12/27/2024 6:54:30 AM	MA 169 Course Outline as of Fall 2020	Changed Course
CATALOG INFORMATION
Discipline and Nbr:  MA 169	Title:  PROCEDURAL CODING
Full Title:  Procedural Coding
Last Reviewed:2/14/2022

Units		Course Hours per Week			Nbr of Weeks	Course Hours Total
Maximum	1.50	Lecture Scheduled	1.00		17.5 max.	Lecture Scheduled	17.50
Minimum	1.50	Lab Scheduled	1.50		17.5 min.	Lab Scheduled	26.25
		Contact DHR	0			Contact DHR	0
		Contact Total	2.50			Contact Total	43.75
		Non-contact DHR	0			Non-contact DHR Total	0

Total Out of Class Hours:  35.00

Total Student Learning Hours: 78.75

Title 5 Category:  AA Degree Applicable
Grading:  Grade Only
Repeatability:  00 - Two Repeats if Grade was D, F, NC, or NP
Also Listed As: 
Formerly:  MA 68.4

Catalog Description:

This course is an introduction to the Current Procedural Terminology (CPT) medical coding system. Students will learn about human anatomy, physiology, and disease processes, to correctly identify and code services and procedures that are provided in a variety of health care settings.  Students will assign codes to services and procedures according to coding guidelines to allow for accurate statistics, claims processing, and reimbursement.

Prerequisites/Corequisites:
Course Completion of MA 160, MA 161, MA 162, MA 163 and MA 167; AND Concurrent Enrollment in MA 164, MA 165, MA 168, and MA 174

Recommended Preparation:
Eligibility for ENGL 1A or equivalent

Limits on Enrollment:

Schedule of Classes Information
Description:

This course is an introduction to the Current Procedural Terminology (CPT) medical coding system. Students will learn about human anatomy, physiology, and disease processes, to correctly identify and code services and procedures that are provided in a variety of health care settings.  Students will assign codes to services and procedures according to coding guidelines to allow for accurate statistics, claims processing, and reimbursement.

(Grade Only)
Prerequisites:Course Completion of MA 160, MA 161, MA 162, MA 163 and MA 167; AND Concurrent Enrollment in MA 164, MA 165, MA 168, and MA 174
Recommended:Eligibility for ENGL 1A or equivalent
Limits on Enrollment:
Transfer Credit:
Repeatability:00 - Two Repeats if Grade was D, F, NC, or NP

ARTICULATION, MAJOR, and CERTIFICATION INFORMATION

Associate Degree:		Effective:		Inactive:
Area:
CSU GE:	Transfer Area			Effective:	Inactive:
IGETC:	Transfer Area			Effective:	Inactive:
CSU Transfer:		Effective:		Inactive:
UC Transfer:		Effective:		Inactive:
C-ID:

Certificate/Major Applicable: Both Certificate and Major Applicable

COURSE CONTENT

Student Learning Outcomes:
At the conclusion of this course, the student should be able to:

1. Accurately code procedures using Current Procedural Terminology (CPT) coding book.

 

Objectives:

Students will be able to:

1. Demonstrate accurate use of CPT coding through proper utilization of characteristics and

    conventions.

2. Cite and apply basic CPT coding guidelines and rules.

3. Code procedures related to all major body systems using CPT.

4. Code physician services that include evaluation and management, medicine, pathology,

    laboratory, radiology, surgery, and anesthesia.

Topics and Scope

I. Introduction to Clinical Coding

    A. History of the CPT coding system

    B. CPT categories and sections

    C. Levels of Basic Current Procedural Terminology and Coding (HCPCS)

    D. General principles of health record documentation

    E. Overview of claim forms

II. Application of the CPT System

    A. Organization of the CPT coding system

     B. Conventions and characteristics

         1. Semicolon

         2. Bullets

         3. Triangles

         4. Plus symbol

         5. Circled bullet

    C. Numerical list

    D. Alphabetic index

    E. General CPT coding rules

    F.  Analyzing and interpreting medical documentation

    G. Identification of operative procedures

III. Modifiers: identification and general uses

IV. Surgical Procedure Coding

     A. Definition of surgical package

    B. Separate procedures

    C. Coding edits

    D. Integumentary system coding - Including:

         1. Debridement

         2. Removal/excision of lesions

         3. Repair of wounds:  simple, intermediate, complex

         4. Mohs surgery

         5. Breast procedures

    E. Musculoskeletal system coding - Including:

         1. Reduction/manipulation of fractures/dislocations

         2. Arthroscopy

    F. Respiratory system coding - Including:

         1. Nasal endoscopy

         2. Laryngoscopy  

          3. Bronchoscopy

         4. Lung procedures

    G. Cardiovascular system coding - Including:

         1. Vascular injection procedures

         2. Pacemakers and pacing cardioverter-defibrillators

         3. Coronary artery bypass graft (CABG)  

          4. Angiography

         5. Arteriovenous fistulas and grafts

         6. Central venous access procedures

    H. Digestive system coding - Including:      

         1. Esophagogastroduodenoscopy (EGD)

         2. Endoscopic retrograde cholangiopancreatography (ERCP)

         3. Lower gastrointestinal endoscopies, such as colonoscopy

         4. Hemorrhoidectomy

         5. Hernia repair

         6. Other laparoscopic procedures

     I.  Urinary system coding - Including:

         1. Urodynamics

         2. Genitourinary endoscopies, such as cystourethroscopy

    J. Male genital system coding, including prostatectomy     

     K. Female genital system coding, including hysterectomy

    L. Endocrine system coding

    M. Nervous system coding - Including:

         1. Laminectomy

         2. Spinal injections

    N. Eye and ocular adnexa coding, such as cataract extraction

    O. Auditory system coding, including tympanostomy

V. Radiology procedure coding

    A. Explanation of chargemaster

    B. Professional and technical components

    C. Radiological supervision and interpretation

    D. Radiology-related modifiers

    E. Diagnostic radiology procedures - Including:

         1. X-rays

         2. CT scans

         3. MRIs

         4. MRAs

    F. Use of contrast material

    G. Diagnostic ultrasound      

    H. Radiation oncology

    I.  Nuclear medicine

VI. Pathology and Laboratory Services Coding

    A. Explanation of chargemaster

    B. Quantitative and qualitative studies

    C. Laboratory-related modifiers

    D. Laboratory tests - Including:

         1. Organ and disease-related panels

         2. Urinalysis

         3. Chemistry

         4. Hematology

    E. Surgical pathology

VII. Evaluation and Management Services Coding

    A. Coding assignment guidelines for evaluation and management services

    B. New versus established patients

    C. Key factors for evaluation and management services code assignment

         1. History

         2. Examination

         3. Medical decision making

    D. Application of key factors against medical documentation for code determination

    E. Evaluation and management services coding within various settings - Including:      

         1. Physician office

         2. Hospital inpatient

         3. Emergency department      

         4. Nursing facility

VIII. Medical Procedure Coding - Including:

    A. Immunizations

    B. Dialysis

    C. Stent placement  

     D. Percutaneous Transluminal Coronary Angioplasty (PTCA)

    E. Cardiac catheterization

    F. Therapeutic infusions and injections, such as for hydration and chemotherapy

    G. Home health services

    H. Medication therapy management

IX. Anesthesia Coding

    A. Definition of anesthesia services

    B. Types of anesthesia

    C. Anesthesia-related modifiers

X. HCPCS Level II Coding

     A. History and purpose of Level II coding

    B. Level II coding sections and sample codes

XI. Reimbursement in the Ambulatory Setting

    A. History of reimbursement in health care   

     B. Retrospective versus prospective payment

    C. Physician reimbursement

    D. Claim rejection and denial  

     E. Office of the Inspector General (OIG) and health care fraud

    F. Importance of claim accuracy

 

All topics are covered in the lecture and lab portions of the course.

Assignments:

Lecture-Related Assignments:

1. Reading: 10 - 20  pages of reading assigned at each class meeting

2. Successful completion of 2 - 4 quizzes

3. Successful completion of final exam

 

Lecture- and Lab-Related Assignments:

1. Coding assignments: 25 - 40 coding problems assigned at each class meeting

Methods of Evaluation/Basis of Grade.

Writing: Assessment tools that demonstrate writing skill and/or require students to select, organize and explain ideas in writing.		Writing 0 - 0%
None
This is a degree applicable course but assessment tools based on writing are not included because this course includes essay exams that fulfil the writing component of the course.
Problem solving: Assessment tools, other than exams, that demonstrate competence in computational or non-computational problem solving skills.		Problem Solving 10 - 20%
Coding assignments
Skill Demonstrations: All skill-based and physical demonstrations used for assessment purposes including skill performance exams.		Skill Demonstrations 0 - 0%
None
Exams: All forms of formal testing, other than skill performance exams.		Exams 80 - 90%
Quizzes and final exam
Other: Includes any assessment tools that do not logically fit into the above categories.		Other Category 0 - 0%
None

Representative Textbooks and Materials:

Basic Current Procedural Terminology and HCPCS Coding. Smith, Gail. AHIMA. Current

CPT Professional. AMA. Current

Print PDF