HIT 202 - Advanced Classification Systems Applications

1. Apply and evaluate the accuracy of diagnosis/procedural coding according to current guidelines.
2. Apply and evaluate the accuracy of diagnostic/procedural groupings.
3. Analyze current regulations and established guidelines in clinical classification systems.
4. Determine accuracy of computer assisted coding assignments and recommend corrective action.
5. Develop appropriate physician queries to resolve data and coding discrepancies.

1. Use reference materials and other resources to ensure coding accuracy.
2. Identify appropriate code sets and guidelines used in a variety of health care settings.
3. Analyze a coding compliance program.
4. Analyze current regulations in clinical classification systems.
5. Apply guidelines in selecting a principal diagnosis, principal procedure, and sequencing codes.
6. Assign diagnosis and procedure codes in a variety of health care settings.
7. Analyze surgical, laboratory, therapeutic and other hospital source documents to determine services that can be coded.
8. Abstract data from medical chart in order to select proper diagnostic and procedure codes.
9. Evaluate the accuracy and completeness of diagnostic and procedural coding.
10. Apply diagnostic and procedural groupings.
11. Evaluate the accuracy of diagnostic and procedural groupings.
12. Develop physician queries to resolve data and coding discrepancies.

1. Coding Reference Materials
   1. Coding Clinic
   2. Official Guidelines for Coding and Reporting
   3. Federal regulations
   4. Professional resources
2. Clinical Classification Systems
   1. ICD-10-CM and PCS
   2. ICD for Oncology (ICD-0)
   3. Healthcare Common Procedure Coding System (HCPCS)
   4. CPT
   5. Systemized Nomenclature of Medicine Clinical Terminology (SNOMED)
   6. Diagnostic and Statistical Manual of Mental Disorders (DSM)
3. Coding Compliance Program
   1. Coding and corporate compliance
   2. Compliance guidelines
   3. Policies and procedures
   4. Auditing tools
   5. Physician queries
4. Current Regulations in Clinical Classification Systems
   1. Medicare Severity Diagnosis-Related Groups (MS-DRGs)
   2. Resource-Based Relative Value Scale (RBRVS) System
   3. Skilled Nursing Facility Prospective Payment System (SNF PPS)
   4. Outpatient Prospective Payment System (OPPS)
   5. Ambulatory Surgery Center Prospective Payment System (ASC PPS)
   6. Home Health Prospective Payment System (HH PPS)
   7. Long-Term Care Hospital (LTCH) Prospective Payment System (PPS)
5. Coding Guidelines
   1. Interpretation of guidelines
   2. Principal diagnosis
   3. Sequencing
   4. Reporting additional diagnoses
6. ICD Coding
   1. Diagnosis coding
   2. Procedure coding
7. Abstracting Data
   1. Medical chart content
   2. Chart content
   3. Use of medical record and reports to ensure quality control and management
8. Diagnosis-Related Groups
   1. MS-DRG Assignment
   2. Complications and Comorbidities
   3. Case-Mix Index
   4. Present on Admission