In this chapter students will be introduced to coding as a profession. Explore the difference between hospital and physician services. How the physician office works and how the coder fits into it. Understanding the hierarchy of providers’ specialty. Exploring the different types of insurance payers. Explaining the importance of medical records; medical necessity and Medicare’s Advance Beneficiary Notice (ABN). Detailing the importance of the Health Insurance Portability & Accountability Act of 1996 (HIPAA) and the need for compliance. Outlining the Office of Inspector General (OIG) workplan. Finally, what will certification from the AAPC do for you.

A thorough knowledge of the human anatomy is essential to be a successful coder as well as the ability to understand the medical terminology used to describe documented medical procedures. This chapter will introduce the student to the basic terminology such pre-fix, suffix and combining forms. The most important key terms of the basic anatomy & physiology of each body system will also be reviewed. This week will give the student an understanding of the anatomy of the boy & how the systems relate to one another.

Coding conventions, coding tips, and understanding ICD-10-CM Volumes 1 and 2 are presented. An addendum introduces the ICD-10 format, which is informational only and not included in the CPC examination. ICD-10-CM Volumes 1 and 2 diagnostic coding through medical necessity, coding guidelines, and how-to steps are presented.

Understanding CPT® and HCPCS codes in relation to reporting physician and/or other provider procedures and services are discussed. This chapter also introduces the basics of formatting, terminology, modifiers, and the two levels of HCPCS codes used in Medicare and most private payer claims. Surgical codes are arranged in sections according to body systems, which are divided according to the type of procedure performed. The AMA’s coding modifiers and coding guidelines are defined.

The Integumentary system is made of structures that cover the human body. The students will have an understanding of the key components of the skin, hair, nails and breast. The various procedures and surgeries that relate to the skin, hair, nails and breast will be reviewed.

One of the largest sets of codes in the CPT®® is the musculoskeletal system. The students will be exposed to how the muscles and bones work together to form the framework of the human body. The application, relevant definitions, anatomical descriptions, and an overview of the various procedures will be revealed during a hands-on demonstration.

Students are introduced to respiratory diseases with subsequent treatment and the functions of the system’s organs. The respiratory system codes with the application and proper documentation are defined. Students will have the opportunity to learn about coding of procedures affecting the cardiovascular system. The chapter covers coding from the Surgery, Medicine and Radiology sections, as well as the major classes of procedures that apply to each system

This week, students will be evaluated on the information you have learned thus far via the administering of a Midterm test is given on information covered from weeks 1-8.

The digestive system main function is to break down food that is taken into the body. The organization and content of the CPT®® Surgery/Digestive System subsections will be explained to students. The key terms associated with the digestive system will be defined along with the anatomy associated with most common procedures performed in this section will be detailed. Four sections of CPT® codes are reviewed in this week. The chapter reviews the Urinary; male genital systems, which is followed by an overview of the female genital system. The forth set of codes discussed reviews the delivery and maternity care codes

Students will have the opportunity to learn about coding of procedures affecting the endocrine and nervous systems. Procedures may range from major to minor surgery, to diagnostic and therapeutic injections, to electro-diagnostic testing. Practical advice will be given to students to overcome CPT®®coding dilemmas involving these systems. The eye and ear are both part of the nervous system, but CPT® and ICD-10-CM treat them separately from the rest of the nervous system codes. The students will have an understanding of coding disorders and procedures for both the eye and ear. Also a discussion of the ASA relative values, anesthesia guidelines, modifiers, code organization and crosswalk, as well as a review of the different types of anesthesia available for patients and the methods in which they are administered is covered in this chapter.

A discussion of radiological procedures and coding guidelines including body positions and relationship terms, radiological supervision and interpretation codes, technique and equipment issues, diagnostic radiology, MRIs, ultrasounds, and chemotherapy administration are covered this week.  This week covers procedure and coding issues pertaining to pathology and laboratory. Topics include organ and disease oriented panels, drug testing, therapeutic drug assays, consultations, hematology and coagulation, blood counts, hemograms and differentials, bone marrow procedures, blood clot studies, transfusion medicine, microbiology, anatomic pathology, and CLIA requirements.

Evaluation and management (E/M) codes are described with the fundamentals in preparation and application to medical claims. Each section explains a topic pertinent to E/M coding such as the definitions of key components, reporting consultations, emergency department visits, critical care, preventive medicine, and home health services. From the basics of E/M coding, the students advance to actual reporting of these codes based on provider information. A step-by-step approach to E/M auditing is presented with the various types of audits common to medical practices.  Also, this chapter discusses immunization and administration for vaccines/toxoids, therapeutic and diagnostic infusions, psychiatry, dialysis, gastroenterology, ophthalmology codes, cardiovascular codes, physical medicine, and other special services that are found in the Medicine section of the CPT®-4 text.

This week, the students will review each section of the Mock Final prior to the administration of a Mock Final Exam.

This week, the students will be evaluated on the information learned during the entire course this program via the administering of a Mock Final Exam.

This week, the students will review the information learned during the entire course this program (section by section) prior to the administration of the national AAPC Certification Exam.

This week, the students will be evaluated via the administering of the national AAPC Certification Exam.