Transcript title

Intro Reimbrsmt/Class Systems

Credits

4

Grading mode

Standard letter grades

Total contact hours

50

Lecture hours

30

Other hours

20

Prerequisites

Instructor approval.

Course Description

Introduces healthcare reimbursement methodologies and healthcare classification (coding) systems. Provides foundational skills for understanding healthcare financing and reimbursement. Introduces the use of classification systems with a focus on the Current Procedural Terminology and the International Classification of Diseases Clinical Modification.

Course learning outcomes

1. Differentiate reimbursement systems used by government-sponsored health plans and commercial insurance companies.
2. Identify classification systems used in healthcare in the United States.
3. Relate reimbursement methodologies to classification standards.
4. Differentiate the use, format, and structure of Current Procedural Terminology and the International Classification of Diseases Clinical Modification.

Content outline

1. Reimbursement systems concepts
2. Reimbursement methodologies
3. Group and individual health
4. Insurance, government-sponsored health plans and workers’ compensation Classification systems concepts
5. Classification systems: Current Procedural Terminology (CPT), International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM)
6. Introduction to additional classification systems (ICD-10-PCS, HCPCS Level II/National Codes, DSM-5, ICD-O, ICF, NDC)

Required materials

Required textbook(s) and the purchase of the current year CPT and ICD-10-CM codebooks. Computer and reliable internet access.