HITT 2340 Course Syllabus - Page 1
Midland College
Syllabus HITT 2340
Spring 2008
Advanced Medical Billing and Coding
Course
Description
Development of coding techniques of CPT and ICD-9-CM with emphasis on case studies,
health records, and federal regulations regarding perspective payment systems and
methods of reimbursement. Prerequisite: HITT 1441. Corequisite: HITT 2435.
Text,
References
and Supplies
Textbooks required:
1)Understanding Health Insurance: A Guide to Billing and Reimbursement, Cengage
Publications, author Green & Rowell, 2008 with ACCESS CODE.
2) Case Studies for Health Information Management, 1st Edition. Charlotte McCuen;
Nanette B. Sayles; Patricia Schnering. Cengage Delmar Learning. 2008
References:
Faye Brown’s ICD-9-CM Coding Handbook, 2007 Edition. American Hospital Association
(AHA) Press.
Coding & Reimbursement for Hospital Outpatient Services, Lolita M. Jones, RHIA, CCS,
AHIMA 2005.
Coding and Reimbursement of Hospital Inpatient Services, Karen S. Scott, MEd, RHIA,
CCS, AHIMA. 2005.
Current Procedural Terminology, CPT, 2008, American Medical Association.
ICD-9-CM Code Book, Volumes 1, 2, & 3, Elsevier Publishing 2007.
Supplies (optional): Either microphone with headset or separate microphone with
speakers through PC for talking with instructor on SKYPE.
Course Goals/
Objectives
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
Locate information in the Federal Register.
Analyze and select proper codes for patient chart exercises.
Evaluate accuracy of coded charts.
Clarify conflicting, ambiguous, or non-specific information appearing in a medical
record.
Abstract information from the medical record.
Select correct principle diagnosis and principle procedure.
Apply payor reimbursement guidelines (i.e. PPS, APCs, and RBRVS).
Assess quality and adequacy of documentation.
Determine and validate appropriate DRG.
Identify all secondary diagnoses and patient procedures.
Accurately complete billing forms.
Analyze MEDPAR data.
Accurately use physician queries.
Perform data quality reviews to validate code assignment.
18. Use encoder to research coding and DRG changes.
19. Research national health information initiatives.
Summarize federal legislation and regulations affecting health care.
Interpret a chargemaster.
Apply special rules for the Medicare physician fee schedule payment system.
Research local coverage determinations (LCD) and national coverage
determinations (NCD).
Complete workers’ compensation claims properly.
HITT 2340 Course Syllabus - Page 2
Domains,
Subdomains
and Tasks
I. Healthcare Data Management
I.D. Subdomain: Reimbursement Methodologies
I.D.1. Apply policies and procedures for the use of clinical data required in
reimbursement and prospective payment systems (PPS) in healthcare delivery.
I.D.2.Support accurate billing through coding, chargemaster, claims management and bill
reconciliation processes.
I.D.3. Use established guidelines to comply with reimbursement and reporting
requirements such as the National Correct Coding Initiative
I.D.4. Compile patient data and perform data quality reviews to validate code
Assignment and compliance with reporting requirements such as outpatient prospective
payment systems.
III. Domain: Health Services Organization and Delivery
III.A.Subdomain: Healthcare Delivery Systems
III.A.1. Apply information system policies and procedures required by national health
information initiatives on the healthcare delivery system.
III.A.2. Apply current laws, accreditation, licensure and certification standards related
to health information initiatives from the national, state, local and facility levels.
IV. Domain: Information Technology & Systems
A. Subdomain: Information and Communication Technologies
IV.A.2. Use common software applications such as spreadsheets, databases, word
processing, graphics, presentation, email and so on in the execution of work processes.
IV.A.3. Use specialized software in the completion of HIM processes such as record tracking,
release of information, coding, grouping, registries, billing, quality improvement, and
imaging.
Student
Contributions
and Class
Policies
1.
2.
3.
4.
5.
6.
Read and study assignments.
Each exercise assigned will be expected to be completed and ready for discussion.
Participate and contribute to the discussions using Discussion Board threads.
Complete each lesson and examination as scheduled.
Use encoder to complete projects, charts, and homework as instructed.
Complete the FINAL EXAM by the due date with an approved proctor.
Late assignments and exams: All work must be submitted on or before the due dates.
Work not submitted on time will be given a grade of zero unless mitigating circumstances
exist. Students can work ahead of schedule when conflicts arise with the course
schedule. Contacting the instructor ahead of time to submit work early is permitted, but
late work is not accepted. A zero will be placed in the gradebook for assignments not
completed by the due date.
Testing philosophy: All tests are reviewed in class as a learning experience. Students
who have completed all pertinent exercises and previous exams may politely challenge
the instructor on questions they felt were poorly worded. If the instructor concedes the
argument, scores will be adjusted for the entire class.
Virtual Lab: Each student will be required to attend online lab in order to learn the
QuadraMed encoder. Case Studies will be assigned as a grade and must be attended in
order to receive a grade other than zero. The instructor will be available during office
hours to work through example.
DISCUSSION BOARD: The posts will be answered daily except for weekends. This form of
HITT 2340 Course Syllabus - Page 3
communication is important in online courses. This tool will help you stay “connected”
to other classmates and it will help students to ask those questions just as if you were in
an actual classroom setting. Discussion board will also be used as a participation tool,
and part of the semester grade is based on participation. When posting a response to the
discussion board about a topic, post your original response before reviewing other
classmate’s postings. Then, read the other postings and respond to at least two other
students for full credit for participation. Scoring: First “original” response: up to 6
points, 2nd and 3rd responses, up to 2 points each.
EMAIL: Only when the content of the question is personal in nature should the instructor
be emailed. Also be sure to sign your name at the end of the email. Remember some
email addresses give instructors absolutely no clue as to who sent it.
ATTENDANCE: Because this is strictly an internet course, attendance will be substituted
by participating on the discussion board. You will be required to respond to 2 posts in the
discussion board 4 out of 7 days of the week. Answers to the discussion questions, and
weekly summaries are counted as a posting. Participation is part of your semester
grade. Original posts should show evidence that the material was read and understood.
ADA POLICY: Students needing additional time to test due to a documented learning
disability, contact Dale Williams, Counselor, at 685-5598 or dwilliams@midland.edu at
the beginning of the course to make accommodations. See the current Midland College
catalog for more information.
Computer Requirements: Students should have access to Microsoft Word and Excel for
assignment submission. Students taking online courses are responsible to have access to
a computer for submission of assignments and postings. For specific computer
requirements, see Blackboard System Requirements for Midland College courses at
www.bb01.edu. AOL, MSN, and Prodigy browsers will not work with Blackboard.
These browsers will lock up or lock you out of assignments and tests. Instead,
download Mozilla at www.mozilla.com or Netscape 7.0.
Computer Downtime: This is an online course. Each student is required to have a
functioning computer for the entirety of the semester. Having computer problems does
not exempt students from completing work by the due date. If the Blackboard system
goes down or is unavailable, an announcement will be posted as the due date will be
extended. If your system goes down, find another computer to submit your
homework/posts before the due date. It is strongly suggested that assignments are to be
submitted early to avoid any technical difficulties.
SUBMITTING ASSIGNMENTS IN BLACKBOARD:
1. Use a word document format.
2. Save assignment in a rich text file (.rtf) or (.doc). You will find this on your computer
under File, Save As, Save Type As (under the name of your document). If you have
questions about rtf files, see Course Documents for more information.
3. Each assignment should be submitted through Blackboard under View/Complete
assignment as attachment. If there is more than one task due with the assignment such
as CH1A (Workbook 1-1, 1-3, and 1-4), all these tasks should be submitted in one word
document. DO NOT send three different files.
4. Each assignment should have a header that includes your name, date, course number,
and assignment name. Failure to include this content will result in points deducted
from your grade. Examples:
To save:
Ch1mct.rtf
Chapter 1 by Melody Cheryl Thompson (rtf file)
Ch2jwj.rtf
Chapter 2 by James W. Johnson (rtf file)
HITT 2340 Course Syllabus - Page 4
Evaluation of
Students
Each student’s grade will be determined by the following ratings:
Discussion Board
Chapter Assignments
Quiz (listed as Exam category)
Section Exams
Final Examination
16%
18%
30%
18%
18%
A semester grade of less than "C" will NOT be acceptable as passing in this course. In
order to progress from one course to another as defined in the program curriculum, the
student is required to complete all courses listed in the curriculum in the college catalog
with a minimum of a "C".
Instructors
Information
Name: Shawnda Meshirer, RHIT, CCS
Office phone: 432-685-5578
Office Hours: 9:00 – 11:00 and 1:30 – 4:30 Tuesdays and Thursdays
Virtual Office online with SKYPE: 8:00 – 9:00 p.m. Monday evenings.
Email: smeshirer@midland.edu
Office Location: A15 AMS (Aaron Medical Science Building)
HITT Department Office Telephone: 432-685-5573
Division Dean and Division Secretary Names: Dr. Becky Hammack and Kay Floyd
Division Office Location and Telephone: 209HS, 432-685-4600
Students are encouraged to contact the instructor at any time; however, making an
appointment will guarantee the instructor’s availability at a specific time.
SKYPE
Instructions
Download software at www.SKYPE.com. This is free software. Students will need a
headset with a microphone OR a computer with speakers and a microphone that is
connected to the computer. SKYPE is free to call anyone through the internet to another
on the internet.
The last day to withdraw from the course with a grade of “W” is
Course
Withdrawal
Academic
Honesty
April 10, 2008. It is the student’s responsibility to complete the Withdrawal Form online
to receive a grade of “W”.
Midland College expects that students will honor the policies set forth by Midland
College. Any student cheating in the course will be removed from the course an “F”
submitted for the grade. A letter will also be sent to the Registar to be added to the
student’s admission file. Please refer to policies on cheating, plagiarism, and collusion in
the Student Responsibilities section of Midland College Catalog & Handbook at
http://www.midland.edu/admissions/images/2007-2008%20Catalog.pdf
HITT 2340 Course Syllabus - Page 5
Course Schedule
HITT 2340 Advanced Billing and Coding
Spring 2008
Due Date
1/20
2/02
Introduce yourself
Take Pre-Test
Ch 1. Health Insurance Specialist Career
Ch 2. Introduction to Health Insurance
Ch 3. Managed Health Care
2/09
Ch 4. Development of an Insurance Claim
2/12
Test #1
2/16
2/23
3/01
Ch 5. Legal and Regulatory Issues
Ch 8. HCPCS Level II Coding
Ch 9. CMS Reimbursement Methodologies
3/08
Ch 10. Coding for Medical Necessity
3/11
Test #2
3/15
Ch 11. Essential CMS-1500 Claim Instructions
3/29
Ch 12. Commercial Insurance
4/05
Ch 13. Blue Cross Blue Shield
4/08
Test #3
4/12
4/19
Ch 14. Medicare
Ch 15. Medicaid
4/26
Ch 16. TRICARE
Take Post-Test
5/03
Ch 17. Workers’ Compensation
5/5 or
5/6
Proctored Comprehensive
Final Exam
1/26
Case Studies in HIM
by case number
Understanding Health Insurance Text
None
2-1 Official Coding Resources
2-5 Coding Quality
2-8 Classification Systems
2-6 Chargemaster Audit
Discussion
Board
Topic
Introduce
yourself
TBA
TBA
TBA
2-10 Encoder Functional Req.
2-11 Encoder Selection
2-16 Using Workflow Tech in
Physician Query Mgmt.
2-17 Physician Orders for
Outpatient Testing
TBA
TBA
TBA
2-42 Calculating Commercial
Insurance Reimbursement
2-33 MEDPAR Data Analysis
2-27 Complication/Comorbidity
(CC) analysis
2-34 Explanation of Benefits
TBA
2-37 Medicare Coverage
2-38 Local Care Determination
(LCD)
2-41 Medical Necessity
2-44 Discharged Not Final
Billed (DNFB)
2-26 Diagnosis-Related Group
Changes
TBA
TBA
TBA
TBA
TBA
TBA
TBA