Course Number and Title:
HIM 120 Coding I
Prerequisites
Prerequisite: BIO 108 and HIM 100
Course Credits and Hours
3 credit(s)
2 lecture hours/week
2 lab hours/week
Course Description
This is the first course in a three-course sequence. Principles and guidelines are introduced for using the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS) and Current Procedural Terminology/Healthcare Common Procedure Coding System (CPT/HCPCS) to code diagnoses and procedures in outpatient and inpatient setting. Emphasis is placed on assigning the correct code to a diagnostic or procedural statement and sequencing diagnoses and procedures.
Additional Materials
Allied Health/Science Department Program Student Policy Manual
Health Information Management Program Policy Manual
Instructor Handouts
Disclaimer
AHIMA Virtual Lab is used for this course.
Core Course Performance Objectives (CCPOs)
- Validate assignment of diagnostic and procedural codes and groupings in accordance with official guidelines for common healthcare classification systems: International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM); International Classification of Diseases, Revision, Procedure Coding System (ICD-10-PCS); Current Procedural Terminology (CPT); and the Healthcare Common Procedure Coding System (HCPCS). (CCC 1; HIM PGC 1, 6)
- Determine diagnosis and procedure codes according to official guidelines. (CCC 1; HIM PGC 1, 6)
- Describe the use of technology to support the coding process. (CCC 1; HIM PGC 1)
- Comply with ethical standards of coding and health information practice. (CCC 4; HIM PGC 6)
See Core Curriculum Competencies and Program Graduate Competencies at the end of the syllabus. CCPOs are linked to every competency they develop.
Measurable Performance Objectives (MPOs)
Upon completion of this course, the student will:
-
Validate assignment of diagnostic and procedural codes and groupings in accordance with official guidelines for common healthcare classification systems: International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM); International Classification of Diseases, Tenth Revision, Procedure Coding System (ICD-10-PCS); Current Procedural Terminology (CPT); and the Healthcare Common Procedure Coding System (HCPCS).
-
Describe the format and code structure of the ICD-10-CM, ICD-10-PCS, CPT, and HCPCS systems.
-
Distinguish the ICD-10-CM, ICD-10-PCS, CPT, and HCPCS systems.
-
Explain the relationship between the CPT and HCPCS systems.
-
Explain the use of modifiers in the CPT and HCPCS systems.
-
Explain how the common code sets are used in various healthcare settings.
-
Acute inpatient
-
Hospital outpatient
-
Physician office
-
Discuss the guidelines for selection of codes within the common code sets.
-
Distinguish among rules, conventions, instructions, and guidelines as they pertain to the common code sets.
-
Explain how to determine principal and secondary diagnoses.
-
Explain how to determine principal and secondary procedures.
-
Determine diagnosis and procedure codes according to official guidelines.
-
Select ICD-10-CM diagnosis codes for all chapters for inpatient and outpatient settings using patient health records information.
-
Select codes for the following conditions and diseases.
-
Infectious and parasitic diseases
-
Neoplasms
-
Endocrine, nutritional and metabolic diseases, and immunity disorders
-
Diseases of the blood and blood-forming organs
-
Mental, behavioral, and neurodevelopmental disorders
-
Diseases of the nervous system
-
Diseases of the eye and adnexa
-
Diseases of the ear and mastoid process
-
Diseases of the circulatory system
-
Diseases of the digestive system
-
Diseases of the genitourinary system
-
Diseases of the skin and subcutaneous tissue
-
Diseases of the musculoskeletal system and connective tissue
-
Pregnancy, childbirth, and the puerperium
-
Certain conditions originating in the perinatal period
-
Congenital malformations, deformations, and chromosomal abnormalities
-
Symptoms, signs and abnormal clinical, and laboratory findings
-
Select codes for the following reasons for encountering the healthcare system:
-
Injury, poisoning, and certain other consequences of external causes
-
External causes of morbidity
-
Factors influencing health status and contact with health services
-
Select CPT procedure codes for all types of services for inpatient and outpatient settings using patient health records information.
-
Select codes for the following:
-
Evaluation and management services
-
Anesthesia services
-
Surgery services
-
Radiology, nuclear medicine, and diagnostic ultrasound
-
Pathology and laboratory services
-
Medicine services
-
Select Category II codes.
-
Select Category III codes.
-
Given a selected CPT code, identify any appropriate modifiers from the appendices.
-
Select HCPCS service codes for all types of services for inpatient and outpatient settings using patient health records information.
-
Select permanent national codes.
-
Select miscellaneous codes.
-
Select temporary national codes.
-
Describe the use of technology to support the coding process.
-
Explain the purpose of an encoder.
-
Explain the purpose of a grouper.
-
Describe computer assisted coding.
-
Comply with ethical standards of coding and health information practice.
-
Distinguish fraud and abuse in coding.
-
Define upcoding.
-
Identify lack of compliance with ethical coding standards.
-
Explain how ethical coding conforms to professional standards of practice.
Evaluation Criteria/Policies
The grade will be determined using the Delaware Tech grading system:
| 90-100 |
= |
A |
| 80-89 |
= |
B |
| 70-79 |
= |
C |
| 0-69 |
= |
F |
Students should refer to the
Catalog/Student Handbook for information on the Academic Standing Policy, the Academic Integrity Policy, Student Rights and Responsibilities, and other policies relevant to their academic progress.
Final Course Grade
Calculated using the following weighted average
|
Evaluation Measure
|
Percentage of final grade
|
|
In Class Activities (Formative)
|
15%
|
|
Homework Quizzes (Formative)
|
20%
|
|
Test Your Knowledge (TYK) (Summative)
|
20%
|
|
CPT / HCPCS Assignments (Summative)
|
20%
|
|
Midterm Exam: 1 exam weighted at 10% (summative)
|
10%
|
|
Final Exam: 1 exam weighted at 15% (summative)
|
15%
|
|
TOTAL
|
100%
|
Program Graduate Competencies (PGCs are the competencies every graduate will develop specific to his or her major)
1. Synthesize knowledge of medical sciences, clinical classification systems and guidelines, vocabularies, and terminologies to accurately and effectively assess, apply or interpret health data.
2. Analyze data to identify trends through the use of health information technologies.
3. Apply legal, regulatory, privacy, and security standards to employ policies and procedures for health information collection, access, and disclosure.
4. Synthesize knowledge of health data and payment methodologies to evaluate the efficiency and effectiveness of revenue cycle processes.
5. Interpret regulatory, coding, legal, and clinical documentation standards to develop, implement, and evaluate compliance.
6. Demonstrate effective leadership through consistent and appropriate interpretation and evaluation of professional behaviors, ethical standards and guidelines.
Core Curriculum Competencies (CCCs are the competencies every graduate will develop)
- Apply clear and effective communication skills.
- Use critical thinking to solve problems.
- Collaborate to achieve a common goal.
- Demonstrate professional and ethical conduct.
- Use information literacy for effective vocational and/or academic research.
- Apply quantitative reasoning and/or scientific inquiry to solve practical problems.
Students in Need of Accommodations Due to a Disability
We value all individuals and provide an inclusive environment that fosters equity and student success. The College is committed to providing reasonable accommodations for students with disabilities. Students are encouraged to schedule an appointment with the campus Disabilities Support Counselor to request an accommodation needed due to a disability. The College's policy on accommodations for persons with disabilities can be found in the College's Guide to Requesting Academic Accommodations and/or Auxiliary Aids Students may also access the Guide and contact information for Disabilities Support Counselors through the Student Resources web page under Disabilities Support Services, or visit the campus Advising Center.