Medical Coding Training Ameerpet

1. Chapter 1The Rationale and History of Coding

2. Learning Objectives • Describe the application of coding • Define nomenclature and classification • Identify the historical timeline of coding • Describe different coding organizations and credentials • Recognize the importance of the Standards of Ethical Coding • Know more at Medical Coding Training

3. Learning Objectives Define compliance as it relates to coding Explain confidentiality as it relates to coding

4. Background of Coding • What Is Coding and What Are Its Applications? • What do you need to know to be a coder? • International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) • Medicare Severity Diagnosis-Related Groups (MS-DRGs)

5. Background of Coding • Nomenclature • Classification • Types of • History of

6. History of Coding • 1893: Bertillon’s Classification of Causes of Death • 1898: Adopted by the American Public Health Association • World Health Organization (WHO) • International Classification of Causes of Death • 1977: Clinical Modifications (CM) for U.S.

7. History of Coding • ICD-10 • 1993: ICD-10 published by the WHO • In use in other countries • Alphanumeric system • Tentative implementation in U.S.

8. History of Coding • ICD-9: Keeping current • ICD-9-CM updated twice a year • Federal Register publication of updates • See www.cms.hhs.gov • Current coding tools a must!

9. History of Coding • Maintaining ICD-9-CM • National Center for Health Statistics (NCHS) • Centers for Medicare and Medicaid Services (CMS) • American Hospital Association (AHA) • American Health Information Management Association (AHIMA)

10. Where Coders Work Hospitals Physician Offices Outpatient Surgical Centers Long-term care facilities Insurance companies Prisons Government Agencies

11. Coding Organizations and Credentials • American Health Information Management Association (AHIMA) • Credentials: • CCA Certified Coding Associate • CCS Certified Coding Specialist • CCS-P Certified Coding Specialist – Physician Based • RHIT Registered Health Information Technician • RHIA Registered Health Information Administrator

12. Coding Organizations and Credentials • American Academy of Professional Coders (AAPC) • Credentials: • CPC Certified Professional Coder • CPC-H Certified Professional Coder Hospital-Based • CPC-P Certified Professional Coder Payer-Based

13. Coding Organizations and Credentials • Certification examinations • Keeping coding knowledge current • Continuing education units (CEUs) • Minimums are required to maintain certification.. • For more info • Medical Coding Training

14. Compliance • Follow the rules! • Who makes the rules? • CMS • Office of the Inspector General (OIG) • Other organizations • Rule-making • Health Insurance Portability and Accountability Act of 1996 (HIPAA) • Increase in Compliance Officers

15. Coding Ethics • AHIMA and AAPC have Standards for Ethical Coding • Examples: • Coding professionals should adhere to coding guidelines • Should only assign and report codes that are supported by physician documentation • Should maintain and enhance coding skills

16. Compliance • Make sure you and your department are in compliance • Steps to assure compliance? • Have a Coding Compliance Plan • What should be in the plan?

17. Confidentiality • Covered in: • Patient Bill of Rights • HIPAA • Common sense/need to know approach

18. Chapter Highlights • Background of Coding • What Is Coding and What Are Its Applications? • Nomenclature and Classification • History of Coding • Coding Organizations and Credentials • Coding Ethics • Compliance • Confidentiality