Download TITLE: Clinical Coding I PREFIX/NO.: HCIA 2421

METROPOLITAN COMMUNITY COLLEGE
COURSE OUTLINE
COURSE TITLE:
Clinical Coding I
COURSE PREFIX AND NO.
HCIA 2421
LEC
4.5
LAB
0 CREDIT HOURS 4.5
COURSE DESCRIPTION:
Students gain knowledge of the International Classification of Diseases, Clinical Modification (ICD-9CM and ICD-10-CM) systems, official coding guidelines, and application of coding principles to
diagnostic statements found across the continuum of healthcare. Students explore utilization of coding
resources and tools. The course includes hands-on activities with coding software.
COURSE PREREQUISITE (S):
`HIMS 1180, HIMS 1310, HIMS 1410, HCIA 1030
RATIONALE:
Coding establishes medical necessity and translates it into a universal language. ICD-9-CM and ICD10-CM coding systems are used by all health care providers to substantiate the need for patient care or
treatment and to provide statistics for morbidity and mortality rates.
REQUIRED TEXTBOOK (S) and/or MATERIALS:
Title:
Edition:
Author:
3-2-1 Code It
Current
Michelle A. Green, MPS, RHIA, FAHIMA, CPC
Title:
Edition:
Author:
Materials:
3-2-1 Code It Workbook
Current
Michelle A. Green, MPS, RHIA, FAHIMA, CPC
Provided by Instructor, AHIMA Virtual Lab Encoder (furnished through
Instructor)
Attached course outline written by:
Dawn Goodselll
Revised by:
Date:
Effective Date:
Academic Dean:
Date: 10/12
Fall/2013
Dr. Thos C. Pensabene
Metro Community College
Date:
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10/25/2012
TITLE:
PREFIX/NO.: HCIA 2421
Clinical Coding I
COURSE OBJECTIVES:
Upon successful completion of this course, students should be able to:
1.
Identify the professional organizations that serve as a resource for coding and offer coding
credentials.
2.
Utilize the ICD-9-CM and ICD-10-CM coding guidelines, coding books, references and
General Equivalence Mapping (GEMS) crosswalk.
3.
Define the abbreviations, punctuation, and other coding conventions used in ICD-9-CM and
ICD-10-CM.
4.
Apply ethical and compliance rules to coding practice.
5.
Apply the following principles in determining ICD-9-CM and ICD-10-CM codes.
a.
Combination coding,
b.
Manifestation
c.
Disease processes
d.
Infectious disease coding
6.
Describe the steps used to locate a disease code in ICD-9-CM and ICD-10-CM.
7.
Assign disease codes using either a code book or a computerized encoder.
TOPICAL UNIT OUTLINE/UNIT OBJECTIVES:
UNIT I:
A.
B.
C.
D.
E.
UNIT II:
A.
OVERVIEW OF CODING
Coding career
Professional associations and credentials for coders
Coding overview
1.
Coding references
2.
Computer assisted coding
Documentation as basis for coding
1.
Patient record formats
2.
Manual record formats
3.
Automated record formats
Healthcare data collection
1.
Reporting hospital data
2.
Reporting physician office data
INTRODUCTION TO ICD-9-CM/ICD-10-CM CODING
Overview of ICD-9-CM and ICD-10-CM/PCS
1.
General Equivalence Mapping (GEMS)
Metro Community College
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B.
C.
D.
UNIT III:
A.
B.
C.
D.
E.
F.
G.
H.
I.
J.
K.
L.
UNIT IV:
A.
B.
C.
D.
E.
F.
G.
H.
2.
Coding manuals
3.
Updating ICD-9-CM and ICD-10-CM/PCS
4.
Mandatory reporting of ICD-9-CM/ICD-10-CM
5.
Medical necessity
ICD-9-CM Tabular List of Diseases and ICD-10-CM Tabular List of Diseases and
Injuries
1.
Format and Structure of ICD-9-CM
2.
Format and Structure of CD-10-CM
3.
ICD-9-CM V codes
4.
ICD-9-CM E Codes
ICD-9-CM /ICD-10-CM index to diseases and injuries
1.
Main terms, sub-terms, and qualifiers
2.
Basic steps for using the index to diseases
Official ICD-9-CM and ICD-10-CM guidelines for coding and reporting
ICD-9-CM AND ICD-10-CM CODING CONVENTIONS
Format and typeface
Eponyms
Abbreviations
Punctuations
Boxed notes
Tables
Includes notes
Excludes notes
Inclusion terms
Other, other specified and unspecified codes
Etiology and manifestation rules
And, due to, in and in (due to); with, cross-references
ICD-9-CM AND ICD-10-CM CODING GUIDELINES
Official Guidelines for Coding and Reporting
1.
Level of detail of coding; conditions that are an integral part of a disease process
2.
Conditions that are not an integral part of a disease process
3.
Multiple coding for a single condition; acute and chronic conditions;
combination codes, late effects, impending or threatened condition.
4.
Reporting same diagnosis code more than once.
5.
Admission encounters for rehabilitation
6.
Documentation for body mass index (BMI) and pressure ulcer stages
ICD-9-CM: Specific Guidelines or Diagnosis Coding (001-139) Infectious and Parasitic
Disease
ICD-9-CM: Neoplasm (140-239)
ICD-9-CM: Endocrine Nutritional and Metabolic Diseases and Immunity Disorders
(240-279)
ICD-9-CM: Diseases of the Blood and Blood Forming Organs (280-289)
ICD-9-CM: Mental Disorders (290-319)
ICD-9-CM: Diseases of the Nervous System and Sense Organs (320-389)
ICD-9-CM: Diseases of the Circulatory System (390-459)
Metro Community College
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I.
J.
K.
L.
M.
N.
O.
P.
Q.
R.
S.
T.
UNIT VIII:
A.
B.
UNIT IX:
A.
B.
C.
UNIT X:
ICD-9-CM: Diseases of the Respiratory system (459-519)
ICD-9-CM: Diseases of the Digestive System (520-579)
ICD-9-CM: Diseases of the Genitourinary System (580-629)
ICD-9-CM: Complications of Pregnancy, Childbirth, and Puerperium (630-677)
ICED-9-CM: Disease of the Skin and Subcutaneous Tissue (680-709)
ICD-9-CM: Diseases of the Musculoskeletal and Connective Tissue (710-739)
ICD-9-CM: Congenital Anomalies (740-759)
ICD-9-CM: Certain Conditions Originating in the Perinatal Period (760-779)
ICD-9-CM: Signs, Symptoms, and Ill-Defined Conditions (780-799)
ICD-9-CM: Injury and Poisoning (800-999)
V-codes
E-codes
INPATIENT HOSPITAL CODING
Acute care facilities (hospitals)
Inpatient diagnosis coding guidelines
OUTPATIENT AND PHYSICIAN OFFICE CODING
Outpatient care
Diagnostic coding and reporting guidelines for outpatient services: hospital-based and
physician Office
Coding Guidelines for Outpatient Diagnostic Tests
ICD-9-CM AND ICD-10-CM WRAP UP
COURSE REQUIREMENTS/EVALUATION:
Upon successful completion of the objectives for this course, students will have acquired basic
cognitive knowledge of ICD-9-CM and ICD-10-CM coding to establish medical necessity, translate
written terminology or descriptions into a universal, common language, and provide data for statistical
analysis.
ADDITIONAL RESOURCES:
AMA
AHIMA
www.ama-assn.org
www.ahima.org
NLM (National Library of Medicine)
www.nlm.nih.gov
HCFA
www.hcfa.gov
Managed links
www.managedhealthlinks.com
National Center for Health Statistics
(ICD-9-CM diagnosis codes)
www.cdc.gov/nchswww
Metro Community College
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OUTCOME ASSESSMENTS
HCIA 2421
COURSE OBJECTIVES
ASSESSMENT
MEASURES
1.
Identify the professional organizations that serve as a resource
for coding and offer coding credentials.
Test and activities
2.
Utilize the ICD-9-CM and ICD-10-CM coding guidelines,
coding books, references and General Equivalence Mapping
(GEMS) crosswalk
Test and activities
3.
Define the abbreviations, punctuation, and other coding
conventions used in ICD-9-CM and ICD-10-CM.
Test and activities
4.
Apply ethical and compliance rules to coding practice.
Test, lab, and
activities
5.
Apply the following principles in determining ICD-9-CM and
ICD-10-CM codes.
a.
Combination coding,
b.
Manifestation
c.
Disease processes
d.
Infectious disease coding
Test, lab, and
activities
6.
Describe the steps used to locate a disease code in ICD-9-CM
and ICD-10-CM.
Test, lab, and
activities
7.
Assign disease codes using either a code book or a computerized
encoder.
Test, lab, and
activities
Metro Community College
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WEEK
ASSIGNMENT
Begin Module 1 assignments are due by the beginning of Module 2
1
All Module 1 assignments due-Begin Module 2
2
All Module 2 assignments due-Begin Module 3
3
All Module 3 assignments due-Begin Module 4
4
All Module 4 assignments due-Begin Module 5
5
All Module 5 assignments due-Begin Module 6
6
All Module 6 assignments due-Begin Module 7
7
8
All Module 7 assignments due-Begin Module 8
Research Project Due
All Module 8 assignments-Begin Module 9
9
All Module 9 assignments-Begin Module 10
10
11
All Module 10 assignments due Final Exam
Metro Community College
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