The eLearning Center for Gatlin Education Services

Continuous changes in the medial billing and coding industry, as well as HIPAA changes, have created an incredible demand for those trained in coding. The Advanced Coding for the Physician's Office Course is designed for students who have previous coding experience, a basic coding education, or who have completed the GES Administrative Medical Specialist Course (click here for more information on the AMS course). CPT, ICD-9-CM (Volumes I and II), and HCPCS Level II Coding are covered, along with information on the Correct Coding Initiative (CCI), compliance and reimbursement issues, E&M guidelines, and much more. Details and tips are provided to ensure that the most in-depth knowledge is acquired. This leads to increased accuracy in code selections and a smoother billing process with quicker and better reimbursement. This course prepares students for the Certified Professional Coder (CPC) certification exam offered by the American Academy of Professional Coders (AAPC).

Upon registering, you are given an initial six months to complete the program. Should you need more time, you may request a 6-month extension at no additional charge.

Course Objectives

Students registering for the Advanced Coding for the Physician's Office Course should have an understanding of CPT-4 (CPT), ICD-9-CM (ICD-9) and HCPCS coding principles. There are brief introductions involving the "basics" of coding, which then will broaden to include the more in-depth information.

Part 1: ICD-9-CM Coding- Disease Classification
Objectives of Part 1:

  · Build upon the prior knowledge of ICD-9 diagnostic coding with increased understanding and confidence.
  · Understand the alphabetic and tabular structures of volumes 1 and 2 of the ICD-9 book, including the tables.
  · Understand and use appropriately the coding conventions in volumes 1 and 2.
  · Understand the CMS guidelines for outpatient diagnostic coding and identify the "special circumstances" specified in the guidelines.
  · Review distinct information about each chapter, subchapter and category within the ICD-9 book.
  · Gain a complete understanding of each sub-category of ICD-9 codes and the disease processes involved, as well as, understanding of the supplementary classifications.
  · Identify both primary and principal diagnoses.
  · Increase accuracy of ICD-9 disease classification coding while using the acquired knowledge of CMS guidelines and chapter specifics.

  · Understand the three levels of HCPCS coding: Level I-CPT, Level II-National Codes and Level III-Local Codes (To be eliminated with HIPAA implementation).
  · Understand the importance of remaining up to date on CPT coding changes and learn steps to avoid missing information on the changes that occur.
  · Gain a complete understanding of the use of modifiers, section guidelines and the uses of specific CPT codes.
  · Know the 10 steps to CPT coding that will help in being compliant and provide better reimbursement because of increased accuracy.
  · Know the difference between each of the categories in the Evaluation and Management (E&M) section in order to simplify code selection.
  · Gain a better understanding of the components surrounding E&M code selection.
  · Know the CMS E&M documentation guidelines (DG) and apply them respectively.
  · Gain detailed information on each CPT modifier and its use.
  · Increase knowledge of each section through comprehensive review.
  · Demonstrate accurate code assignment with the increased knowledge of CPT coding guidelines.
  · Better understand when to use unlisted procedures.
  · Know the difference between national and local HCPCS codes and modifiers.
  · Learn and apply the HCPCS coding conventions.
  · Gain knowledge on the HCPCS modifiers and their uses.
  · Increase knowledge of Medicare guidelines for both inpatient and outpatient services.

  · Know how to use the Internet for looking up Local Medical Review Policies (LMRP), state specific guidelines, compliance issues, and other issues of coding and billing.
  · Know the foundation of the LMRP's, their uses and when to apply them.
  · Learn about Internet Web sites that allow contact with other people in the coding and billing environment for comparison of difficult issues.
  · Realize that, no matter how long you have been in the business, issues will arise that prove difficult in resolving and may require networking with others in the business.

Part I: ICD-9-CM - Disease Classification

  · Introduction
  · Understanding the Structure

  · Alphabetic Index
  · Tabular List

  · Classification of Disease and Injury
  · Supplementary Classifications

  · V-Codes
  · E-Codes

  · Appendices

  · ICD-9-CM Conventions

  · Alphabetic Index
  · Tabular List
  · Conventions shared by both

  · Putting ICD-9-CM to work
  · ICD-9-CM Disease Classification Chapter Review

  · Part II: CPT and HCPS Coding
  · Introduction

  · History
  · Level I

  · Structure
  · Guidelines
  · Modifiers

  · Putting CPT to Work

  · Reviewing Source Documents
  · Using the Index
  · Basic Steps to CPT Coding

  · CPT Chapter Review

  · 

Evaluation and Management


  · Documentation Guidelines of Key Components

  · History
  · Examination
  · Medical Decision Making

  · Demonstration of E&M Level Selection
  · E&M Modifiers

  · Anesthesia

  · Guidelines
  · Anesthesia Modifiers

  · Surgery

  · General Information and Definitions
  · Guidelines
  · Special Circumstances
  · Surgery Modifiers

  · Radiology

  · General Information
  · Guidelines
  · Radiology Modifiers

  · Pathology and Laboratory

  · General Information
  · Guidelines

  · Medicine

  · General Information
  · Medicine Modifiers
  · Special Services and Reports
  · Quiz for Medicine Modifiers

  · HCPCS Level II

  · Introduction
  · Understanding the Structure

  · The Index
  · The Appendixes
  · The Text

  · Coding Conventions

  · Symbols
  · Modifiers
  · Coding Principles

  · Medicare Coding Requirements

  · Using the Internet for Finding Resources

  · Pros
  · Cons

  · Valuable Resources

  · Local Medical Review Policies

  · Specific CPT Coding Guidelines
  · Covered and Non-Covered ICD-9 Codes

  · National Correct Coding Initiative (NCCI)
  · Finding Other Resources

  · Compliance and Reimbursement Issues

  · Fraud
  · Medicare

  · Part I
  · Part II

  · Resource-Based Relative Value Scale
  · Traditional Insurance
  · Managed Care Organizations
  · Health Maintenance Organizations
  · Centers for Medicare and Medicaid Services
  · Diagnosis-Related Groups
  · Ambulatory Patient Groups