Course Description

Medical coding is not the same thing is medical billing. Many people lump them together as one career, but they are actually two separate careers.
We prepare our students for professional medical coding certification exams in Certified Coding Specialist (CCS) through AHIMA and Certified Professional Coder (CPC) through AAPC.  We recommends that our enrollees obtain both credentials as soon as they can following course graduation in order to increase medical coding job options. Many of coders work from home as medical coders, some even in their first medical coding job. Let us help you reach the goal you have set for yourself, whether that goal is to work on-site or at home as a professional medical coder.
The Outpatient Medical Coding Course includes training in ICD-10, CPT, HCPCS classification systems.
Important Note: Medical code books, medical coding textbooks, and other materials for the medical coding program are NOT included but we may provide some additional resources.
Outpatient Coding Course facilitates learning by:
- Structuring coding as the foundation and focus of each module throughout the course, from the very beginning to the end.
- Integrating coding, medical language, and the basic sciences in carefully planned lessons so that students begin using what they are learning right away.
- Emphasizing faculty interaction and instruction to facilitate mastery of concepts and accuracy in coding.
Some of the benefits of the Andrews program include:
- Structured assistance in developing scheduling and pacing skills in a production coding environment.
- Minimal technological requirements.
- Emphasis on research, reference, and self-learning skill development to enable successful work and advancement in the coding field.
- Inpatient and outpatient ICD-10 coding are taught as separate modules, enabling students to grasp the distinction between the two.
Outpatient Course covers the following:
Healthcare Data Content & Structure
Procedure & Diagnosis Coding for Outpatient Services
Reimbursement Methodologies
Clinical Practice Simulation

Healthcare Data Content & Structure

An introduction to the purpose, structure and content of medical records used in inpatient, outpatient, and alternative care settings. Examines medical record storage, numbering and filing systems, data collection, indexes and registers. Provides an overview of the legal aspects of health information, including state and federal law, confidentiality of information, the HIPAA privacy and security provisions, and requirements for release of protected health information.
Diagnosis Coding for outpatient services
An introductory study of the ICD-10-CM diagnosis coding system with a focus on physician services coding. Emphasis is on developing a thorough grounding in the content and use of the ICD-10-CM code book, including Official Coding Guidelines and Coding Conventions, as well as on study of medical conditions and their coding. Through close instructor interaction, students develop the ability to recognize when physician query is necessary and they are encouraged and guided toward achieving at least 95% accuracy in code selection. This unit also includes an introduction to professional ethics and responsibilities, the DSM-V code set, and other code sets commonly used in healthcare settings.

Procedure Coding for Physician Services - CPT & HCPCS
A study of the Current Procedural Terminology (CPT-4) and HCPCS code sets for physician services, including guidelines and rules. Students study the indications for and techniques employed in major medical and surgical procedures, diagnostic tests, and laboratory tests. This unit includes a discussion of professional ethics and responsibilities pertaining to submission of procedure codes for reimbursement. Through close instructor interaction, students develop the ability to recognize when physician query is necessary and they are encouraged and guided toward achieving at least 95% accuracy in code selection.
Reimbursement Methodologies
A study of reimbursement and payment systems for all types of healthcare systems and managed care. Includes prospective payment systems, charge master maintenance, DRGs, APCs, ASC Groups, RBRVS, third-party payers, EOB, Quality Improvement Organizations, managed care/capitation, and compliance. Covers billing and insurance procedures, contracts, and regulatory requirements, coding and claims processing for health plans, medical office management software, submission of paper and electronic claims, auditing and monitoring the coding process, and identification of fraudulent billing practices.
Clinical Practice Simulation
This simulation provides coding practice similar to what would be experienced in a variety of office settings. Emphasis is on maintaining accuracy while developing speed in the coding process.

Suggested Pre-requisites
Medical Terminology
Anatomy and Physiology
Pathophysiology
Pharmacotherapy

Course Content


Intro to ICD-10-CM
Diagnosis Coding Conventions
Intro to ICD-10 Coding Guidelines
General ICD-10 Coding Guidelines
ICD-10 Guidelines: Chapters 1 - 21
Competency Questions for each chapter
ICD-10-CM Self Assessment Test (100 questions)

CPT/HCPCS
Chap. 1 Reimbursement, HIPAA, and Compliance
Chap. 13 Introduction to the CPT & Level II National Codes (HCPCS)
Chap. 15 Evaluation & Management Section
Chap. 14 Modifiers & Chap. 16 Anesthesia Section
Chap. 30 The Medicine Section
Chap. 17 Surgery Guidelines and General Surgery
Chap. 18 Integumentary Section
Chap. 19 Musculoskeletal System & Chap. 20 Respiratory System
Chap. 21Cardiovascular System& Chap. 22:Hemic, Lymphatic,
Mediastinum, and Diaphragm
Chap. 23: Digestive System
Chap. 24 Urinary and Male Genital System
Chap. 25 Reproductive, Intersex Surgery, Female Genital System,
and Maternity Care and Delivery
Chap. 26 Endocrine and Nervous Systems
Chap. 27 Eye, Ocular Adnexa, Auditory, and Operating Microscope
Chap. 28 Radiology
Chap. 29 Pathology/ Laboratory
Chapter 08: An Overview of ICD-9-CM
Chapter 10: Using ICD-9- CM
Chapter 09: Outpatient Coding and Reporting Guidelines
Chapter 11: Chapter-Specific Guidelines (ICD-9-CM Chapters 1-8)
Chapter 12: Chapter-Specific Guidelines (ICD-9-CM Chapters 9-17)
How to Code from an Operative Report & CPT / ICD-9-CMCoding
Practice




Depending on your prior educational and work experience background, this course may take you longer or shorter than the estimated one hundred ninety two (192.0) hours identified for CE credit.

You may enter and leave the course as many times as you'd like, but once you submit the 100-question Final Self-Assessment Test you will no longer have access to the course.


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Outpatient Coding Course