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Administrative Master Syllabus (Wharton County Junior College)

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Administrative Master Syllabus
Administrative Master Syllabus
Revised February 2016 Page 1 of
5
Purpose: It is the intention of this Administrative Master Syllabus to provide a general description of the course, outline the
required elements of the course and to lay the foundation for course assessment for the improvement of student learning, as
specified by the faculty of Wharton County Junior College, regardless of who teaches the course, the timeframe by which it
is instructed, or the instructional method by which the course is delivered. It is not intended to restrict the manner by which
an individual faculty member teaches the course but to be an administrative tool to aid in the improvement of instruction.
Course Title:
Course Prefix & Number:
Division & Department:
Course Type
Academic General Education Course (from ACGM, but not WCJC Core)
Academic WCJC Core Course
WECM Course
This course is a Special Topics or Unique Needs Course.
Semester Credit Hours (SCH): Lecture Hours: Lab/Other Hours _____:_____:_____
Equated Pay Hours:_____
Catalog Course Description:
Pre-Requisites:
Co-Requisites:
Signature Date
Prepared by:
Department Head:
Division Chair:
Dean/VPI:
Approved by CIR:
List Lab/
Other Hours
Lab Hours
Clinical Hours
Practicum Hours
Other (List)
Coding and Reimbursement Methodologies
HITT 2435
Allied Health: Health Information Technology
✔
4
2
4
Advanced coding techniques with emphasis on case studies, health
records, and federal regulations regarding prospective payment
systems and methods of reimbursement.
4
HITT 1311, 1355, and 1441, HPRS 2301
Debora Lutringer
Digitally signed by Debora Lutringer
DN: cn=Debora Lutringer, ou=HIT, email=lutringerd@wcjc.edu,
c=US
Date: 2017.03.03 15:44:45 -06'00'
Debora Lutringer
Digitally signed by Debora Lutringer
DN: cn=Debora Lutringer, ou=HIT,
email=lutringerd@wcjc.edu, c=US
Date: 2017.03.03 15:44:52 -06'00'
CJ Derkowski
Digitally signed by CJ Derkowski
DN: cn=CJ Derkowski, o=WCJC, ou=Allied Health,
email=CarolD@wcjc.edu, c=US
Date: 2017.03.06 15:15:11 -06'00'
Megan Costanza
Digitally signed by Megan Costanza
DN: cn=Megan Costanza, o=WCJC, ou=DVI,
email=costanzam@wcjc.edu, c=US
Date: 2017.03.07 10:18:27 -06'00'
Emmons, Tracy
Digitally signed by Emmons, Tracy
DN: cn=Emmons, Tracy, email=EmmonsT@wcjc.cc.tx.us,
o=Wharton County Junior College
Date: 2018.04.11 09:31:02 -05'00'
3/23/17
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Administrative Master Syllabus
Administrative Master Syllabus
Revised February 2016 Page 2
of 5
I. Topical Outline: Each offering of this course must include the following topics (be sure to include
information regarding lab, practicum, clinical, or other non-lecture instruction).
A. Reimbursement and Insurance Basics
1. Understanding Insurance Basics
2. Reimbursement Terminology
3. Types of Insurance and Third-Party Payers
B. Prospective Payment Systems
1. Background
2. Reasons for a Prospective Payment System
3. Acute Care Hospitals
a. Inpatient Prospective Payment System (IPPS)
b. Diagnosis Related Groups (DRGs)
4. Skilled Nursing Facilities
a. Skilled Nursing Facility Prospective Payment System (SNF PPS)
b. Resource Utilization Groups (RUGs)
5. Home Health Agencies
a. Home Health Prospective Payment System (HH PPS)
b. Home Health Resource Groups (HHRGs)
6. Hospital Outpatient Services
a. Outpatient Prospective Payment System (OPPS)
b. Ambulatory Patient Classification System (APCs)
7. Inpatient Rehabilitation Facilities (IRFs)
a. Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS)
b. Case Mix Groups
8. Long-Term Care Hospitals
a. Long-Term Care Prospective Payment System (LTC PPS)
b. Long-Term Care Diagnosis Related Groups (LTC DRGs)
9. Physicians/other Outpatient Services
a. Medicare Fee Schedule (MFS)
b. Resource-Based Relative Value System (RBRVS)
10. Clinical Laboratory Fee Schedule
11. Durable Medical Equipment, Prosthetics/Orthotics & Supplies (DMEPOS)
12. Ambulatory Surgery Centers (ASCs)
13. Ambulance Fee Schedule
C. Current Procedural Terminology (CPT)
1. Introduction to Clinical Coding
2. Application of the CPT System
a. Section Numbers and Their Sequences
b. Instructions for Use of the CPT Codebook
3. Modifiers
4. Surgery
a. Integumentary System
b. Musculoskeletal System
c. Respiratory System
d. Cardiovascular System
e. Hemic and Lymphatic System
f. Mediastinum and Diaphragm
g. Digestive System
h. Urinary System
i. Male Genital System
j. Female Genital System
k. Maternity Care and Delivery
l. Endocrine System
m. Nervous System
n. Eye and Ocular Adnexa
o. Auditory System
5. Radiology
6. Pathology and Laboratory
7. Evaluation and Management Section
a. Medicare’s Documentation Guidelines-various versions
b. Selection of appropriate code
8. Medicine Section
9. Anesthesia Section
a. Modifiers
b. Qualifying codes
D. HCPCS Levels II (Health Care Procedural Coding System) Structure of Level II HCPCS codes Modifiers
E. Reimbursement in the Ambulatory Setting Medicare Outpatient Code Editor Quality Controls
F. Charge Description Master (CDM) Components of the CDM Use of Revenue Codes Importance of CDM and coding for proper reimbursement Updating the CDM
Administrative Master Syllabus
Administrative Master Syllabus
Revised February 2016 Page 3
of 5
__________________________
Administrative Master Syllabus
Administrative Master Syllabus
Revised February 2016 Page 4
of 5
II. Course Learning Outcomes
Learning Outcomes: Upon successful
completion of this course, students will:
Methods of Assessment:
Sequence codes according to established
guidelines and standards.
Apply reimbursement methodologies.
Written tests and workbook activities.
Written tests.
Administrative Master Syllabus
Administrative Master Syllabus
Revised February 2016 Page 5
of 5
III. Required text(s), optional text(s) and/or materials to be supplied by the student:
IV. Suggested course maximum: ________
V. List
any specific or physical requirements beyond a typical classroom required to teach
the course.
VI. Co
urse Requirements/Grading System—Descri
be any course specific requirements such as
research papers or reading assignments and the generalized grading format for the course.
VII. Curriculum Checklist
Acad
emic General Education Course (from ACGM-but not in WCJC core)
• No additional documentation needed.
Academic WCJC Core Course. Attach the Core Curriculum Review Forms.
Critical Thinking
Communication
Empirical & Quantitative Skills
Teamwork
Social Responsibility
Pers
onal Responsibility
WECM Course
• If needed, revise the Program SCANS Matrix and Competencies Checklist.
Current Procedural Terminology, Chicago, IL : American Medical Association, Current Year.
Bowie, Mary Jo, Understanding Current Procedural Terminology and HCPCS Coding Systems, Boston, MA: Cengage Learning, 2017.
Regular access to technology appropriate for www.courses.
20
Lecture/Lab classroom with computers and appropriate software. Instructor
must have training in and access to all appropriate technology for
www.courses.
Final evaluation will be based on grades achieved
during the semester and the final exam.
Daily Grade Average 20%
Test Average 65%
Final Exam 15%
Grading scale:
93—100% A
85—92% B
78—84% C
70—77% D
69—0% F
✔
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Completed 8 October 2020

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