24 Chapter CPC-H Course Description
Chapter One - Compliance in the Outpatient Facility
Compliance in the facility will be reviewed along with important terms the coder needs to know such as the importance of continuing education, accuracy, and ethics pertaining to medical coding.
Chapter Two – Anatomy and Medical Terminology
This week will review the basics of human anatomy to include medical and surgical terms. Medical terms are broken down into elements to obtain word meaning and common abbreviations used in the facility setting.
Chapter Three – Documentation and Coding Standards
The accurate documentation of procedures and services for the outpatient hospital facility is paramount to coding and reimbursement. This week will review the documentation terminology as well as guidelines to proper documentation and coding.
Chapter Four - Diagnosis Coding for Outpatient Facilities- ICD9 CM Volumes 1 and 2
Students will learn diagnosis coding guidelines for billing various outpatient services in order to support medical necessity for reporting purposes. The official ICD-9-CM guidelines will be reviewed related to facility coding.
Chapter Five - ICD-9-CM Volume 3
The essentials of ICD-9-CM procedural coding in Volume 1 and 2 for the outpatient setting are reviewed to code to the highest level of specificity.
Chapter Six - Outpatient Hospital Facilities
This week provides an overview of the various facilities available for direct patient care and the departments involved in the reimbursement process. A listing of the terminology and the abbreviations associated with the outpatient side of health care is included as well as an example of a charge description master (CDM)), which is an essential component of any outpatient billing program.
Chapter Seven - Outpatient Prospective Payment System
Will be reviewing the outpatient prospective payments system that is based on ambulatory payment classifications.
Chapter Eight – Facility Billing
This week we will be reviewing the major differences between hospitals and free standing facilities in regards to the coding and billing processes through topics such as ABN's, assisting the coder to understand the Medicare insurance types.
Chapter Nine - Revenue Codes and Hospital Payment Systems
An understanding of revenue codes and how they differ from diagnosis related groups (DRG) is essential to outpatient billing and coding. This chapter covers hospital departments and their role in the outpatient hospital facility.
Chapter Ten - Charge Capture and the HCPCS Coding Process
In this chapter, students will learn the differences between hospitals and freestanding facilities in regards to the coding and billing processes pertaining to the use of modifiers, global fees, HCPCS coding for facilities, and procedural coding guidelines.
Chapter Eleven - Teaching Physicians
Issues specific to facilities that participate in an approved graduate medical education (GME) program.
Chapter Twelve - Surgery Guidelines
This chapter will cover general surgery guidelines. Explanations of coding modifiers for outpatient hospital facilities are reviewed along with the coding guidelines developed by AMA.
Chapter Thirteen - Integumentary System
Descriptions of each section of surgery codes are in-depth and begin with the integumentary system. Definitions and anatomical descriptions give an overview of these code ranges, which are updated annually to reflect any changes in health care.
Chapter Fourteen - Musculoskeletal System
One of the largest sets of codes in the CPT® is the musculoskeletal system. The application, relevant definitions, anatomical descriptions, and an overview of the various procedures are demonstrated.
Chapter Fifteen - Respiratory System
Students are introduced to respiratory diseases with subsequent treatment and the functions of the system's organs. The respiratory system codes with the application and proper documentation are defined.
Chapter Sixteen – Cardiovascular, Hemic, and Lymphatic Systems
Cardiothoracic surgery of the heart, coronary arteries and great vessels are discussed in this chapter, in addition to pacemaker and cardioverter-defibrillator placement, surgery, therapeutic and diagnostic vascular procedures.
Chapter Seventeen – Digestive System
This chapter covers the digestive process, diagnostic tests and procedures and endoscopies pertaining to the digestive system.
Chapter Eighteen - Urinary System
The urinary system range of the CPT® manual includes codes specific to males and females and explores the general concepts and anatomy of the urinary system as well as the anatomy and consequent services and procedures specific to each gender.
Chapter Nineteen – Reproductive Systems, Delivery and Maternity Care
Three sections of CPT® codes are reviewed in this chapter of the PMCC. The chapter reviews the male genital system, which is followed by an overview of the female genital system. The third set of codes discussed reviews the delivery and maternity care codes.
Chapter Twenty – Nervous and Endocrine System
This chapter covers coding procedures and techniques of the skull, meninges and the brain, spine and spinal cord, extracranial nerves, peripheral nerves, and the autonomic nervous system.
Chapter Twenty One – Eye, Ocular Adnexa, and Ear
This chapter covers procedures and coding pertaining to the eye and auditory system are discussed. The final code in the chapter reports the use of an operating microscope.
Chapter Twenty Two – Radiology
A discussion of radiological procedures and coding guidelines including body positions and relationship terms, radiological supervision and interpretation codes, technique and equipment issues, diagnostic radiology, MRIs, ultrasounds, and chemotherapy administration are covered in this chapter.
Chapter Twenty Three – Pathology and Laboratory
This chapter covers procedure and coding issues pertaining to pathology and laboratory. Topics include organ and disease oriented panels, drug testing, therapeutic drug assays, consultations, hematology and coagulation, blood counts, hemograms and differentials, bone marrow procedures, blood clot studies, transfusion medicine, microbiology, anatomic pathology, and CLIA requirements.
Chapter Twenty Four – Medicine
This chapter discusses immunization and administration for vaccines/toxoids, therapeutic and diagnostic infusions, psychiatry, dialysis, gastroenterology, ophthalmology codes, cardiovascular codes, physical medicine, and other special services that are found in the Medicine section of the CPT®-4 text.
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