HM 117 CPT and HCPCS Coding

1. Use and maintain electronic applications and work processes to support clinical classification and coding. 
2. Apply diagnosis/procedure/supply codes according to current nomenclature. 
3. Ensure accuracy of diagnostic/procedural grouping. 
4. Adhere to current regulations and established guidelines in code assignment. 
5. Validate coding accuracy using clinical information found in the health record. 
6. Use and maintain applications and processes to support other clinical classification and nomenclature systems. 
7. Resolve discrepancies between coded data and supporting documentation. 
8. Define the purpose of insurance coding and how CPT fits into the process. 
9. Utilize medical terminology, medical dictionaries, NCCI edits, and other resources in the CPT coding process. 

• Introduction to CPT 
  • Purpose and development 
  • Structure and design of CPT 
  • Common symbols and terms used in the CPT manual 
  • How CPT fits as part of HCPCS 
  • Relationship between CPT coding and diagnosis coding 
• Categories of CPT codes 
  • Review CPT guidelines for choosing correct code in all categories/body systems of CPT 
  • Review terminology specific to each category/body system of CPT 
  • Review sequencing guidelines for correct code assignment 
  • Practice assigning CPT codes correctly in each category/body system 
• National Correct Coding Initiate 
  • Explain purpose of the NCCI 
  • Explain how to access the NCCI, both electronically and paper form 
  • Review when the NCCI should be referenced 
  • Practice assigning correct codes using the NCCI edits 
• Coding Audits 
  • Review the importance of documentation in health record as it pertains to coding 
  • Review audit tools that can be used to conduct appropriate audits 
  • Explain how to find and handle discrepancies between coding and documentation. 
  • Practice finding/handling coding and documentation discrepancies