Medical Billing & Coding
Anatomy
Intro to Reimbursement/ Coding |
---|
-ENGL202651- Research and Writing |
College Mathematics |
Career Dev II Theory & Practice |
Electronic Health Records |
Survey of Anatomy & Physiology |
Human Disease & Drug Pharmacol |
ICD Diagnostic Coding |
CPT and HCPCS Level II Coding |
ICD Procedural Coding |
Clinical Documentation |
Advanced ICD Diagnostic Coding |
Advanced CPT and HCPCS II Coding |
Evaluation & Management Serv. |
Professional Code Practicum II |
Medical Billing
CDI Program
Audits
CPT Coding
Inpatient & Outpatient
Electronic Health Records
Organization
E/M Coding
- Transfer knowledge, skills and behaviors acquired through formal and informal learning and life experiences to new situations.*
- Abstract information from medical charts to assign the correct diagnosis (ICD-10), procedure (CPT) and supply (HCPCS Level II) code in a variety of medical situations.
- Utilize appropriate current technology and resources to locate and evaluate information needed to accomplish a goal, and then communicate findings in visual, written and/or oral formats.*
-
Follow established methods of inquiry and mathematical reasoning to form conclusions and make decisions.
- Demonstrate competency to assemble, process, maintain, store, abstract, analyze, index and retrieve health information data.
- Evaluate the accuracy and completeness of the patient record as defined by policy, external regulations and standards.
- Employ strategies for reflection on learning and practice in order to adjust learning processes for continual improvement. *
Through this project I explained the roles of the Clinical Documentation Improvement Specialist & The Health Information Management team and the difference between the designated record set and the legal health record. Meeting the outcomes as i demonstrated knowledge of knowing the difference between the designated record set and the legal health record while also educating the audience on how policy, external regulations and standards work surrounding them. 231204101158_Designated_Record_Set_Legal_Record_.docx (.docx) 0.05mb
- Utilize appropriate current technology and resources to locate and evaluate information needed to accomplish a goal, and then communicate findings in visual, written and/or oral formats.*
- Participate in social, academic, and professional communities for individual growth and to function as a citizen of a multicultural world. *
- Follow established methods of inquiry and mathematical reasoning to form conclusions and make decisions.
- Employ strategies for reflection on learning and practice in order to adjust learning processes for continual improvement. *
- Utilize appropriate current technology and resources to locate and evaluate information needed to accomplish a goal, and then communicate findings in visual, written and/or oral formats. *
- Analyze the results of coded data to ensure medical necessity is met when auditing charts.
For this project I created an ICD-10-CM coding and guidelines training program for the coding department to help with claim denials within the department. I used Inpatient & Outpatient coding examples with rationales in order to "quiz" team members and gave them and idea on being aware of the challenges and small mistakes that can easily lead to claim denials.
This project met the outcomes as I created the training program for coders in order to address claim denials which included making sure the codes that are assigned meet medical necessity for the procedures performed while also explaining why. I current technology and resources to locate and evaluate information needed to accomplish a goal, and then communicated the findings in written and/or oral format in order to accomplish the goal of reducing claim denials. I gave strategies and reflection on learning and practice in order to adjust learning processes for continual improvement through quizzing the team and also giving them an idea of how often we will be doing this in order to see the changes reflected I had to use methods of inquiry and mathematical reasoning when it came to deciding on what codes to choose. 231203070146_1692079485_MCCG212_Portfolio_Project_.docx (.docx) 0.06mb
- Demonstrate competency to assemble, process, maintain, store, abstract, analyze, index and retrieve health information data.
- Employ strategies for reflection on learning and practice in order to adjust learning processes for continual improvement.*
- Participate in social, academic, and professional communities for individual growth and to function as a citizen of a multicultural world.*
- Analyze the results of coded data to ensure medical necessity is met when auditing charts.
This project met the outcomes because I demonstrated competency to assemble, process, maintain, store, abstract, analyze, index and retrieve health information data through case examples. Since this was set up like an in-service, it gave strategies for reflection on learning and the examples provided practice in order to adjust learning processes for continual improvement as well as making room for individual growth functioning as a citizen in a real job setting. I had to review documentation vs. the nature of the procedure performed. Health Record and Coding In-Service (.docx) 0.03mb
- Employ strategies for reflection on learning and practice in order to adjust learning processes for continual improvement.*
- Participate in social, academic, and professional communities for individual growth and to function as a citizen of a multicultural world.*
- Evaluate the accuracy and completeness of the patient record as defined by policy, external regulations and standards.
- Transfer knowledge, skills and behaviors acquired through formal and informal learning and life experiences to new situations.*
- Analyze the results of coded data to ensure medical necessity is met when auditing charts.
A project i did where i acted a CDI manager to address poor documentation and inaccurate coding which has led to a decrease in the case mix index. I provided strategies and ways to fix this issue as well as explaining to the team how important the CDI team & case mix index are. The 7 criteria for high quality documentation & Medicare Conditions of Participation requirements for complete health records were explained. The relationship between quality documentation, regulatory compliance, and reimbursement would be the result of a strong CDI program.
This met the outcomes as i acted as a CDI manager getting ready for an audit in a professional setting where i had to evaluate the accuracy and completeness of the patient record as defined by policy, external regulations and standards and explain those standards. Strategies for reflection on learning and practice in order to adjust learning processes for continual improvement were included on how to increase the CMI and avoid errors. I had to transfer knowledge, skills and behaviors acquired throughout this program and apply it to a real-world situation. 231109022702_1697301826_Clinical_Documentation_Portfolio_Project.docx (.docx) 0.03mb
Attention to detail
AHIMA Lab
HIPPA
Fraud Awareness
Electronic Health Record
Excel
Microsoft programs
Creating Tables
SHARE
Download QR Code