Ability to utilize health information management systems as related to coding; Gain encoding proficiency; Proficiency in using grouping software in order to accurately determine reimbursement rates.

1. Uses and maintains electronic application and work process to support clinical classification and coding

Ability to utilize both coding books and 3M coders

1. Applies diagnosis and procedure codes appropriately

Develop skills/systems to determine diagnostic/procedural accuracy of DRG’s, MSDRG’s and other groupings Develop skills/systems to determine diagnostic/procedural accuracy to apply ICD 10 codes

1. Demonstrates skills needed to ensure accuracy of diagnostic/procedural groupings

1. Applies coding and is able to validate accuracy using clinical information found in health record

Understand and apply regulations and guidelines as they apply to principal diagnosis Understand and apply regulations and guidelines as they apply to principal procedures Understand and apply sequencing and other coding guidelines

1. Applies current regulations and established guidelines while coding

1. Uses and maintains applications and processes to support other clinical classifications

1. Resolves discrepancies between coded data and support documentation

Develop specific communication techniques and skills to enhance communications with physicians and other care providers Develop strong ability to work collaboratively with other coders, supervisors and other hospital personnel

1. Communicates appropriately with physicians and other care providers to ensure appropriate documentation

1. Applies policies and procedures for the use of clinical data required in reimbursements and prospective payment systems (PPS)

Apply policies and procedures to comply with Medicare Apply policies and procedures to comply with Medicaid Apply policies and procedures related to Medicaid managed care plans Apply policies and procedures to comply with private insurers and State regulations

1. Applies policies and procedures to comply with changing regulations among various payment systems

1. Able to support accurate billing through coding, charge master, claims management, and bill reconciliation processes

1. Demonstrates understanding and the ability to apply established guidelines such as the National Correct Coding Initiative to comply with reimbursement and reporting requirements

Validate code assignment and compliance with reporting requirements Ability to create patient data reports

1. Demonstrates proficiency in performing quality reviews

1. Ability to ensure accuracy of diagnostic/procedural groupings such as DRG and APC

Participate in HIPAA training Participate in other employer specific training

1. Participates in and benefits from department compliance (including fraud and abuse) training

Focus on medical terminology: students learn to articulate concepts of body systems, components within individual systems, and relationships between systems including the terminology of body systems relevant to disease, diagnostic and therapeutic tests, and procedures.

An introduction to computers and their use in information processing. Use computer programs such as word processing, spreadsheets, and data base management, as well as Internet applications

The organization of the human body, the definition of the terminology used to describe the location and function of anatomical structures, the outline of the basic chemical concepts essential for understanding physiological processes.

Combination of the study of human disease processes and treatments. Discussion of etiology and pathogenesis of diseases along with the application of diagnostic procedures and patient care. Includes pathology and underlying principles of the human systems along with characteristics of typical drugs, side effects, cautions, and interactions.

Payment systems, including those for inpatient and ambulatory care settings, as well as those for psychiatric, hospice, and home health services.

Legal principles and terminology, as well as health records as legal documents, administration of the law, legal aspects of healthcare facilities, medical staff organization, privacy, and security.

Introduction to the health information management field and opportunities available for students after graduation. Presents an evolutionary view of health information systems. Professional ethics and exposure to current issues impacting the field are included.

The historical development of classification systems for documenting diagnoses and procedures. Application of current and future coding systems as well as coding clinical guidelines for diseases and procedures. Both inpatient and outpatient systems will be reviewed. Compliance and ethics are stressed in each lesson.

In depth study of diagnosis coding using the International Classification of Diseases (ICD) classification system.

An in depth study of procedural coding using the International Classification of Diseases (ICD) classification system and the Current Procedural Terminology (CPT) system

Intermediate and advanced study of International Classification of Diseases (ICD) classification systems, the Current Procedure Terminology (CPT) system, and HCPCS Level II classification systems. Students will demonstrate mastery of coding conventions, coding principles, and official inpatient and outpatient guidelines using case studies.

Students use the skills they have learned in diagnostic and procedural coding and apply it to experiential learning through virtual and/or field -based coding practice (to be demonstrated through project work)