10-530-165Intermediate Coding
Course Information
Description
Prepares students to assign ICD and CPT/HCPCS codes supported by medical documentation and official coding guidance to support appropriate reimbursement. Students will participate in CDI activities, including preparation of appropriate physician queries in accordance with compliance guidelines.  Use of coded data to promote health equity is addressed.
Total Credits
3
Course Competencies
  1. ASSIGN reportable diagnosis and procedure codes for cases with moderate to advanced clinical complexity
    Assessment Strategies
    Coding case study or medical record
    Criteria
    your code assignment is supported by medical documentation
    multiple codes are sequenced to ensure maximum allowable reimbursement
    your code assignment and sequencing complies with official coding guidelines/conventions and reimbursement rules
    your code assignment and sequencing complies with national standards of ethical coding (e.g., AHIMA, AAPC, ACDIS)

  2. INTERPRET coding advice (Coding Clinic, CPT Assistant, Clinical indicators, etc.) in the process of coding cases with moderate to advanced clinical complexity
    Assessment Strategies
    Coding case study or medical record
    Criteria
    you identify all pertinent guidance for the given scenario
    you apply the guidance for the given scenario
    your code assignment and sequencing complies with official coding guidance/conventions and reimbursement rules

  3. ABSTRACT data elements for the purpose of coding, reimbursement, and data collection
    Assessment Strategies
    Coding case study or medical record
    Criteria
    abstract is complete
    abstracted data is accurate
    abstracted data complies with reporting and reimbursement guidelines

  4. PERFORM coding and grouping processes using electronic applications for cases with moderate to advanced clinical complexity
    Assessment Strategies
    Coding case study or medical record
    Criteria
    your code assignment is supported by medical documentation
    multiple codes are sequenced to ensure maximum allowable reimbursement
    your code assignment and sequencing complies with official coding guidelines/conventions and reimbursement rules
    your code assignment reflects application of national standards of ethical coding (e.g., AHIMA, AAPC, ACDIS)

  5. VALIDATE the accuracy of coding (coder/CAC), abstraction and grouping of cases with moderate to advanced clinical complexity
    Assessment Strategies
    Coding case study or medical record
    Criteria
    you resolve coding, grouping, and abstracting discrepancies
    you determine the root cause of coding errors
    you evaluate the financial impact of coding errors
    you provide recommendation to improve coding, abstraction and grouping quality

  6. CONDUCT clinical documentation improvement activities
    Assessment Strategies
    Coding case study or medical record
    Criteria
    you identify  scenarios that require a physician query
    your query complies with regulatory guidelines (e.g., AHIMA, ACDIS, CMS)