Advanced Coding for the Physician's Office (80 hours)

Course Overview/Description

Continuous changes in the medial billing and coding industry, as well as HIPAA changes, have created an incredible demand for those trained in coding. The Advanced Coding for the Physician's Office Course is designed for students who have previous coding experience, a basic coding education, or who have completed the GES Administrative Medical Specialist Course (click here for more information on the AMS course). CPT, ICD-9-CM (Volumes I and II), and HCPCS Level II Coding are covered, along with information on the Correct Coding Initiative (CCI), compliance and reimbursement issues, E&M guidelines, and much more. Details and tips are provided to ensure that the most in-depth knowledge is acquired. This leads to increased accuracy in code selections and a smoother billing process with quicker and better reimbursement. This course prepares students for the Certified Professional Coder (CPC) certification exam offered by the American Academy of Professional Coders (AAPC).

Course Objectives

Students registering for the Advanced Coding for the Physician's Office Course should have an understanding of CPT-4 (CPT), ICD-9-CM (ICD-9) and HCPCS coding principles. There are brief introductions involving the "basics" of coding, which then will broaden to include the more in-depth information.

Part 1: ICD-9-CM Coding- Disease Classification
Objectives of Part 1:

• Build upon the prior knowledge of ICD-9 diagnostic coding with increased understanding and confidence.
• Understand the alphabetic and tabular structures of volumes 1 and 2 of the ICD-9 book, including the tables.
• Understand and use appropriately the coding conventions in volumes 1 and 2.
• Understand the CMS guidelines for outpatient diagnostic coding and identify the "special circumstances" specified in the guidelines.
• Review distinct information about each chapter, subchapter and category within the ICD-9 book.
• Gain a complete understanding of each sub-category of ICD-9 codes and the disease processes involved, as well as, understanding of the supplementary classifications.
• Identify both primary and principal diagnoses.
• Increase accuracy of ICD-9 disease classification coding while using the acquired knowledge of CMS guidelines and chapter specifics.

 

Part 2: CPT & HCPCS Coding
Objectives of Part 2:

 

• Understand the three levels of HCPCS coding: Level I-CPT, Level II-National Codes and Level III-Local Codes (To be eliminated with HIPAA implementation).
• Understand the importance of remaining up to date on CPT coding changes and learn steps to avoid missing information on the changes that occur.
• Gain a complete understanding of the use of modifiers, section guidelines and the uses of specific CPT codes.
• Know the 10 steps to CPT coding that will help in being compliant and provide better reimbursement because of increased accuracy.
• Know the difference between each of the categories in the Evaluation and Management (E&M) section in order to simplify code selection.
• Gain a better understanding of the components surrounding E&M code selection.
• Know the CMS E&M documentation guidelines (DG) and apply them respectively.
• Gain detailed information on each CPT modifier and its use.
• Increase knowledge of each section through comprehensive review.
• Demonstrate accurate code assignment with the increased knowledge of CPT coding guidelines.
• Better understand when to use unlisted procedures.
• Know the difference between national and local HCPCS codes and modifiers.
• Learn and apply the HCPCS coding conventions.
• Gain knowledge on the HCPCS modifiers and their uses.
• Increase knowledge of Medicare guidelines for both inpatient and outpatient services.

 

Part 3: Local Resources and the Internet.
Objectives for Part 3:

 

• Know how to use the Internet for looking up Local Medical Review Policies (LMRP), state specific guidelines, compliance issues, and other issues of coding and billing.
• Know the foundation of the LMRP's, their uses and when to apply them.
• Learn about Internet Web sites that allow contact with other people in the coding and billing environment for comparison of difficult issues.
• Realize that, no matter how long you have been in the business, issues will arise that prove difficult in resolving and may require networking with others in the business.

Course Outline

Part I: ICD-9-CM - Disease Classification

1. Introduction
2. Understanding the Structure
   1. Alphabetic Index
   2. Tabular List
      1. Classification of Disease and Injury
      2. Supplementary Classifications
         1. V-Codes
         2. E-Codes
      3. Appendices
   3. ICD-9-CM Conventions
      1. Alphabetic Index
      2. Tabular List
      3. Conventions shared by both
   4. Putting ICD-9-CM to work
   5. ICD-9-CM Disease Classification Chapter Review
Part II: CPT and HCPS Coding
1. Introduction
   1. History
   2. Level I
      1. Structure
      2. Guidelines
      3. Modifiers
2. Putting CPT to Work
   1. Reviewing Source Documents
   2. Using the Index
   3. Basic Steps to CPT Coding
3. CPT Chapter Review
   1. Evaluation and Management
      1. Documentation Guidelines of Key Components
         1. History
         2. Examination
         3. Medical Decision Making
      2. Demonstration of E&M Level Selection
      3. E&M Modifiers
   2. Anesthesia
      1. Guidelines
      2. Anesthesia Modifiers
   3. Surgery
      1. General Information and Definitions
      2. Guidelines
      3. Special Circumstances
      4. Surgery Modifiers
   4. Radiology
      1. General Information
      2. Guidelines
      3. Radiology Modifiers
   5. Pathology and Laboratory
      1. General Information
      2. Guidelines
   6. Medicine
      1. General Information
      2. Medicine Modifiers
      3. Special Services and Reports
      4. Quiz for Medicine Modifiers
4. HCPCS Level II
   1. Introduction
   2. Understanding the Structure
      1. The Index
      2. The Appendixes
      3. The Text
   3. Coding Conventions
      1. Symbols
      2. Modifiers
      3. Coding Principles
   4. Medicare Coding Requirements
Part III: Local Resources and the Internet
1. Using the Internet for Finding Resources
   1. Pros
   2. Cons
2. Valuable Resources
   1. Local Medical Review Policies
      1. Specific CPT Coding Guidelines
      2. Covered and Non-Covered ICD-9 Codes
   2. National Correct Coding Initiative (NCCI)
   3. Finding Other Resources
3. Compliance and Reimbursement Issues
   1. Fraud
   2. Medicare
      1. Part I
      2. Part II
   3. Resource-Based Relative Value Scale
   4. Traditional Insurance
   5. Managed Care Organizations
   6. Health Maintenance Organizations
   7. Centers for Medicare and Medicaid Services
   8. Diagnosis-Related Groups
   9. Ambulatory Patient Groups

Prerequisites/Audience

The Advanced Coding for the Physician's Office Course is not an entry-level course. This course is designed specifically for students with previous coding experience, previous education, or who have taken the GES Administrative Medical Specialist course.

The intended audience for this course is a student who is seeking preparation for national certification or a student who wants to enhance his/her coding skills in order to become more marketable in the workplace.

PC Requirements/Materials Included

This course is compatible with Windows Vista Operating System.

This course can be taken on either a Mac or a PC; however, most medical offices currently use PCs.

GES provides the textbook needed for this course The Next Step: Medical Coding. When the course is completed, GES provides a current copy of the official CPC Study Guide to help further prepare for the CPC exam. As a current coder seeking more in-depth knowledge, students should already have a set of coding books. They are not provided by GES. Students are expected to have their own current year CPT, HCPCS, and ICD-9-CM coding books.

Instructor Bio

Samantha Mullins, CPC, MCS-P, ACS-AN
Samantha is a goal and result oriented individual who has educated and trained extensively as a Certified Professional Coder (CPC), Medical Compliance Specialist for Physicians (MCS-P) and Advanced Coding Specialist in Anesthesia (ACS-AN). Her most recent honor is accepting the request for her to sit as a member of the Advanced Medical Coding (BAMC) Anesthesia Advisory Board.

Samantha is equally energetic with intense focus on success and the ability to identify problem areas and develop efficient solutions in her current role of overseeing the coding and compliance areas of VitalMed, Inc, a company providing anesthesia management, consulting and billing services.

Her 11+ years in the business includes additional experiences in developing and facilitating on-line coding, compliance and reimbursement curriculums; serving as an AAPC approved Professional Medical Coding Curriculum (PMCC) instructor; and speaking, consulting and educating on various topics.

In addition to her anesthesia background, she has experience in internal medical, podiatry and surgery. The surgery specialties include general, urology, orthopedics, plastic/reconstructive and neurology; mainly involving the pediatric patient population.

Integrity, quality and compliance top her list of standards.

Frequently Asked Questions (FAQs)

1. Why would I want CPC certification?
This certification was developed by the American Academy of Professional Coders (AAPC), a well-known and respected organization. This certification proves your knowledge and skill in professional medical coding and is one of the certifications of choice for both coders and their employers. It helps your chances in getting a coding job and some companies give pay increases for becoming certified.

2. What is the difference between CPC and CCS certification?
CPC proves your knowledge and skill in physician-based coding where the CCS certification is for facility based coding.

3. Who will recognize CPC certification?
The majority of employers seeking physician-based coders recognize and prefer the CPC certification.

4. How do I register?
Click on the register button at the top of the page and follow the directions. It is important that you type all your information in the boxes, then print it out to sign.  Payment and sending instructions are in the bottom right corner of the form.

5. How much do the courses cost?
The fee is in the pink box at the top of the page.

6. Can I register for courses if I live outside the United States?
Yes you can!

7. Do I ever have go to the school I register with?
All of our courses are delivered entirely online, so you never have to go to a class or travel to the school.

8. How long does it take to complete a course?
All of our courses are self-paced and open enrollment. You can start and finish the course at your own pace. When you register for a course, you are given 180 days (six months) to complete the course. If you need more time, extensions are available.

9. Do I have to buy additional materials?
If you do not have access to current coding books, you will be responsible for obtaining them. Students who sit for the CPC exam will be responsible for paying the AAPC's examination fee.

10. Does this course prepare for National Certification?
Yes, the Advanced Coding for the Physician's Office course prepares students to sit for the Certified Professional Coder exam offered by the American Academy for Professional Coders.

11. Can I get financial aid?
GES courses are non-credit courses, so they do not qualify for federal aid. In some states, vocational rehab or workforce development boards will pay for qualified students to take our courses.

• GES provides a loan opportunity for students. Simply go to www.collegeloanapplication.com to apply for an easier qualifying loan at a slightly higher rate. Click here for more information on this loan program.

12. What happens when I complete the course?
Upon successful completion of the course, you will be awarded a certificate of completion from the school with which you registered. You must obtain a final passing grade of 70% or greater to be awarded a certificate.

13. Am I guaranteed a job?
GES courses will provide you with the skills you need to obtain an entry-level position in most cases. We do not provide direct job-placement services, but our instructors will help you build your resume and are available to give advice on finding your first job. Potential students should always do research on the job market in your area before registering.

14. Who will be my instructor?
Each student is paired with a facilitator for one-on-one interaction. The facilitator will be available (via email or phone) to answer any questions you may have and to provide feedback on your performance. All of our facilitators are successful working professionals in the fields in which they teach.

15. What computer equipment do I need to take an online course, and what are the system requirements?
In order to take our online courses, you must have access to a computer and the Internet (a normal dial-up connection is fine). You can access the course contents from any web-enabled computer. There are no necessary plug-ins. You do not have to use the same computer to log-in to the course every time. We recommend that you have a word-processing program (Microsoft Word is best) and the latest version of Internet Explorer.

16. Can this course be taken on a Mac?
Yes.

17. How can I get more information on the course?
All of the information we have is available online under our course catalog (www.gatlineducation.com). If you have questions that are not answered online, please feel free to email us at courseinfo@gatlineducation.com or call 817-870-2870. We will answer your questions promptly.

18. When can I start the course?
Our courses are all open enrollment. You can register and start the course as soon as you are ready.