PELLISSIPPI STATE COMMUNITY COLLEGE MASTER SYLLABUS
MEDICAL INSURANCE CODING OST 2940
Class Hours: 3.0								Credit Hours: 3.0
Lab Hours: 0.0								Revised: Fall 09
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, latest edition. 2. Saunders 2009 ICD-9-CM Volumes 1, 2, & 3 Standard Edition, WB Saunders Publishers 3. Saunders 2008 HCPCS Level II, WB Saunders Publishers 4. CPT 2008 Standard Edition, WB Saunders Publishers 5. Workbook for text, Step-by-Step Medical Coding, latest edition 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					Overview of Course and Coding in the Physician Office Setting. & Introduction to the CPT
		2					Assign Codes for Anesthesia and Modifiers
		3					Assign Codes for Surgical Procedures/Services
		4					Assign Codes for Surgical Procedures/Services
		5					Assign Codes for Surgical Procedures/Services
		6					EXAM and Assign Codes for Surgical Procedures/Services
		7					Assign Codes for Surgical Procedures/Services and Radiological Services
		8					Assign Codes for Laboratory/Pathology Services
		9					Assign Codes for Medicine Services
		10					EXAM and Introduction to the ICD-9-CM
		11					Assign Diagnostic Codes
		12					Assign Diagnostic Codes
		13					Assign Diagnostic Codes
		14					Assign Diagnostic Codes for Special Situations
		15					FINAL EXAM
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 materials including ICD-9-CM, CPT, and HCPCS code books, medical dictionaries, periodicals, encyclopedias, etc. which will allow accurate and timely interpretation of the medical terms necessary for effective coding (both verbal and written) in a medical environment. Communication Outcome
		2.			Solve medical coding problems using the ICD-9-CM, CPT, and HCPCS code books. Active Learning Strategy
		3.			Access Pellissippi State User Account to find library resources pertaining to Health Care Insurance, and evaluate these resources with particular reference to coding. Technological Literacy Outcome
		4.			Read assigned materials and participate in class discussions. Communication Outcome, Active Learning Strategy
		5.			Use E-mail to communicate with the instructor and classmates to express and answer questions. Technological Literacy Outcome, Communication Outcome
		6.			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. Transitional Strategy, Active Learning Strategy
*Strategies and outcomes listed after instructional processes reference TBR’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/Homework: 40% of final 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. Class work/ homework will be evaluated via weekly quiz.
		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.]  (Pellissippi State Online Catalog) 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.  (Pellissippi State Online Catalog)
	C. Accommodations for disabilities:
			Students who need accommodations because of a disability, have emergency medical information to share, or need special arrangements in case the building must be evacuated should inform the instructor immediately, privately after class or in her or his office. Students must present a current accommodation plan from a staff member in Services for Students with Disabilities (SSWD) in order to receive accommodations in this course. Services for Students with Disabilities may be contacted by going to Goins 134 or 126 or by phone: 694-6751(Voice/TTY) or 539-7153. More information is available at www.pstcc.edu/departments/swd/.
		D. Other Policies:
			Assignments: 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. Computer Usage Guidelines: College-owned or –operated computing resources are provided for use by students of Pellissippi State. All students are responsible for the usage of Pellissippi State’s computing resources in an effective, efficient, ethical and lawful manner. (Pellissippi State Online Catalog) Veteran’s Benefits Regular attendance is required to receive veterans’ benefit pay. Instructors are required to report non-attendance of veterans 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. PROFICIENCY CREDIT BY EXAM (CBE): A student with a minimum GPA of 2.5 may apply for credit by examination for any college-level course at Pellissippi State Technical Community College on the basis of experience or training. Students may apply for credit by examination no later than the first week of class for OST students. MATH and OST credit by examinations are given only in the fall and spring semesters. 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 concentration of OST will administer credit-by-examination tests on the Saturday prior to the first day of class for the semester.]