HIMT 2303 (formerly HIT 2231) Syllabus
HIMT 2303 (formerly HIT 2231) - Advanced Coding
3 Credit Hours
This course focuses on advanced topics in diagnosis and procedural coding including ICD-10-CM, ICD-10-PCS and CPT/HCPCS. The course will concentrate on official coding guidelines, sequencing skills and use of ICD-10-CM and ICD-10-PCS in healthcare reimbursement, as well as prospective payment system theory and methodology. The course will include practice in coding clinical documentation improvement techniques using both case studies and actual health records and computerized coding and grouping software.
Upon successful completion of this course, students will be able to:
- Explain the historical development of healthcare reimbursement in the United States.
- Identify Centers for Medicare and Medicaid Services (CMS) prospective payment systems, theory and methodology.
- Determine principal diagnosis and procedure for case studies accurately.
- Define terminology associated with diagnosis related groups (DRG) prospective payment system.
- Using coding software to accurately assign ICD-10-CM, ICD-10-PCS and CPT codes for assigned case studies and actual health records.
- Demonstrate, ICD-10-CM, ICD-10-PCS and CPT/HCPCS coding skills by application of, ICD-10-CM, ICD-10-PCS Official Guidelines for Coding and Reporting and Official Guidelines for CPT/HCPCS codes as identified in CPT Assistant.
- Apply American Health Information Management Association Standards for Ethical Coding.
- Review documentation for information that substantiates the principal and secondary diagnoses as well as complications and/or comorbidities
- Define the purpose of the UB-04 and CMS 1500 claim forms
- Apply medical knowledge in review of documentation to substantiate medical necessity of services provided.
- Display appropriate method for querying a physician for questions concerning documentation.
- Determine appropriate MS-DRG assignment through use of computerized coding and grouping software.
Refer to home school requirements.
- Development of United States healthcare reimbursement
- Role of ICD-10-CM, ICD-10-PCS and CPT/HCPCS coding in determination of reimbursement levels for healthcare providers
- Advanced topics in ICD-10-CM and ICD-10-PCS
- Advanced topics in CPT/HCPCS
- Selection of principal diagnosis, secondary diagnoses, principal procedure
- Coding guidelines including official guidelines and facility specific guidelines
- Content of claim forms UB-04 and CMS 1500
- DRG assignment
- Use of computerized coding and grouping software
- Code of ethics for coders
- Review of documentation for accurate code assignment
- Process to conduct a quality audit for appropriate code assignment
- Coding of intermediate case studies, advanced case studies and actual health records
This course is an advanced study of principles and applications of ICD-10-CM, ICD-10-PCS and CPT/HCPCS coding with a focus on prospective payment systems. Students should have an understanding of the basic coding guidelines for ICD-10-CM, ICD-10-PCS and CPT/HCPCS coding to comprehend presented material.
HIM Associate Degree Entry Level Competencies: Domains, Subdomains and Tasks
- Subdomain I.A.2 - Evaluate the accuracy of diagnostic and procedural coding
- Subdomain I.A.3 - Apply diagnostic/procedural groupings
- Subdomain I.A.4 - Evaluate the accuracy of diagnostic/procedural groupings
- Subdomain I.B.1 - Analyze the documentation in the health record to ensure it supports the diagnosis and reflects the patient's progress, clinical findings, and discharge status
- Subdomain I.B.2 - Verify the documentation in the health record is timely, complete and accurate
- Subdomain I.B.2 Identify a complete health record according to organizational policies, external regulations, and standards
- Subdomain III.A.1 - Utilize software in the completion of HIM processes
- Subdoamin IV.A.1 - Apply policies and procedures for the use of data in healthcare reimbursement
- Subdomain V.B.1 - Analyze current regulations and established guidelines in clinical classification systems
- Subdomain V.B.2 - Determine accuracy of computer assisted coding assignment and verify corrective action
- Subdomain V.D.1 - Identify discrepancies between supporting documentation and coded data
- Subdomain V.D.2 - Develop appropriate physician queries to resolve data and coding discrepancies
- Subdomain VI.H.1 - Comply with ethical standards of practice
If you have different editions of textbooks from previous HIMT courses, contact your instructor before purchasing new textbooks. The required textbooks used in this course were used in other courses in the HIMT program. It is recommended that you do NOT sell these books back at the end of the course.
Access to the AHIMA Virtual Lab is required to access the 3M encoder. You should already have access to the Virtual lab, however, if you do not, please contact your instructor immediately.
All word processed assignments should be completed in Microsoft Word. Students must have software that will permit assignments to be saved in Microsoft Word format or as an html file so the instructor may view.
Adobe Acrobat will be needed to view the scanned records.
Textbooks, Supplementary Materials, Hardware and Software Requirements
Please visit the Virtual Bookstore to obtain textbook information for this course. Move your cursor over the "Books" link in the navigation bar and select "Textbooks & Course Materials." Select your Program, Term, Department, and Course; then select "Submit."
Suggested resource: A medical abbreviation book such as The Davis Book of Medical Abbreviations or Dictionary of Medical Acronyms & Abbreviations Book with CD-ROM and a medical dictionary such as Dorland's or Mosby's.
Minimum hardware requirements can be found here.
Minimum software requirements can be found here.
Common applications you might need:
Purdue OWL Online Writing Lab (for APA, MLA, or Chicago style)
The Writing Center Online Writer's Handbook
- Technical support information can be found on the TN eCampus Help Desk page.
- Smarthinking virtual tutoring is available FREE of charge. to access Smarthinking, visit the course homepage and select Smarthinking under Course Resources. You also view sample sessions to see what Smarthinking offers and how it works.
- Information on other student issues or concerns can be located on the TN eCampus Student Resources page.
Please see "Instructor Information" in the Getting Started Module for instructor contact information, virtual office hours, and other communication information. You can expect to receive a response from the instructor within 24-48 hours unless notified of extenuating circumstances.
Participation, Assessments, & Grading
Letter grades for this course will be assigned based on the following scale.
|Point Range||Assigned Grade|
|639 - 690 points||A|
|584 - 638 points||B|
|528 - 583 points||C|
|480 - 527 points||D|
|under 480 points||F|
|3 discussions at varying points each||75 subtotal points|
|1 diagnostic and 2 procedural statement codings @ 20 points each||60 subtotal points|
|5 coding case studies @ 15 points each||75 subtotal points|
|3 clinical coding workouts at varying points each||90 subtotal points|
|5 outpatient record codings @ 5 points each||25 subtotal points|
|5 inpatient record codings @ 5 points each||25 subtotal points|
|6 HIM case studies @ 20 points each||120 subtotal points|
|2 other drop box assignments @ varying points each||45 subtotal points|
|3 quizzes @ 25 points each||75 subtotal points|
|1 final exam, 3 parts at varying points each||100 subtotal points|
|Total points||690 total course points|
There are several different types of assignments in this course. You will have diagnostic and procedure coding statements that need coded. You will complete HIM case studies from the Case Studies book. You will code specific questions in the Clinical Coding workout and will also code 5 Inpatient and 5 outpatient records. There are three discussion posts that will need completed. There are also three quizzes and a comprehensive final exam.
Complete all assignments as directed and on time. Ask questions if instructions are unclear. Notify instructor if circumstances cause a delay in compliance with deadlines.
It is expected that all work will be completed on time. Assignments will not be accepted after the due date. Any exceptions are at the discretion of the instructor.
Course Ground Rules
The following two statements (1., 2.) were derived from the TBR System-wide Student Rules document, released January 2012:
RULES OF THE TENNESSEE BOARD OF REGENTS STATE UNIVERSITY AND COMMUNITY COLLEGE SYSTEM OF TENNESSEE SYSTEMWIDE STUDENT RULES CHAPTER 0240-02-03 STUDENT CONDUCT AND DISCIPLINARY SANCTIONS
1. Standards of Conduct:
- Students are required to adhere to the same professional, legal and ethical standards of conduct online as on campus. In addition, students should conform to generally accepted standards of "netiquette" while sending e-mail, posting comments to the discussion board, and while participating in other means of communicating online. Specifically, students should refrain from inappropriate and/or offensive language, comments and actions.
- In their academic activities, students are expected to maintain high standards of honesty and integrity. Academic dishonesty is prohibited.
Such conduct includes, but is not limited to:
- an attempt by one or more students to use unauthorized information in the taking of an exam
- to submit as one's own work, themes, reports, drawings, laboratory notes, computer programs, or other products prepared by another person,
- or to knowingly assist another student in obtaining or using unauthorized materials.
Plagiarism, cheating, and other forms of academic dishonesty are prohibited.
Students guilty of academic misconduct, either directly or indirectly through participation or assistance, are subject to disciplinary action through the regular procedures of the student’s home institution. Refer to the student handbook provided by your home institution to review the student conduct policy.
In addition to other possible disciplinary sanctions that may be imposed, the instructor has the authority to assign an "F" or zero for an activity or to assign an "F" for the course.
Other Course Rules:
Students are expected to:
- Participate in all aspects of the course
- Communicate with other students
- Learn how to navigate in Brightspace
- Keep abreast of course announcements
- Use the assigned course management (Brightspace) email address rather than a personal email address
- Address technical problems immediately:
- Observe course netiquette at all times.
Guidelines for Communications
- Always include a subject line.
- Remember without facial expressions some comments may be taken the wrong way. Be careful in wording your emails. Use of emoticons might be helpful in some cases.
- Use standard fonts.
- Do not send large attachments without permission.
- Special formatting such as centering, audio messages, tables, html, etc. should be avoided unless necessary to complete an assignment or other communication.
- Respect the privacy of other class members
- Review the discussion threads thoroughly before entering the discussion. Be a lurker then a discussant.
- Try to maintain threads by using the "Reply" button rather starting a new topic.
- Do not make insulting or inflammatory statements to other members of the discussion group. Be respectful of other’s ideas.
- Be patient and read the comments of other group members thoroughly before entering your remarks.
- Be cooperative with group leaders in completing assigned tasks.
- Be positive and constructive in group discussions.
- Respond in a thoughtful and timely manner.
The Tennessee Virtual Library is available to all students enrolled in TN eCampus programs and courses. Links to library materials (such as electronic journals, databases, interlibrary loans, digital reserves, dictionaries, encyclopedias, maps, and librarian support) and Internet resources needed by learners to complete online assignments and as background reading will be included within the course modules. To access the Virtual Library, go to the course homepage and select the Virtual Library link under Course Resources.
Students with Disabilities
Qualified students with disabilities will be provided reasonable and necessary academic accommodations if determined eligible by the appropriate disability services staff at their home institution. Prior to granting disability accommodations in this course, the instructor must receive written verification of a student's eligibility for specific accommodations from the disability services staff at the home institution. It is the student's responsibility to initiate contact with their home institution's disability services staff and to follow the established procedures for having the accommodation notice sent to the instructor.
The instructor reserves the right to make changes as necessary to this syllabus. If changes are necessitated during the term of the course, the instructor will immediately notify students of such changes both by individual email communication and posting both notification and nature of change(s) on the course bulletin board.
The information contained in this syllabus is for general information purposes only. While we endeavor to keep this information up-to-date and accurate, there may be some discrepancies between this syllabus and the one found in your online course. The syllabus of record is the one found in your online course. Please make sure you read the syllabus in your course at the beginning of the semester. Questions regarding course content should be directed to your instructor.