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Areas of Study
| HITT235 syllabus
|COURSE NUMBER: ||HITT235|
|COURSE TITLE:||Advanced Coding|
|SEMESTER CREDIT HOURS:||3|
|STUDENT ENGAGEMENT HOURS:||143|
The course will examine the coding of actual charts utilizing International Classification of Diseases (ICD), The Healthcare Common Procedure Coding System (HCPCS level II), and Current Procedural Terminology - Fourth Revision (CPT-4), with emphasis on official coding guidelines, and sequencing. Special emphasis is placed on validation of coded clinical information in relation to Diagnosis-Related Groups (DRGs), Ambulatory Payment Groups (APGs), and Ambulatory Payment Classifications (APCs), as well as the purpose of case mix and severity of illness.
Completion of HITT106
with a grade of C or better.
This course is not available for web registration.
STUDENT LEARNING OUTCOMES:
Upon completion of this course, students will be able to:
- Acquire professional entry-level skills and proficiency in coding diagnoses and operative procedures for inpatients, outpatients, emergencies, and ancillary services.
- Apply correct International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), International Classification of Diseases, Tenth Revision, Clinical Modification/Procedure Coding System (ICD-10-CM/PCS) coding for hospitals and physicians' offices using prospective coding guidelines.
- Abstract information from patients’ records for reimbursement, coding, and indices.
- Follow coding rules for sequencing and appropriate assignment of codes (ICD-10-CM, ICD-10-CM/PCS, The Healthcare Common Procedure Coding System (HCPCS), and CPT) for Medicare, Medicaid, and other charts for hospitals and physicians’ offices.
- Describe an Office of the Inspector General (OIG) work plan and Human-Computer Interface (HCI) edit.
- Assign DRG codes using encoder to the highest possible level.
- Verify validity of data sources (charges, billing reports, and other data sources).
- Review charts against the Evaluation and Management (E/M) Medicare criteria.
- Appraise data to ensure that regulatory and accreditation standards are met.
- Analyze data to ensure optimization.
- Monitor changes in federal, state, and local laws and accreditation that will affect the health information management department.
- Use the encoder and obtain the appropriate codes.
- Apply confidentiality policies and procedures when coding health records.
- Use and maintain electronic applications and work processes to support clinical classification and coding.
- Ensure accuracy of diagnostic/procedural grouping such as DRG, APC, and so on.
- Adhere to current regulations and established guidelines in code assignment.
- Validate coding accuracy using clinical information found in health records.
- Use and maintain applications and processes to support other clinical classification and nomenclature systems (ex: ICD 10-CM, SNOMED).
- Resolve discrepancies between coded data and supporting documentation.
- Compile patient data and perform data quality reviews to validate code assignment and compliance with reporting requirements such as outpatient prospective payment systems.
- Assign diagnostic and procedure codes based on health record documentation.
- Ensure physician documentation supports coding.
- Validate code assignment.
- Abstract data from health record.
- Sequence codes in correct order.
- Review and resolve coding edits.
- Review the accuracy of abstracted data.
- Assign Present on Admission (POA) indicators.
- Provide educational updates to coders.
- Validate grouper assignment.
- Identify Hospital Acquired Conditions (HAC).
- Create standards for coding productivity and quality.
- Perform concurrent audits.
- Develop educational guidelines for provider documentation.
- Provide educational updates to coders.
- Use specialized software in the completion of coding, grouping (Health Information Management (HIM) processes).
TEXTBOOK / SPECIAL MATERIALS:
- Review of coding rules for ICD, CPT-4 and HCPCS and coding compliance
- Review of coding clinic, CPT assistant, coding clinic for HCPCS
- Review of ICD-10-CM/PCS coding rules
- Coding using encoder
- Case Mix and Severity of Illness
- Inpatient Health Records
- Ambulatory Care Health Records
- Case-mix and severity
- Abnormal lab value
- Coding Compliance
- The latest rules and regulations regarding coding from Medicare and Medicaid
- Importance of proper coding of difficult cases especially in regards to DRG, APC's and fraud
See bookstore website for current book(s) at https://www.dacc.edu/bookstoreEVALUATION:
A percentage system will be used to determine students' grades. Point values will be assigned to homework, attendance, tests, quizzes, and mid-term and final.
90 - 100 = A
80 - 89 = B
70 - 79 = C
60 - 69 = D
59 & below = F
NOTE: Must receive C or better to pass.
This course addresses the following domains of knowledge identified by the
American Health Information Management Association as indicators of entry-level
competency for Health Information Technology. See the student handbook for a
complete list of domains and subdomains.
Domain I. Data Content, Structure & Standards
Subdomain I.A. Classification Systems
- Apply diagnosis/procedure codes according to current guidelines
- Evaluate the accuracy of diagnostic and procedural coding
- Apply diagnostic and procedural groupings
- Evaluate the accuracy of diagnostic/procedural groupings
Subdomain I.B. Health Record Content and Documentation
- Analyze the documentation in the health record to ensure it supports the
diagnosis and reflects the patient’s progress, clinical findings, and discharge
- Verify the documentation in the health record is timely, complete, and
- Identify a complete health record according to organizational policies,
external regulations and standards
- Differentiate the roles and responsibilities of various providers and
disciplines, to support documentation requirements, throughout the continuum of
Subdomain I.C. Data Governance
- Apply policies and procedures to ensure the accuracy and integrity of
Subdomain I.D. Data Management
- Collect and maintain health data
Subdomain I.E. Secondary Data Sources
Domain II. Information Protection: Access, Disclosure, Archival, Privacy &
Subdomain II.A. Health Law
Subdomain II.B. Data Privacy, Confidentiality & Security
Subdomain II.C. Release of Information
Domain III. Informatics, Analytics and Data Use
Subdomain III.A. Health Information Technologies
- Utilize software in the completion of HIM processes
Subdomain III.B. Information Management Strategic Planning
Subdomain III.C. Analytics and Decision Support
Subdomain III.D. Health Care Statistics
Subdomain III.E. Research Methods
Subdomain III.F. Consumer Informatics
Subdomain III.G. Health Information Exchange
Subdomain III.H. Information Integrity and Data Quality
Domain IV. Revenue Management
Subdomain IV.A. Revenue Cycle and Reimbursement
- Apply policies and procedures for the use of data required in healthcare
- Evaluate the revenue cycle management processes
Domain V. Compliance
Subdomain V.A. Regulatory
Subdomain V.B. Coding
- Analyze current regulations and established guidelines in clinical
- Determine accuracy of computer assisted coding assignment and recommend
Subdomain V.C. Fraud Surveillance
Subdomain V.D. Clinical Documentation Improvement
- Identify discrepancies between supporting documentation and coded data
- Develop appropriate physician queries to resolve data and coding
Domain VI. Leadership
Subdomain VI.A. Leadership Roles
Subdomain VI.B. Change Management
Subdomain VI.C. Work Design and Process Improvement
Subdomain VI.D. Human Resources Management
Subdomain VI.E. Training and Development
Subdomain VI.F. Strategic and Organizational Management
Subdomain VI.G. Financial Management
Subdomain VI.H. Ethics
- Comply with ethical standards of practice
Subdomain VI.I. Project Management
Subdomain VI.J. Vendor/Contract Management
Subdomain VI.K. Enterprise Information Management
|STUDENT CONDUCT CODE:||Membership in the DACC community brings both rights and responsibility. As a student at DACC, you are expected to exhibit conduct compatible with the educational mission of the College. Academic dishonesty, including but not limited to, cheating and plagiarism, is not tolerated. A DACC student is also required to abide by the acceptable use policies of copyright and peer-to-peer file sharing. It is the student’s responsibility to become familiar with and adhere to the Student Code of Conduct as contained in the DACC Student Handbook. The Student Handbook is available in the Information Office in Vermilion Hall and online at: https://www.dacc.edu/student-handbook|
|DISABILITY SERVICES:||Any student who feels s/he may need an accommodation based on the impact of a disability should contact the Testing & Academic Services Center at 217-443-8708 (TTY 217-443-8701) or stop by Cannon Hall Room 103. Please speak with your instructor privately to discuss your specific accommodation needs in this course.|