Prep Course Objectives:

ICD-10 Coding Objectives:

• Familiarize yourself with the layout of the ICD-10 manual

• Translate a written diagnosis into the correct ICD-10-CM codes.

• Learn the correlation between the alphabetic index and the tabular list.

• Effectively use the Table of Drugs and Chemicals and the Index to External Causes of Injury and Poisoning.

• Know what "main terms" and "sub-terms" are.

• Know what Eponyms are.

• Understand the concept of sub-categories.

• Be familiar with ICD-10 Instructional Notes

• Know the nine steps for accurate coding.

• Know Acute versus Chronic coding

• Coding Suspected Conditions

• Combination Codes

• Multiple Coding

• Infectious and Parasitic Diseases

• Know the difference between HIV and AIDS

• Neoplasms

• Diabetes

• Arthritis and Arthropathies

• Respiratory Diseases

• Circulatory System (cardiology)

• Injuries

• Fractures

• Burns

• E Codes

• V Codes

• Coding for Late Effects

• Coding for Complications from Medical care

Basic CPT Coding Concepts

• What does CPT mean?

• Who developed and manages CPT?

• What is the organization of CPT?

• What are the coding conventions of the CPT manual?

• How are new codes or changed/revised codes identified?

•  What are CPT modifiers?

• What are subsections of CPT?

•  What are the classes of main terms?

• What are Eponyms?

• What is the difference between See This & See Also?

• What are the general rules for CPT Coding?

HCPCS

• What does HCPCS stand for?  

• What are the three levels of HCPCS?  

• What is the organization of the HCPCS manual?  

• Which codes are temporary codes?  

• How do you use the Table of Drugs?  

• Which letters are reserved for local use?

CPT Modifiers

• Know why modifiers are used.

• Know the three (3) ways to report modifiers.

• Review all modifiers and examples.

• Know how and when to use HCPCS National modifiers

• Know what information carriers may need to justify payment of modified procedure and service codes.

E & M Services

• Introduction of E & M

• The levels of E & M Services

• New versus Established patient.

• Coding for E & M Services and surgical procedures.

• Coding for preventive medicine services.

• Coding for Emergency Room and Critical Care.

• Coding for Inpatient services.

• Coding for Special E & M Services.

• Key components.

• Contributory "ancillary" components.

• How Time, Coordination of care and Counseling impact the level of E & M Service.

• Know what systems are included in a Review of Systems.

• Know what PFSH is.

• Know the levels of Examination

• Understand the levels and components of Medical Decision Making.

• Understand the role of the three main components of MDM (possible diagnoses, amount of tests and information and risk of complications, morbidity and comorbidities.

• Understand how to document for an Encounter Dominated by Counseling or Coordination of Care.

• Understand the difference between a consult and a referral

Anesthesia

• Know the difference between general, region and local anesthesia.

• Know what services are/are not included in an anesthesia services.

• Know how anesthesia values are determined.

• Know what basic units, time units and modifying units are.

• Anesthesia modifiers (P1 - P6).

• Know the Four qualifying circumstances modifiers (99100; 99116; 99135 & 99140).

• Know what constitutes an emergency condition for anesthesia.

• Know when time is not a factor in coding Anesthesia services.

• Know the Anesthesia Billing Formula

Integumentary

• Know the difference between the epidermis, dermis and subcutaneous tissue.

• Know the components of the dermis.

• Know the Incision and Drainage Codes.

• Know the Debridement codes.

• Know biopsy codes.

• Code for removal of skin tags.

• Coding for excision of lesions.

• Coding for excisions and avulsions.

• Know the difference & how to code simple, intermediate and complex repairs.

• Know the 7 steps of coding for repairs.

• Understand tissue transfers, flaps and grafts.

• Know the 4 categories of tissue transplantation.

• Know what a decubitus ulcer is.

• Coding for burns.

• Understand what the "Rule of Nines" means.

• Coding for breast disorders.

• Know the different types of mastectomies (radical, partial, simple).

• Know the chest wall excision codes.

Musculoskeletal System

• Introduction

• Arthritis and Arthropathies (ICD-10 Review)

• Understand the wound exploration codes.

• Understand the three (3) types of fracture care categories.

• Understand the two (2) types of fixation.

• Understand the types of manipulation and stabilization.

• Understand how to code for casts and strapping.

• Coding for dislocations.

• Understand arthroscopies and the difference between diagnostic versus surgical.

• Know the different purposes for surgery.

• Shoulder Procedures

• Special procedures for knees.

• Understand Osteochondritis Dissecans.

• Cruciate Ligament repair, augmentation & reconstruction.

• Understand arthrodesis, the proper questions and approaches.

• Understand the correct steps to code Bone Grafting.

• Understand the correct steps to code Bone Grafting.

Respiratory System

• Understand polyps and excision of polyps.

• Understand the vocabulary for accessory sinuses.

• Understand nasal endoscopy. Larynx procedures.

• Coding for bronchoscopies.

• Terms associated with thoracotomy.

• Coding for Laryngoscopy.

• Coding for surgical thoracoscopy.

Cardiology

• Know the kinds of blood vessels.

• Understand the difference between the technical and professional component of a procedure.

• Understand the cardiac graphics (Medicine section).

• Coding for Rhythm Strips.

• Know what a Signal Averaged Electrocardiogram is.

• Coding for patient event recorders.

• Coding for exercise stress tests.

• Coding for electrocardiography.

• Coding for and understanding TEE.

• Coding for and understanding Doppler Echocardiography.

• Coding for stress echocardiography.

• Coding for PTCA.

• Coding for Stent Placement.

• Coding for cardiac catheterization.

• Know what CABG is and how to code for it.

• Coding for pacemakers, their insertion and removal.

• Know what an AICD is.

• Know what VAD's are and do.

• Know what a PICC line is.

• Coding for implantable infusion pumps.

Digestive System

• Review the format and organization of the digestive system section.

• Review the medical terminology of the structures of the mouth (above the esophagus).

• Coding and terminology for tonsillectomies.

• Understand the variations of code 43121.

• Understand the mechanics and coding for insertion of a stent.

• Know how to code for a PEG tube.

• Know how to code for EGD.

• Understand and know how to code for ERCP.

• Understand the difference between a gastronomy, gastrectomy and gastrostomy.

• Be familiar with the gastric bypass procedure.

• Understand the difference between a proctosigmoidoscopy, sigmoidoscopy and a colonoscopy.

• Coding for hemorrhoid surgery.

• Coding for laparoscopic cholecystectomy.

• Coding for hernias (important!).

Urinary

• Understand what the lithotomy approach is.

• Understand the difference between Endoscopy,

• Cystoscopy, Urethroscopy, and Cystourethroscopy.

• Know urological medical terms.

• Know the difference between the Ureter and urethra (important!).

Male / Female Urinary

• Coding for Vasectomy

• Coding for the biopsy of the prostate

• Coding for Laparoscopy and related procedures.

• Know coding for an inguinal hernia.

• Know how to code for the insertion and removal of contraceptive devices.

• Know how to code for surgical sterilization procedures.

• Know the difference between a surgical and a diagnostic hysteroscopy.

• Coding for a D & C.

• Know how to code for laparoscopy/hysteroscopy procedures.

• O/B

• Know how to code for maternity care and delivery

• Know the difference between delivery, postpartum and antepartum care.

• Know the components of ante partum care.

• Know how to code for multiple births.

Endocrine

• Know what organs are part of the endocrine system.

• Be familiar with the options of the endocrine system procedures (i.e., partial, complete, limited, etc...).

• Know what organs are part of the endocrine system.

• Know where to find surgical operations on the pituitary and pineal gland.

• Be familiar with the options of the endocrine system procedures (i.e., partial, complete, limited, etc...).

• Understand the variations of a thyroidectomy  

• Understand the variations of a Parathyroidectomy  

• Know what a Carotid Body is.

Nervous

• Know the anatomy and terminology of the nervous system.

• Familiarize yourself with the twelve (12) cranial nerves.

• Know the difference between parasympathetic and sympathetic nerves.

• Understand and know how to code for pain management.

Pain Management

• Be able to define Pain Management

• Be familiar with pain management methods.

• Be sure to follow the coding guidelines for unilateral / bilateral procedures and radiological guidance.

Eye

• Know how to code for Adnexa

• Know what is included in the code for extraction of a lens.

• Coding for insertion and removal of ocular implants.

• Coding for strabismus surgery

Auditory

• Be familiar with the 69100 ear excision codes.

• Understand what a tympanostomy is and how to code for it.

• Know which procedure code to use when the physician inserts ventilating tubes in to the opening of the tympanum.

• Understand the difference between a stapedectomy and a stapedectomy.

• Auditory System 2

• Know what cochlear implant, aural rehabilitation, speech processor mean.

• Know what a Basic Audiologic Assessment includes.

• Know the components and factors involving coding for hearing screening

Radiological

• Know the difference between the professional and technical component.

• Understand the terms and coding for diagnostic radiology.

• Always pay careful attention to the number of views for X-rays.

• Be familiar with CAT technology.

• Understand the purpose and coding associated with contrast studies.

• Be familiar with Computed Tomographic Angiography (CTA).

•  Understand MRI coding and techniques.

• Understand diagnostic ultrasound techniques and coding.

• Be familiar with the different types of ultrasound.

• Understand the role and coding for radiation oncology.

• Note the difference between simple, intermediate and complex planning for the treatment of radiation oncology.

• Be familiar with nuclear medicine.

Pathology/ Lab

• Review the sections of the Path/Lab section.

• Know that mod-51 is not used with Path/Lab codes.

• Know the different types of lab test methods used.

• Understand the guidelines for billing panels.

• Lab panels have changed over the last few years.

• If you have been coding for years, be sure to review this section as many codes have been deleted.

• Familiarize yourself with the 11 panels.

• Familiarize yourself with the drug screening tests.

• Note that coding for qualitative screening tests is based on procedure, not method or analyte.

• Be familiar with the types of tests included under Evocative/Suppression Testing.

• Know the guidelines for coding blood transfusions.

• Be familiar with anatomical and surgical pathology.

Medicine

• Be familiar with what type of information is found in the medicine section.

• Be familiar with the Immunization Injection Codes.

• Know how to use Prolonged Intravenous Infusion codes.

• Be sure to read the Psychiatry Guidelines at the beginning of the Psychiatry section of CPT.

• Be familiar with coding for dialysis for ESRD.

• Understand the "separate procedure" rule.

• Be sure to read the notes under the different vestibular and audiologic function tests.

• Know how to code for hand-held doppler devices.

• Know how to code for ventilation assist and management.

• Know how to code for code 95004.

• Understand how to code for the Skin End Point Titration Test.

• Review the five levels of dermatological services.

• Know that time is a major factor in coding physical therapy and rehabilitation codes.

• Familiarize yourself with Osteopathic, Chiropractic and Special Services. Even though you may never code them, they still may (and probably will) be on the certification exam

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