Catalog Course Search Details

 Department:    AHE

 Course #:    221

 Credits:    5

 Variable:     No

 IUs:    5

 CIP:    51.0713

 EPC:    313

 REV:    2024

 Course Description  

Application of professional skills in abstracting medical records and assigning appropriate CPT and HCPCS procedural and service codes for data retrieval and claims processing in outpatient health care settings.

 Prerequisite  

Prerequisites: AHE 106 and AHE 110 with a grade of C or higher. Concurrent enrollment in AHE 222 required.

Contact Hours (based on 11 week quarter)

Lecture: 55

Lab: 0

Other: 0

Systems: 0

Clinical: 0

Intent: Distribution Requirement(s) Status:  

Vocational Preparatory Required for ATA degree, Required for certificate  

Equivalencies At Other Institutions

Learning Outcomes

After completing this course, the student will be able to:

1. Apply the research process in the selection of proper CPT codes using the Index and Tabular List in the CPT� code book.
2. Analyze medical record documentation and assign correct CPT and HCPCS codes and modifiers using chapter guidelines, coding conventions, parenthetical instructions, modifier use, and appendices in the CPT� code book.
3. Correctly assign HCPCS codes for pharmaceuticals, supplies, procedures, and durable medical equipment, per Centers for Medicare and Medicaid Services (CMS) regulations.
4. List and describe the key components and classifications used for Evaluation and Management (E/M) coding utilizing the CPT� code book.
5. Apply Evaluation and Management (E/M) codes using correct section, subsection, and category for type of service, place of service, and patient status.
6. Coordinate use of CPT and HCPCS coding systems in a variety of patient care settings; acute, inpatient, outpatient, and ancillary departments (imaging centers and pathology/laboratories) using provider notes, and laboratory and radiologic results.
7. Accurately code Evaluation and Management (E/M) services per the Centers for Medicare and Medicaid Services (CMS) guidelines and CPT instructions for leveling E/M services utilizing internal audit forms to ensure data compliance with all coding rules, laws, and guidelines.

General Education Learning Values & Outcomes

Revised August 2008 and affects outlines for 2008 year 1 and later.

Course Contents

1. Abstracting pertinent information to accurately code health care records for billing purposes.
2. Assignment and sequencing of HCPCS Level II codes for pharmaceuticals, supplies, procedures, and services.
3. Common medical terminology and abbreviations used in medical record documentation.
4. Assignment and sequencing of CPT Level I modifiers.
5. Assignment and sequencing of HCPCS Level II modifiers.
6. Appendices of the CPT and HCPCS coding manuals.
7. Category II and Category III codes.
8. Medical necessity linkage between diagnosis codes and CPT/HCPCS codes.