HITM2224

In this course, students will integrate their coding knowledge from CPT, ICD-10-PCS and ICD-10-CM courses to coordinate the various classification systems needed to code encounters for inpatient and outpatient settings across all major specialties. Students will use an electronic application (encoder application software) as an aid in the selection of appropriate codes. They will evaluate and audit the revenue cycle processes, including compliance with coding guidelines, payer policies and reimbursement methodologies. Students will also identify clinical documentation improvement opportunities and recommend solutions. Student Learning Outcomes

• Determine clinical documentation to assign appropriate diagnostic, service and procedure codes and groupings in accordance with coding guidelines and payer policies. IV.1 RM
• Evaluate denials by analyzing documentation, coding guidelines and payer policies to identify resolutions. IV.2 RM
• Ensure coding compliance by auditing coded encounters. IV.3 RM
• Assess the completeness of data and data sources for the billing process. IV.2 RM
• Determine clinical documentation improvement strategies to improve reimbursement. IV.2 RM
• Ensure codes are applied according to various reimbursement methodology regulations for risk adjustment and payment. (IV.2 RM)
• Demonstrate the ability to communicate professionally and effectively with internal and external customers.
• Evaluate revenue cycle processes using electronic resources such as encoders and grouper software. IV.3 RM
• Comply with American Health Information Management Association (AHIMA) standards of ethical coding. (VI.7)