Course Name:
Course Number:
Insurance Coding
POFM 1350
Term:
Section Number:
Semester Credit Hours
4.0
Clock hours
Instructor
Mindy Smith, RN
CPC PCS CHAA
E-mail
Phone #1
503-488-5389
88
40
48
Total
Lecture
Lab
0
Clinical
mburnssmith@concorde.edu
Phone #2
Office Location
Teacher Prep Rm
Class Location
Office Hours
Variable
Class Time
COURSE DESCRIPTION
This course gives students a detailed approach to using the Physician’s Current Procedural
Terminology (CPT) and The International Classification of Diseases of (ICD-10-CM), used for
diagnosis coding. The Health Care Procedure Coding System (HCPCS) used for the processing
of government insurance claims such as Medicare is introduced. Skills are achieved through
practice, memorization and software applications.
COURSE OBJECTIVES


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
Explain the purposes of health care coding
Apply the official guidelines to find the best, most accurate codes
Use the documentation to find the correct codes to establish medical necessity
Understand the specific guidelines for inpatient coding
Relate diagnosis coding to procedure coding
Abstract the documentation and apply the correct steps to accurate coding
TEXTS
Safian, Shelley C. The Complete Procedure Coding Book.3rd Ed New York, NY: McGraw Hill,
©2016.
Safian, Shelley C. The Complete Diagnosis Coding Book.3rd Ed New York, NY: McGraw Hill,
©2016.
ICD-10-CM Code Book
CPT 2016 Code Book
STUDENT RESOURCES
COMPUTER ACCESS
Some homework activities in this course series require computer access. Students who do not
have home access to a computer should complete computer-based activities at a Concorde
computer lab, resource center, or public library.
EVALUATION
Grade Scale
90-100
80-89
=
=
A
B
70-79
60-69
=
=
C
D
59 or less
=
F
Students will be evaluated on knowledge of textbook content, writing and presentation skills, and
analysis and application of thinking skills. The minimum acceptable term grade is 70% for
advancement.
Lab and Class work
Typing
Quizzes
Tests
Final Exam
Homework
Total
20
5
15
30
10
20
100
%
%
%
%
%
%
%
Make-up work
A student who misses class work, or deadlines due to absence, including being tardy or leaving
early will be ineligible for make-up or late submission. The student will receive a zero (0) for
missed work. Class work is defined as any lab, competency, quiz, activity, or discussion that
occurs during scheduled class hours.
Typing
Keyboarding is a skill that employers expect in order to run efficient offices. Daily practice is the
only thing that will increase speed and accuracy. Instructors will assign specific assignments to
each student based on his/her progress in speed and accuracy. Your typing grade is a reflection
of completing the required lessons and your speed and accuracy on timed typing tests. Points for
timed typing tests are defined below:
If your GWAM is
43-45
40-42
37-39
34-36
Below 33
you will receive
50 points
40 points
30 points
20 points
10 points
If your accuracy is
95 or above
85-94
75-84
65-74
below 64
you will receive
50 points
40 points
30 points
20 points
10 points
Tutoring
Tutoring will be scheduled at the discretion of the instructor or Academic Dean.
Exams & Quizzes
An exam missed as a result of an absence may be made up within 5 regularly scheduled class
days from the first day the student returns to class. The student must initiate the request to
reschedule on the first day s/he returns. It is the student’s responsibility to schedule time outside
the student’s regularly scheduled class hours to take a missed exam. Not rescheduling on the day
of return, or not appearing for the rescheduled time will result in an automatic zero (0). An exam
taken after the course’s original exam scheduled date will have its grade reduced by one letter
grade. A student arriving late for a test or quiz will only be given the remaining time allotted for
taking the test or quiz to answer as many questions as s/he can. Additional time will not be given
in order to complete the test or quiz.
Quizzes cannot be made up. Quizzes and tests may include material from any previously taught
material in this course. The final exam will be comprehensive.
MAINTAINING SATISFACTORY ATTENDANCE STATUS
Attendance is mandatory. All absences are unexcused. Review your school catalog for specifics
of satisfactory attendance, probation and terms of dismissal.
STUDENT RESPONSIBILITIES
Students are expected to abide by the policies established in the school catalog. Dress code is to
be followed as outlined in catalog.
If you miss a class, it is up to you to obtain a copy of any notes from your fellow classmates and/
or request any handouts or missed work from the instructor. It is also courteous and professional
to call the school and inform the instructor, PD and/or Dean of your absence, just as you would
an employer.
This course will require a great deal of individual effort. If, for any reason, you are experiencing
problems in this course, please speak with the instructor immediately. Do not let any problem
continue to grow until it is too late or unmanageable.
In addition to class time, you are expected to spend outside of class each day on assignments and
activities to help you achieve the course objectives. Your outside class time should be spent
reading the textbook materials, developing outlines and notes for exam preparation, memorizing
theory, and practicing application of theory. For practice, complete the chapter activities in the
textbook, utilize the web resources associated with the text, and perform any other practice as
assigned by the instructor. In order to progress on your final project you will need to research,
draft and revise on a weekly basis. Details of weekly activities will be in your course schedule.
CLASSROOM CONDUCT
Refer to the catalog for details on eating, breakage, cleanliness, etc. Other items not covered are
below:
Cell Phones – Cell phones are not allowed in the classrooms or hallways. Upon entering the
classroom please turn off all cell phones and store away. Cell phones must not be visible at any
time. If seen during quizzes or exams, the student’s paper will be collected and given a zero (0)
with no option for make-up or retake. Calls may be made outside or in the student breakroom.
Participation/Class work — You are expected to participate in class. Class assignments,
which are a part of your course grade, occur throughout the day, with or without announcement,
at the instructor’s discretion.
BREAK TIMES
Instructor: State Times & length

Classwork is defined as any competency, skill, quiz, activity, or discussion that occurs during scheduled class
hours.
COURSE SCHEDULE
*Homework is due at the next class unless otherwise stated.
Day 1
Topics
Covered
Class/Lab
Activities
Homework*
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Course Intro
Diagnostic Coding, ICD-10 Book Ch. 1
Typing
CSS Module #5 start
Chapter Case Studies
Read Chapters Diagnosis 2 & 3
Week 1 definitions
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
Ch. 2-Intro to ICD-10
Ch. 3-General Guidelines
Typing
Chapter Case Studies
Read Chapters Diagnosis 4 & 5
Study terminology

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

Ch. 4-Infectious Disease
Ch. 5-Neoplasms
Typing
Chapter Case Studies
Read Chapter Diagnosis 6, 7
Study for weekly quiz

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
Ch. 6-Blood/Immune Sys
Ch. 7-Metabolic/Endocrine
MT Quiz #1
Typing
CSS Module #5
Chapter Case Studies
Read Ch. 8-Mental Health Coding
Read Ch. 9-Nervous System Coding
Study for weekly test
Day 2
Topics
Covered
Class/Lab
Activities
Homework*
Day 3
Topics
Covered
Class/Lab
Activities
Homework*
Day 4
Topics
Covered
Class/Lab
Activities
Homework*
Day 5
Topics
Covered
Class/Lab
Activities





Ch. 8-Mental Health
Ch. 9-Nervous System
Typing
Test #1
CSS Module #5



Read Ch. 10-Eye Diseases
Read Ch. 11-Auditory Diseases
Week 2 definitions
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
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


Ch. 10-Eye Diseases
Ch. 11-Auditory Diseases
Typing
CSS Module #5
Read Chapters Diagnosis 12 & 13
Complete any lab or class activities not finished in class
Study terminology







Ch. 12-Circulatory Diseases
Ch. 13-Respiratory Diseases
Typing
CSS Module #5
Chapter Case Studies
Read Chapters Diagnosis 14-15
Complete any lab or class activities not finished in class







Ch. 14-Digestive System
Ch. 15-Integumentary System
Typing
Chapter Case Studies
Read Chapters Diagnosis 16 & 17
Complete any lab or class activities not finished in class
Study for quiz
Homework*
Day 6
Topics
Covered
Class/Lab
Activities
Homework*
Day 7
Topics
Covered
Class/Lab
Activities
Homework*
Day 8
Topics
Covered
Class/Lab
Activities
Homework*
Day 9
Topics
Covered


Ch. 16-Muscular Conditions
Ch. 17-Skeletal Conditions
Class/Lab
Activities

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




Typing
MT Quiz #2
CSS Module #5
Chapter Case Studies
Read Ch. 18-Urinary System
Read Ch. 19-Obstetrics
Study for test








Ch. 18-Urinary System
Ch. 19-Obstetrics
Typing
Test #2
Chapter Case Studies
Read Ch. 20-Pediatric Conditions
Read Ch. 21-External Causes
Week 3 definitions

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

Ch. 20-Pediatric Conditions
Ch. 21-External Causes
Ch. 22-Z codes
Typing
CSS Module #5
Chapter Case Studies
Read Procedure Coding Ch. 1 & 2
Complete any lab or class activities not finished in class
Study terminology







CPT Ch. 1-Legal Issues
CPT Ch. 2-Intro to CPT
Typing
Chapter Case Studies
Read CPT Ch. 3-Modifiers
Read CPT Ch. 4-E/M Coding
Complete any lab or class activities not finished in class
Homework*
Day 10
Topics
Covered
Class/Lab
Activities
Homework*
Day 11
Topics
Covered
Class/Lab
Activities
Homework*
Day 12
Topics
Covered
Class/Lab
Activities
Homework*

Study terminology









CPT Ch. 3-Modifiers
CPT Ch. 4-E/M coding
Typing
CSS Module #5
Chapter Case Studies
Read CPT Ch. 5-E/M Coding
Read CPT Ch. 6-Anesthesia
Complete any lab or class activities not finished in class
Study for quiz








CPT Ch. 5-E/M
CPT Ch. 6-Anesthesia
Weekly Quiz #3
Typing
Chapter Case Studies
Read CPT Ch. 7-Surgery Coding
Read CPT Ch. 8-Surgery Coding
Study for test








CPT Ch. 7-Surgery Coding Part 1
CPT Ch. 8-Surgery Coding Part 2
Typing
CSS Module #5
Chapter Case Studies
Read CPT Ch. 9-Radiology Coding
Read CPT Ch. 10-Path & Lab Coding
Week 4 definitions






CPT Ch. 9-Radiology Coding
CPT Ch. 10-Path & Lab Coding
Typing
Chapter Case Studies
Read CPT Ch. 11-Medicine Coding
Read CPT Ch. 12-Cat. II & III Coding
Day 13
Topics
Covered
Class/Lab
Activities
Homework*
Day 14
Topics
Covered
Class/Lab
Activities
Homework*
Day 15
Topics
Covered
Class/Lab
Activities
Homework*
Day 16
Topics
Covered
Class/Lab
Activities
Homework*



Read CPT Ch. 13-HCPCS Intro
Complete any lab or class activities not finished in class
Study terminology






CPT Ch. 11-Medicine Coding
CPT Ch. 12-Cat. II & III Coding
CPT Ch. 13-HCPCS Intro
Typing
CSS Module #5 Due
Chapter Case Studies



Read CPT Ch. 15-HCPCS Supplies
Read CPT Ch. 16-ICD-10-PCS
Study terminology
Topics
Covered


CPT Ch. 15-HCPCS Supplies
CPT Ch. 16-ICD-10-PCS
Class/Lab
Activities
Homework*





Typing
Chapter Case Studies
Read CPT Ch. 17-ICD-10-PCS
Read CPT Ch. 18-ICD-10-PCS
Read CPT Ch. 19-ICD-10-PCS


CPT Ch. 17, 18, 19-ICD-10-PCS
Review Coding



Chapter Case Studies




Final Exam
Final MT Quiz
Finish CSS Module
Project papers due
Day 17
Topics
Covered
Class/Lab
Activities
Homework*
Day 18
Day 19
Topics
Covered
Class/Lab
Activities
Homework*
Study for Final Test/MT Quiz
Day 20
Topics
Covered