

  • If the matter is not resolved upon communicating with the instructor about the violation, the student shall, within five business days of the issuance of the written notice of violation, submit a completed Academic Honesty Appeal Form and supporting documentation to the appropriate department chairperson to initiate an Academic Honesty Appeal.
  • Within two business days of receiving the student's completed Academic Honesty Appeal Form, the Department Chair and VPAA will review and the VPAA will render a decision.
  • Within two business days, a response will be sent to the student's HutchCC email address. The VPAA's decision is final.

INCOMPLETE GRADE:

Instructors may give a student a grade of Incomplete (I) under the following conditions:

  1. The student must initiate the request prior to the time final course grades are submitted to Records.
  2. The request must be made because of an emergency, illness or otherwise unavoidable life-event.
  3. The instructor must agree to the request before a grade of Incomplete can be submitted.
  4. A written contract between the instructor and student, signed by both, will document the work required and date needed to complete course work.
  5. If a student does not complete the course requirements within the time frame established by the instructor, a grade of "F" will be recorded on the student's transcript at the end of the next semester.

PROGRAM ACCREDITATION:

Commission on the Accreditation for Health Informatics and Information Management Education (CAHIIM)
233 N. Michigan Ave, 21st Floor
Chicago, IL 60601-5800

HLC ACCREDITATION:

Hutchinson Community College is accredited by the Higher Learning Commission (HLC). The Higher Learning Commission is one of six regional institutional accreditors recognized by the US Department of Education and the Council on Higher Education Accreditation (CHEA).

Last Revised: 03/19/2020