Dec 06, 2023
BTAC 258 - Intermediate CPT/HCPCS Coding Credits: 5
Focuses on intermediate coding using Current Procedural Terminology (CPT), Healthcare Common Procedural Coding System (HCPCS) and International Classification of Diseases (ICD) procedural classification coding systems to assign accurate codes to complex authentic case studies. Teaches students to abstract and assign valid procedural codes and verify code selection using real-life challenging coding cases to a variety of procedural groupings including Ambulatory Payment Classifications (APC) and Resource Utilization Groups (RUG).
Enrollment Requirement: BTAC 145 and BTAC 146 with a grade of 2.0 or higher; or instructor consent.
Students who successfully complete this class will be able to:
- Define and apply the guidelines for procedure classification systems; Current Procedural Coding (CPT), Healthcare Common Procedural Coding System (HCPCS) Level II and International Classification of Diseases (ICD-9-CM Volume III and ICD-10-PCS).
- Read and interpret complex authentic source documents to abstract and identify all services and procedures to be coded.
- Accurately assign service and procedure codes utilizing classification systems studied to intermediate coding case studies.
- Accurately assign both CPT and HCPCS modifiers to intermediate coding case studies.
- Define the use of Relative Value Units (RVU’s) and Resource Based Relative Value Scales (RBRVS) to assign payment value to procedures.
- Create a detailed and accurate evaluation and management (E/M) audit tool for the three key components; History, Exam and Medical Decision Making.
- Demonstrate use of the E/M audit tool as an educational resource for medical coders and providers. Apply codes to professional fee billing examples for Ambulatory Payment Classification (APC’s), Ambulatory Surgery Centers (ACS’s), Resource Utilization Group (RUG) and other common payment systems.
- Abstract diagnostic and procedural terminology to accurately assign ICD-10-CM, CPT-4 and HCPCS level II codes.
- Utilize a computerized encoder to determine procedure values based on RBRVS (resource based relative value scale), coding guidelines based on LCD (local coverage determination), NCD (national coverage determination) and CCI (correct coding initiative) edits.
- Critical Thinking - Critical thinking finds expression in all disciplines and everyday life. It is characterized by an ability to reflect upon thinking patterns, including the role of emotions on thoughts, and to rigorously assess the quality of thought through its work products. Critical thinkers routinely evaluate thinking processes and alter them, as necessary, to facilitate an improvement in their thinking and potentially foster certain dispositions or intellectual traits over time.
- Responsibility - Responsibility encompasses those behaviors and dispositions necessary for students to be effective members of a community. This outcome is designed to help students recognize the value of a commitment to those responsibilities which will enable them to work successfully individually and with others.
- Quantitative and Symbolic Reasoning - Quantitative Reasoning encompasses abilities necessary for a student to become literate in today’s technological world. Quantitative reasoning begins with basic skills and extends to problem solving.
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