Medical/Hospital Outpatient Coder

Care New England/SEIU 1199NE JATC

Rhode Island (SAA)

Documents

Individual state requirements may vary. Please contact your local apprenticeship office to ensure this version is suitable to your state’s requirements.

Work Process Schedule

Work Process Content

On the Job Training

Anonymous

Skills

1.3K

OJT hours

OGCC - outpatient clinic coding

160

Apply diagnosis and procedure codes according to current nomenclature. Coding book and Epic.

Interventional Radiology

160

Uses appropriate coding books such as: ICD 10, PCS, CPT & HCPCS.

250

Use and maintain electronic applications and work processes to support clinical classifications and coding, encoding and grouping software.
Applies patient services using CPT, HCPCS Level 11, and coding guidelines for Professional setting.

Endoscopy

250

Ensure accuracy of diagnostic/procedural grouping such as RVIJ (Relative Value units).
Participate in compliance fraud and abuse, HIPPA and other organization specific training.

Same Day Surgery

250

Applies current regulations and established guidelines in code assignment of principle diagnosis, principle procedure, and sequencing as well other clinical coding guidelines.
Supports accurate billing through coding, charge master, claims management, and bill reconciliation.

Observation Coding

260

Understands reporting of ED and clinic Evaluation and Management services are reported in the professional setting.
Ensure accuracy of charges billed.

Apply policies and procedures to comply with changing regulations among various payment systems for healthcare services such as Medicare, Medicaid, managed care, etc.
Understand and apply established reporting requirements such as the NCC' edits. (National Correct Coding Initiative).
Understand application of modifiers for professional setting.
Use and maintain electronic applications and work processes to support clinical classifications and coding, encoding and grouping software.
Apply diagnosis and procedure codes according to current nomenclature. Coding book and 3M.
Uses appropriate coding books such as: ICD 10, PCS, CPT & HCPCS.
Ensure accuracy of diagnostic/procedural grouping such as APC (Ambulatory Payment classification), OPPS — Outpatient Prospective Payment System.
Applies current regulations and established guidelines in code assignment of principle diagnosis, principle procedure, and sequencing as well other clinical coding guidelines.
Understands reporting of ED and clinic Evaluation and Management services are reported in the facility setting.
Applies patient services using CPT, Level 11, and coding guidelines for facility setting.
Participate in compliance fraud and abuse, HIPPA and other organization specific training.
Ensure accuracy of charges billed.
Apply policies and procedures to comply with changing regulations among various payment systems for healthcare services such as Medicare, Medicaid, managed care, etc.
Understand and apply established reporting requirements such as the NCC' edits. (National Correct Coding Initiative).
Understand application of modifiers for facility setting.

Related Instruction Outline

Related Instruction Content

Training Provider(s):

AAPC

The Business of Medicine

CPC Certification

Medical Terminology and Anatomy Review

CPC Certification

Introduction to ICD-10-CM

CPC Certification

ICD-10-CM Coding Chapters 1-11

CPC Certification

ICD-10-CM Coding Chapters 12-21

CPC Certification

Intro to CPT, Surgery Guidelines, HCPCS, and Modifiers

CPC Certification

Integumentary System

CPC Certification

Musculoskeletal System

CPC Certification

Respiratory, Hemic, Lymphatic, Mediastinum and Diaphram

CPC Certification

Cardiovascular System

CPC Certification

Digestive System

CPC Certification

Urinary System and Male Genital System

CPC Certification

Female Reproductive System

CPC Certification

Endocrine and Nervous System

CPC Certification

Eye and Ocular Adnexa, Auditory Systems

CPC Certification

Anesthesia

CPC Certification

Radiology

CPC Certification

Pathology and Laboratory

CPC Certification

Evaluation and Management

CPC Certification

Medicine

CPC Certification

Final Examination

CPC Certification

Coding all hospital outpatient types including outpatient, surgical day care, emergency room, and ancillary services

COC Certification

ICD-10-CM diagnostic coding system

COC Certification

Current Procedural Terminology (CPT) coding

COC Certification

Identifying and correcting common coding errors

COC Certification

Understanding the role of coding in reimbursement

COC Certification

Recognizing data quality impact and characteristics

COC Certification

Appreciating the role of compliance in the outpatient setting

COC Certification

Being aware of the legal aspects of healthcare and HIPAA

COC Certification

Understanding documentation and coding standards

COC Certification

Resource-based Relative Value Scale (RBRVS)

COC Certification

Ambulatory Payment Classifications (APCs)

COC Certification

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