Coding and Reimbursement Methodologies Syllabus for 2020-2021
Return to Syllabus List

Instructor Information

Office Location

<p>West Campus Allied Health 166</p>

Office Hours

Appointments must be scheduled.

Instructor will be checking course 3 times a day.

Course Information

COVID-19 Protocols

Recording Policy

Disability Statement

If you have a disability (learning, mental, physical) that affects your ability to participate effectively and have access to any program or service at Amarillo College please contact Disability Services at (806) 345-5639 . Our offices are located in the Student Service Center office 112. More information may be found at www.actx.edu/disability.
Disability Services facilitates access to all programs and services according to the ADA, Americans with Disabilities Act and Section 504 of the Rehabilitation Act, as well as other federal and state laws.

Amarillo College Web Accessibility Policy Statement

Amarillo College is committed to providing equal access to all programs and services, including all working, learning, and service environments that affect equal access for persons with disabilities. This commitment to provide equal access and opportunity for persons with disabilities is in compliance with federal and state law. Amarillo College also strives to provide Electronic and Information Resources (EIR) that are accessible to all authorized users.

If you find you are unable to access material in an accessible format please contact the Disability Services Office at (806) 345-5639 . This office will work in conjunction with other campus resources to address and accommodate your issue in a timely manner.

Statement for Mental Health and Advocacy & Resource Center:

As a student you may experience a range of issues that can cause barriers to learning, such as strained relationships, increased anxiety, alcohol/drug problems, feeling down, difficulty concentrating and/or lack of motivation. These mental health concerns or stressful events may lead to diminished academic performance or reduce a student's ability to participate in daily activities. Amarillo College offers services to assist you with addressing these and other concerns you may be experiencing. If you or someone you know are suffering from any of the aforementioned conditions, you can learn more about the broad range of confidential mental health services available on campus by calling the AC Counseling Center at 806-371-5900. The AC Counseling Center website is https://www.actx.edu/counseling/ . Also, if you are in need of social services (affordable housing, utilities, transportation, food, clothing, childcare, medical/dental/vision, legal), please call the AC Advocacy & Resource Center at 806-371-5439. The AC Advocacy & Resource Center website is https://www.actx.edu/arc

Amarillo College Tutoring for Success Policy:

The Tutoring for Success policy applies to any student whose grade or performance in the course falls below a departmentally determined minimum threshold. In either of those cases, the instructor will direct the student to the appropriate tutoring service, which may be faculty-led, discipline-specific, and/or general. Under this policy, the instructor will follow specific departmental guidelines governing the use, duration, and grade component of the tutoring need.

Administrative Drop Policy

Students who do not attend class on or prior to the census date will be administratively dropped. Effective Fall, 2016

Student Withdrawal Procedures

Students who wish to withdraw from a course must complete all steps indicated on the Academic Withdrawal Request form by the course withdrawal deadline.

NOTE: Students who are attending Texas institutions of higher education, for the first time fall 2007 and later, may not withdraw from more than six courses during their academic career. This withdrawal limitation does not include dual credit or developmental classes (Senate Bill 1231 Rule 4.10.) For more information on Drop and Withdrawal Policies, please visit the Registrar's Office Web site.

Privacy Statement

The Amarillo College Privacy Policy is found at https://www.actx.edu/-amarillo-college-privacy-notice , and applies to all Amarillo College students.  If you have questions about this privacy statement or you believe that your personal information has been released without your consent, send email to humanresources@actx.edu .

Course

HITT-2335-001 Coding and Reimbursement Methodologies

Prerequisites

Prerequisite: HITT 1341

Course Description

Advanced coding techniques with emphasis on case studies, health records and federal regulations regarding prospective payment systems and methods of reimbursement.  

Student ResourcesStudent Resources Website

Department Expectations

Occupational License Disclaimer

Notice to Students enrolled in an educational program for preparation of issuance of certain occupational licenses:

Students enrolled in an educational program in preparation for obtaining certain occupational licenses are potentially ineligible for such license if the student has been convicted of an offense. For further information, please contact:

Melodie Graves
Justice Involved Advocate
Student Service Center 117
mgraves24@actx.edu
806-371-5995
Make appointment at https://melodiegraves.youcanbook.me

You can also contact the Legal Clinic, or the faculty member in charge of the educational program that you seek to enroll in. The further information you will receive will include notification to you of your right to request a criminal history evaluation letter from the licensing authority in order to clarify your particular situation.

Hours

(3 sem hrs; 3 lec, 1 lab)

Class Type

On Campus Course

Syllabus Information

Textbooks

ICD-10-CM Code Book, 2020-2021Carol J. Buck, Elsevier

ICD-10-PCS Code Book, 2020-2021 Carol J. Buck, Elsevier

ICD-10-CM / PCS  Coding Theory and Practice, 2021-2022 Edition, Elsevier

Supplies

Textbook and Coding Manuals

Student Performance

END OF COURSE OUTCOMES:

Sequence codes according to established guidelines and standards; and apply reimbursement methodologies.

COURSE OBJECTIVE:             

This course is designed to teach the student to code correct diagnoses and procedures in order for the physician and/or patient to receive optimal reimbursement.

COURSE GOALS:
Recognize and identify the tracking of the disease processes..
Demonstrate knowledge of practices used in protecting and securing patient health information.
Demonstrate how to use the medical record and ICD-10-CM codes for Medical Research.
Describe how to use ICD-10-CM codes in the evaluation of hospital service utilization. Demonstrate proficiency in the administration and the use of health information systems and software applications.
Demonstrate advanced expertise in applying healthcare standards, concepts, and regulations in the delivery of healthcare services

COURSE COMPETENCIES:

Upon completion of the following the student will be able to perform & recognize the following with at least a 70% accuracy as evaluated by the program’s faculty.

Understand the reason for coding.
Explain the contents of the ICD-10-CM/PCS coding volumes and the steps involved in coding.        
Define, understand and recognize the use of special terms for coding.  These will involve the following categories: synonyms in the Alphabetic Index, NEC, NOS, main term, subterm, carry-over line, “see also” categories, eponyms, and adjectives.

Recognize when more than one code is needed to code a diagnosis properly.
Understand and explain the reason for 3-7 alpha numeric characters in coding with ICD-10-CM.
Understand and explain the reason for “includes” and “excludes 1 & 2” with ICD-10-CM coding.
For ICD-10-PCS coding understand the medical and surgical section guidelines.
For procedural coding the student will also be introduced to CPT-4 coding.  There will be an understanding of the coding procedure manual for coding of Medicare surgical procedures and any other insurance purposes.
Recognize the need for and understanding the Z and Y code supplemental classifications incorporated into main classification in ICD-10-CM and how used in coding diagnostic statements.
Correctly code the module exercises by using the coding instructions received from the lecture sessions.
Understand the principles and philosophy of advanced coding logic.  Define and understand the basic terms involved with coding diagnosis and procedure statements, and in working with MS-DRG’s
Apply the UHDDS definitions and coding guidelines to coding problems.
Utilize the medical record for coding properly.  The student will be cognitive of how important it is to fully understand the medical record and all of its uses.
Recognize the reasons for multiple coding, override exclusion notes and combination codes
Differentiate “principal” from “primary” diagnosis.
Understand the basic facts for coding in sequence while using MS- DRG grouping.
Understand external causes of morbidity and apply all the uses of “V,W,X,& Y” codes.
Understand the OGCR in sequence while using DRG grouping. 
List the six (6) surgical approaches, fifth character in the ICD-10-PCS.
Correctly code the following coding areas:  Poisonings, colitis, neoplasms, diabetes, immunity disorders, anemia, substance (drug) abuse and dependence, blindness, circulatory diseases, hypertension, respiratory diseases, pregnancy, special disorders involving the digestive system, abortions and delivery codes, and fractures.
Understand the codes for chiropractic care.
Understand and apply additional sixth character in some chapters.
Assign additional seventh characters for obstetrics, injuries, and external causes of injuries.
Understand the process of constructing codes in ICD-10-PCS that will include 7 characters: section, body system, root operation, body part, approach, device, and qualifier.
Understand the need and reasons for coding special procedures such as the following:  complications of surgical and medical care and residuals and late effects.
Locate codes for diagnoses expressed in vague terms.
Correctly code the module exercises by using the coding instructions received from the lecture sessions.
Discuss the disease process related to coding.
Advanced Coding:  Case scenarios and case studies.
Analytically apply the Principle Diagnosis, complication, co-morbidities/procedures appropriately.
Check the MCC coding edits, as warranted.
Read smart tips after computing the MS-DRG populated by the 3M encoder.
Understand how to apply references:  coding clinic, official conventions, dictionary, anatomy and physiology, and Physician’s Desk Reference.
Understand the reimbursement methodology.  (Optimization vs. Maximization).
Understand and know how to compute a MS-DRG rate.
Understand and know how to compute a Case-Mix.

Students Rights and Responsibilities

Student Rights and Responsibilities

Log in using the AC Connect Portal

In order to receive your AC Connect Email, you must log in through AC Connect at https://acconnect.actx.edu .

If you are an active staff or faculty member according to Human Resources, use "Exchange". All other students, use "AC Connect (Google) Email".

Expected Student Behavior

.

WITHDRAWING FROM A COURSE:

It is the responsibility of the student to officially drop or withdraw  from a course.  Failure to officially withdraw may result in the student receiving a grade of “F” in the course.  Students are not automatically dropped from their class roles as a result on non attendance.
Students who wish to withdraw from a course must complete all steps indicated on the Academic Withdrawal Request form by the course withdrawal deadline.

NOTE: Students who are attending Texas institutions of higher education, for the first time fall 2007 and later, may not withdraw from more than six courses during their academic career. This withdrawal limitation does not include dual credit or developmental classes (Senate Bill 1231 Rule 4.10.) For more information on Drop and Withdrawal Policies, please visit the Registrar's Office Web site.

STUDENT GRIEVANCE PROCEDURE:

A student who has a problem with the course or the course instructor should make every attempt to resolve the problem with the course instructor.  If that is not successful, the student may appeal the decision of the instructor to the Program Director, Judy Massie, 354.6068, Associate Dean of Health Sciences, Kim Boyd, 354.6060, Dean of Health Sciences, Kim Crowley, 354.6087, Asssociate Vice President of Academic Affairs, Becky Burton, 371.5122, Vice-President of Academic Affairs, Dr. Tamara Clunis, 371.5226, and the President -- IN THAT ORDER.   Please refer to the current Amarillo College catalog for complete explanation of the grievance procedures.

CELLULAR TELEPHONES:

Cell telephones are disruptive during class time.  Telephones must be turned off during class time with the exception of emergency personnel, pagers must either be turned off or set on vibrate during class time.   Please notify me in writing if you fall in this category, otherwise failure to comply will result in you being asked to leave class for that day.  You will still be responsible for the material covered in class.  If you feel that you will have an emergency during class time, leave the number of the student services office and they will contact you immediately.  The number is 371-5300. 

ACADEMIC DISHONESTY:

Academic dishonesty shall constitute a violation of the college rules & regulations & is punishable as prescribed by Amarillo College Board policies.  Academic dishonesty shall include, but is not limited to, cheating on a test, plagiarism, and collusion.  “Cheating on a test” shall include:

  • Copying from another student’s test paper.
  • Using test materials not authorized by the person administering the test.
  • Collaborating with or seeking aid from another student during a test without permission from the test administrator/instructor.
  • Knowingly using, buying, selling, stealing, or soliciting, in whole or in part, the contents of an administered/unadministered test.
  • Substituting for another student, or permitting another student to substitute for one’s self, to take a test.
  • Bribing another person to obtain an administered/unadministered test or information about an administered/unadministered test.

    “Plagiarism”shall be defined as the appropriating, buying, receiving as a gift, or obtaining by any means another’s work and the unacknowledged submission or incorporation of it in one’s own written work.

         “Collusion” shall be defined as the unauthorized collaboration with another person in
          preparing written work for fulfillment of course requirements.

Grading Criteria

QUIZZES:                                                          

Quizzes will be given at the discretion of the instructor.  Quizzes may or may not be announced by the instructor. 
Material covered by these quizzes will consist of review material or new material assigned in class.

If a student arrives late to class, while a quiz is in progress, he/she will NOT be given extra time to complete the quiz. 
If a student arrives late to class after a quiz has been given, he/she will not be allowed to take the quiz. 

Take-home quizzes may be assigned during the semester.  Students must be in attendance during the class in which the quizzes are distributed in order to receive the quiz. 
Take-home quizzes must be turned in on the date assigned in order to receive credit. 
NO LATE QUIZZES WILL BE ACCEPTED FOR A GRADE!


There will be approximately 7-8 quizzes during the semester.
There will be NO makeup quizzes.     
No quiz grades will be dropped.
Quizzes will be worth 25% of your final grade.

HOMEWORK/CASE STUDIES                                      

These assignments will be included in the quiz category. 

Homework and Case Studies are worth 25% of your final grade average.
There will be a 20% foe late homework, case studies, or any other assignment made by the instructor. 

MAJOR EXAMS:

Exams will be announced during class at least a week in advance of the exam date. 
Major exams will be given in several types of format.   Multiple choice, scan-trons, and/or take-home exams. 

There will be approximately 3-4 exams administered during the semester. 

Major Exams that are considered take-home exams will be treated as the other major exams that are given during class time.  Take-home exams are due at the beginning of class. 

If you are not in class on the day a take-home exam is handed out, you will be able to makeup this exam, however, the exam will be considered LATE.  There will be a 15% deduction from the exam grade, regardless of the reason for missing class that day.

If a take-home exam is due and you are unable to attend class, it is the STUDENT’S RESPONSIBILITY to make arrangements for the exam to be delivered to me no later than 5:30 pm on the date due.

Students with questions regarding examination results may review examinations, under the supervision of the MDS faculty, by appointment only.  Students who feel that a question was scored improperly must submit the following to the appropriate instructor, in writing.

The exam question and the reason for requesting an instructor review of the score.
The page and paragraph number, in the student's textbook or lecture notes, that verifies that the student's answer is correct.  Other sources of information, such as textbooks that have not been assigned, will not be considered.

The request must be submitted within one (1) calendar week after the instructor notifies the student of the grade.  The student will be notified within one (1)calendar week if the points have or have not been awarded.  Exam questions from an exam given more than one (1) week previously will not be considered.

Exams will be worth differing numbers of points (which is a different total each semester).  The letter grade is calculated by dividing the number of points earned on an exam by the total number of points possible on an exam. Example:  There are 50 questions on an exam.  The student answers 39 correctly.  The student's grade will look like a fraction.  39 / 50, which means the student has earned 39 points and has scored 78% of the exam correctly, which translates to a grade of "C".  That percentage obtained will then be applied to the grade scale listed below:

The student will be able to access their current average by logging into the AC Homepage (www.actx.edu) and then by logging into AC Online

MAJOR EXAMS ARE WORTH 40% OF YOUR FINAL GRADE.

MAKE-UP EXAMS:

A student who misses a major exam regardless of the reason(s) for missing the exam, must contact the instructor to make arrangements to make up the exam.  The student must contact the instructor within 48 hours.  If an exam is given on Tuesday and you do not contact the instructor until Friday morning, the student will be unable to schedule the make-up exam!

The make-up exam will be scheduled at the convenience of the instructor

Any student who does not contact the instructor within the specified 48 hours will not be permitted to make up the missed exam.  There are no exceptions.

Any student that does not make up a missed exam will receive a grade of zero (0) for that exam.

The student should contact the course instructor by email in order to comply with the 48 hour rule.  The student may call the department number (806) 354-6068 and leave a message, however, the message will have to be forwarded to the instructor.
Make sure the student leaves the Date, Time of the call, Name of the student, & Exam missed.

If the student is unable to contact the instructor or the office, it is his/her responsibility to designate  someone else who can do this for them.        

All make-up exams, with the exception of a take-home exam, will be given in the Testing Center on the Washington Street Campus.  The Testing Center is located in the Student Service Center, north of the library.  All makeup exams will be graded at the convenience of the instructor. 
Please remember to bring your I.D. with you.  Your exam will not be administered without the proper identification.  Please contact the Testing Center personnel on the date you wish to take your make-up exam, in order to ensure that your make-up exam is available.

TESTING CENTER PHONE NUMBER IS 371-5445.

HOURS FOR THE TESTING CENTER (WASHINGTON STREET CAMPUS)

Monday - Thursday      8:00 A.M. -    7:00 P.M.
Friday                            8:00 A.M. -    Noon.

*** Makeup exams will not be given out the last hour before closing.

It is the sole responsibility of the student who has been absent to arrange with the instructor to makeup any missed exams.  When the student returns to class after an absence, the student will be expected to fully participate in any class activities including quizzes or exams. 

FINAL EXAM:

You will have a COMPREHENSIVE FINAL EXAM, WHICH IS WORTH 20% OF YOUR FINAL GRADE. 
If a STUDENT  misses the designated time for the FINAL EXAM,  a grade of zero (0)  will be given for the exam, unless an incomplete has been granted. 
Arrangements to receive an incomplete "I" grade for the course must be made prior to the date of the final exam. 
Incompletes are granted only for emergency situations such as hospitalization of the student, serious injury to the student on the day of the final exam, etc. 
Incompletes will not be granted for situations involving vacation plans, transportation difficulties, appointments, etc. 
Students who need to request an incomplete must do so prior to the scheduled time of the final exam with appropriate documentation given to the instructor.

Final grades will not be rounded in this course.

 

GRADING SUMMARY:

Attendance                                      =          15% of the final grade.

Quizzes/Hmwk/Case Studies     =           25% of the final grade.

Major Exams                                   =           40% of the final grade.

Final Exam                                       =           20% of the final grade.

Students are advised to keep a record of all quizzes and major exam grades in order to be informed of their academic progress.

Grade Scale:

A  =      90.0 - 100.0%

B  =      80.0 - 89.9%

C  =      70.0 - 79.9%

F  =      69.9% or less

Attendance

ATTENDANCE POLICY:

"Regular attendance is necessary for satisfactory achievement.  Therefore, it is the responsibility of the student to attend class."  Any student who is chronically late to class or leaves early or is absent more than 3 times during the course may earn a failing final course grade.

Attendance will be taken at the beginning of all class meetings.  100 points will be given to all students who arrive on time to class and who stay for the entire class period. 
Students who arrive late or leave early, regardless of the reason, will be awarded only 50 points
A zero (0) will be given for a students' absence. 

After 3 absences the student’s final grade average will DROP 1 (one) letter grade.

Attendance will be worth 15% of your final grade

Calendar

HITT-2335-001 Coding/Reimbursement Methodologies

Summer Schedule 2021   CALENDAR IS SUBJECT TO CHANGE:


5/25:  Syllabus, Chapter 14 Homework assignment

5/27:   Ch. 14 Homework Workbook Due in class; Chapter 15 Homework Workbook

6/01:   Ch. 15 Homework Due, Workbook;  Ch. 16 Homework due;Workbook 

6/03:  Ch. 17 Homework DUE, Workbook in Dropbox

6/08:  Exam 1 Chapters 14 - 16:

6/10:  Ch. 18 Homework DUE, Workbook in Dropbox

6/15:  Ch. 19 Homework due; Workbook

6/17: Ch. 20 Homework due; Workbook in Dropbox

6/22Exam 2 Chapters 17 - 19;  AND  Ch. 21 Homework due; Workbook

6/24: Ch. 22 Homework due; Workbook in Dropbox

6/29:  Ch. 23 Homework due, Workbook

7/01:  Ch. 24 Homework due; Workbook in Dropbox

7/06: Exam 3 Chapters 20 -22

7/08: Ch. 25 Homework due; Workbook in Dropbox

7/13: Exam 4 Chapters 23 - 25  AND  Read Chapter 26

7/15:  FINAL EXAM

Homework is DUE at the beginning of Class.

There will be a 20% Deduction for any LATE HOMEWORK.
          

Additional Information

DATES OF IMPORTANCE:

May 25, 2021                            First day of class

July 06, 2021                                    LAST DAY TO DROP / WITHDRAW FROM A CLASS

July 15, 2021                            Final Exam

Syllabus Created on:

05/24/21 8:16 PM

Last Edited on:

06/01/21 3:56 PM