PELLISSIPPI STATE TECHNICAL COMMUNITY COLLEGE MASTER SYLLABUS
MEDICAL INSURANCE CODING OST 2940
Class Hours: 3.0							Credit Hours: 3.0
Lab Hours: 0.0							Revised: Spring 04
NOTE: This course is not designed for transfer credit.
Catalog Course Description:
	Introduction to insurance coding guidelines developed for use with the International Classification of Disease (ICD-9-CM), Current Procedural Terminology (CPT-4), and Health Care Financing Common Procedure Coding System (HCPCS).
Entry Level Standards:
	Must be able to read, write, speak and reason at the college level. Successful completion of the Medical Terminology course sequence is required.
Prerequisite:
	OST 2920 or department approval
Textbook(s) and Other Course Materials:
	1. Buck, Carol J., Step by Step Medical Coding, WB Saunders Publishers, 4th Edition, 2002.  2. Physician ICD-9-CM HCPCS pack(most recent issue) 3. CPT (most recent issue) 4. Newby, Cynthia, Medical Insurance Coding Workbook for Physician Practices, Glencoe McGraw-Hill Publishers, 2001-2002 Edition, 2002.  5. Medical Dictionary not more than five years old; or continue to use the same one purchased for previous courses.
I. Week/Unit/Topic Basis:
	Week					Topic
	1					Introduction to Course and ICD-9-CM
	2					Using the ICD-9-CM
	3					Code Diseases
	4					Introduction to CPT Code Book and Code Diseases
	5					Code Surgery Services and Diseases
	6					EXAMINATION and Code Surgery Services & Diseases
	7-9					Code Surgery Services and Diseases
	10					Code Radiology and Code Diseases
	11					EXAMINATION and Code Radiology Services
	12					Code Laboratory/Pathology Services
	13					Code Medicine Services
	14-15					Code Evaluation/Management Services
	16					FINAL EXAMINATION
II. Course Objectives*:
	A.			Understand the different types of health care coding and be aware of the procedures associated with the coding for medical claims. VI,X,XI
	B.			Learn the ICD-9-CM diagnostic coding system. III,V,XI,XII
	C.			Learn the CPT-4 procedural coding system. III,V,XI,XII
	D.			Learn the HCPCS coding system. III,V,XI,XII
	E.			Demonstrate the ability to use correct medical insurance terminology, abbreviations, and understand the various medical insurance programs available to consumers.  IV, VIII, XI
	F.			Relate the importance of diagnostic and procedural coding to physician reimbursement. III, V, X, XII
*Roman numerals after course objectives reference goals of the OST program.
III. Instructional Processes*:
Students will
	1.				Initiate a personal library of reference material including ICD9 Code Books, CPT Code Book, and HCPCS Code Book, medical dictionaries, common abbreviations/eponyms which will allow accurate and timely interpretation of the medical terms necessary for effective coding (both verbal and written) in a medical environment. Personal Development Outcome
	2.				Solve medical coding problems in a simulated real world environment like a medical office or  affiliated health care practice to allow accurate and efficient utilization. Problem Solving and Decision Making Outcome, Transitional Strategies
	3.				Research the Internet to find the latest technologies used in medical fields and to relate this to medical terminology employed in the health care coding.  Information Literacy Outcome
	4.				Access Pellissippi State User Account to find library resources pertaining to health care insurance, and evaluate these resources with particular reference to coding.  Information Literacy Outcome
	5.				Use independently gathered material and presentation skills to review specific medical specialty topics  with special emphasis on medical coding, the tests ordered, the abbreviations employed, and the medical diagnoses most frequently employed for that specialty. Communication Outcome, Information Literacy Outcome
	6.				Use E-mail to communicate with your instructor and other www-classmates to express and answer questions. Active Learning Strategies
	7.				Learn to use a computer software package to evaluate coding questions. Practice communication skills by use of E-mail to other students and to communicate with the lead instructor. Technological Literacy Outcome
	8.				Internalize the work ethic by regularly completing assignments, being punctual, dependable, cooperating with the teacher and other classmates, completing class projects, and acting in a professional manner while taking class. Personal Development Outcome
*Strategies and outcomes listed after instructional processes reference Pellissippi State’s goals for strengthening general education knowledge and skills, connecting coursework to experiences beyond the classroom, and encouraging students to take active and responsible roles in the educational process.
IV. Expectations for Student Performance*:
Upon successful completion of this course, the student should be able to:
	1.			Discuss the economic impact of correct coding on a medical office. A,F
	2.			Identify the system used in diagnosis coding. B
	3.			Identify the systems used for procedural coding. C,D
	4.			Explain why accuracy is essential in coding. A,E,F
	5.			Describe how diagnosis and procedural coding tie together on the claim form. E,F
	6.			State the basic steps and apply the basic guidelines in using ICD-9-CM. B,E
	7.			Describe the use of fifth digits, notes, includes and excludes in diagnosis coding. B
	8.			Describe the primary use of E codes and V codes. B
	9.			Apply coding guidelines to specific problems. A,B,C,D,E
	10.			Describe the format of CPT codes, sections, guidelines and punctuation. C
	11.			State the basic steps and apply the basic guidelines in using CPT-4 for a given procedure or service. C,E
	12.			Describe the format, levels of coding and use of the HCPCS codes. D
	13.			Describe the use of special service codes. D
	14.			Abstract data from mock patient records to code for diagnosis and procedures. A, B, C, E
*Letters after performance expectations reference the course objectives listed above.
V. Evaluation:
	A. Testing Procedures: 60% of grade
			There will be three (3) exams given during the semester, each consisting of coding problems and objective questions in the form of multiple choice, true/false, short answer, or short essay. The  final exam is comprehensive and will be given in accordance with the final exam schedule published by the College.
	B. Laboratory Expectations:
		N/A
	C. Field Work:
		N/A
	D. Other Evaluation Methods: 40% of grade
		Classwork and/or homework assignments will be given for each unit. Each student is expected to complete all homework assignments. Selected classwork and homework assignments will be turned in for a grade and will be calculated into the final grade as shown above. Classwork/ homework will be evaluated via weekly quiz.  Plan 2-4 hours of study for each one hour of class. If you are experiencing problems, please consult the instructor. Participation in class is vitally necessary to developing ease in pronouncing, spelling, and dissecting medical terms.
	E. Grading Scale:
		A        93-100 B+      90-92 B        85-89 C+      80-84 C        75-79 D        70-74 F        less than 69
VI. Policies:
	A. Attendance Policy:
		Pellissippi State Technical Community College expects students to attend all scheduled instructional activities. As a minimum, students in all courses must be present for at least 75 percent of their scheduled class and laboratory meetings in order to receive credit for the course. [NOTE: No differentiation is noted for excused/unexcused absences. These will be treated as an absence.]  Regular attendance is required to receive veteran's benefit pay.  Instructors are required to report non-attendance to the Veterans Affairs Office which reports non-attendance to the Veterans Administration Regional Office. Payments are adjusted or canceled if attendance is not regular.
	B. Academic Dishonesty:
		Plagiarism, cheating, and other forms of academic dishonesty are prohibited. Students guilty of academic misconduct, either directly or indirectly through participation or assistance, are immediately responsible to the instructor of the class. In addition to other possible disciplinary sanctions which may be imposed through the regular Pellissippi State procedures as a result of academic misconduct, the instructor has the authority to assign an F or a zero for the exercise or examination or to assign an F in the course.
	C. Other Policies:
		1. In order for grades to be calculated, all assigned work must be submitted in a timely fashion.  Assigned work must be turned in by date designated. Late work will be charged with a late  penalty.  2. A student with a minimum GPA of  2.5 may apply for credit by examination for any college-level course at Pellissippi State on the basis of past experience or training. The student's application for credit by examination must be approved by the department head and vice president of Academic and Student  Affairs. [NOTE: The HCOA Program will administer credit-by-examination tests on the Saturday prior to the first day of class for the semester.]