Standard

Posted. 02/2005

MAS 152 – ICD-9 Coding II

Course Description

Continues development of skills and knowledge presented in ICD-9 Coding I and provides for patient disease and medical procedure coding for billing purposes by health care facilities. Topics include: medical records coding techniques; coding linkage and compliance; third-party reimbursement issues; and ethics in coding including fraud and abuse.
Competency Areas:		Hours
Medical Records Coding Techniques		Class	2
Coding Linkage and Compliance		D. Lab	0
Third-Party Reimbursement Issues		P. Lab/O.B.I.	3
Ethics in Coding		Credit	3
Prerequisite: MAS 151
Corequisite:	MAS 153

Course Guide

Competency	After completing this section, the student will:	Hours
		Class	D. Lab	P. Lab/ O.B.I.
MEDICAL RECORDS CODING TECHNIQUES		5	0	25
Structure of medical records	Review medical records to identify the diagnosis and procedures that should be reported.
Terminology	Determine correct terminology for diseases and procedures from abbreviation and doctor’s notations entered in patient’s medical records.
Application	Use the international classification of diseases (ICD-9-CM) manual to numerically code diagnoses entered in sample patient records.
CODING LINKAGE AND COMPLIANCE		5	0	0
Compliance Plan	Identify the parts of a compliance plan, and discuss how they help avoid errors.
Compliance Regulations	Discuss the major laws and guideline that regulate coding compliance.
Linkage	Properly link diagnoses and procedures when reporting services for reimbursement.
Audits	Discuss the use of audit tools to verify the code selection.
THIRD-PARTY REIMBURSEMENT ISSUES		10	0	0
Claim Processing	Identify the steps in the claims processing sequence.
Computer	Discuss the use of computer technology in claims processing.
Linkage	Properly link diagnoses and procedures when reporting services for reimbursement.
Patient Responsibility	List the types of charges for which patients may be responsible.
Claim Follow-up	Describe the methods used to monitor and follow-up on claims of third-party payers.
Payments	Discuss the process of payer remittances and payments.
ETHICS IN CODING		5	0	0
Reporting	Describe actions that are considered fraudulent and discuss major types of errors medical practices make in reporting codes.
Confidentiality	Describe the guidelines for release of patient information to requestors outside of the practice.
Fraud and Abuse	Identify and define fraud and abuse and legal implications of each.

Suggested Resources

Books:

Bayes, Nenna L. (2002) Medical Insurance A Guide to Coding and Reimbursement. New York: Glencoe McGraw-Hill.

Brown, Faye (2003) ICD-9-CM Coding Handbook without Answers. Chicago: AHA Press.

Buck, Carol J. (2004) Step-By-Step Medical Coding 5^th Edition. St. Louis, MO: Saunders.

Buck, Carol J. (2004) Saunders 2004 ICD-9-CM, Volumes 1,2,and 3 and HCPCS Level II. St. Louis, MO: Saunders.

Falen, Thomas J. (2004) Learning to Code with ICD-9. Philadelphia, PA: Lippincott Williams and Wilkins

Newby, Cynthia (2002) Medical Insurance Coding Workbook for Physician Practices. New York: Glencoe McGraw-Hill

FA Davis. Taber’s Cyclopedic Medical Dictionary, 19^th Edition.

Fordney, (2002). Insurance Handbook for the Medical Office Student Workbook, 7^th ed.

Diamond, (2001). Mastering Coding: Tools, Techniques, and Practical Applications, A Worktext

Buck, (2002) 2002 ICD-9-CM, Vol. 1, 2 & 3 & 2002 HCPCS with Official Coding Guidelines, Saunders.