Inpatient Coding Module Objectives    

Objectives: 

Introduction to Inpatient Coding

Know what ICD-9 Procedure Codes are:
Understand the difference between Inpatient and Outpatient coding.
Know the Key Components of inpatient coding.
Know the Organization of the ICD-9 manual, Volume 3.
Understand the significance of third and fourth digits.
Know the ICD-9 Volume 3 manual Conventions.
Know what an Omit Code is.
Know what a Synchronous Procedure is

 

Module 2

Know the Five Steps to accurate inpatient ICD-9 Procedural Coding.
Know what Nonessential Modifiers are.
Know what Essential Modifiers are.
Learn how to use the Tabular List.

 

Module 3

What are Inpatient Coding Rules?
What at the hierarchy of codes?
What is the Principal Procedure?
What are Secondary Procedures?
List the three reimbursement methodologies.
Know what fee for Service, Prospective Payment system and  Per Diem payments are.

 

Module 4

Understand coding for DRG's
Know what MDC's are.
Be able to provide an example of DRG's.
Know what the Prospective Payment System is.
Know what CDAC's are.
Know what a Professional Review Organization is.
Know how Comorbid Conditions (CCs) impact DRG assignment.
Know what the Variables affecting DRG assignment are.
Know what a Quality Improvement Organization is.
Know the potential significance of ICD-10 Procedural Codes

 

Module 5

Know what the UB-92 form is.
Have a working knowledge of UB-92 Fields
Know what a Fiscal Intermediary is.
Know which type of institutions a Fiscal Intermediary is responsible for processing of claims.
Know what revenue Codes are.
Know some examples of Revenue Codes

 

Module 6

Know the five steps of DRG assignment.
Be familiar with DRG coding Software

 

Module 7

Know the five-Most Common Hospital Reports

1.        Triage Report

2.        Operative Reports (Op Reports, Surgical Op Reports)

3.        Diagnostic Tests Report

4.        Medical History Report

5.        Discharge Report

Module 8 - APCs

What defines an Ambulatory Surgery Center?
What is the basis for payment for an ASC?
What are Covered Services?
What are Non-Covered Services?
What services are Excluded and Out of Scope?
What is the history of the UB-92?
What is Payment Control?
What is APC Discounting?
What are terminated procedures?
What is the significance of same-day visits?
What is the Site of Service Differential?