Compliance – Xpert HealthCare Group

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Module 1: Introduction to Medical Coding
Overview of the Healthcare System Importance of Medical Coding in Healthcare Basics of ICD-10, CPT, and HCPCS Level II Key Roles and Responsibilities of a Certified Professional Coder

Module 2: Medical Terminology and Anatomy
Understanding Medical Terminology Body Systems: Functions and Structure Common Medical Conditions and Terminology Anatomy Essentials for Coders

Module 3: ICD-10-CM Coding
Structure and Format of ICD-10-CM Codes Coding Guidelines and Conventions Understanding Diagnosis Coding Application of ICD-10-CM in Real-World Scenarios

Module 4: CPT (Current Procedural Terminology) Coding
Introduction to CPT Code Categories: Evaluation, Management, Surgery, Radiology, and More Modifier Usage in CPT Coding Procedure Coding Guidelines

Module 5: HCPCS Level II Coding
Introduction to HCPCS Commonly Used HCPCS Codes Durable Medical Equipment (DME) and Supplies Coding Integration with CPT and ICD-10

Module 6: Medical Coding Compliance and Ethics
HIPAA Regulations and Compliance Standards Avoiding Fraud and Abuse in Coding Ethical Considerations for Medical Coders

Compliance

Module 7: Practical Coding Applications
Coding Case Studies for Various Specialties: Orthopedics, Cardiology, Dermatology, etc. Abstracting Information from Medical Records Coding Exercises and Assignments

Module 8: CPC Exam Preparation Tips
Exam Format and Structure Practice Exams and Test-Taking Strategies Tips for Time Management During the Exam

Module 9: Career Guidance and Next Steps
How to Land Your First Job in Medical Coding Resume and Interview Tips for Coders Continuing Education and Career Development

Compliance

About Lesson

HITECH: Health Information Technology For Economic and Clinical Health

OIG: Office of Inspector General

IP-DRG: Inpatient Diagnosis Related Group

EHR: Electronic Health Record

GPCI: Geographic Practice Cost Index

HMO: Health Maintenance Organization

PPO: Preferred Provider Organization

RVU: Relative Value Unit

CMS: Center for Medicare and Medicaid Services

UB 04: Uniform Billing (Inpatient claim form)

CMS-1500 Center for Medicare and Medicaid Services (Outpatient claim form

HIPAA: Health Insurance Portability and Accountability Act 1996

CMS 1500= Total 33 Box

ABN: Advance Beneficiary Notice (Medicare patient signed this document before the service ). This form valid for one year.

LCD: Local Coverage Determination

NCD: National Coverage Determination

NDC: National Drug Codes

Medicare eligibility

Above 65+year old patient
Physical Disable patient
End stage renal Disease patient

Medicare Part

Medicare A (Inpatient Claims)

Medicare B (Outpatient Claims)

Medicare C (Advantage Plan)

Medicare D (Prescription of Drug)

HCFA: Healthcare Financial Administration

CMS 1500 (Outpatient form)

UB-04: Uniform Billing (Inpatient form)

Who design these 2 forms

NUBC: National Uniform Billing Committee

CLIA: Clinical Laboratory Improvement Amendments

QW: The QW modifier is used to indicate that a laboratory test is Clinical Laboratory Improvement Amendment (CLIA) waived. It’s used when a lab with a CLIA certificate performs a test that doesn’t require the same level of complexity as more complicated tests.

Module 1: Introduction to Medical Coding Overview of the Healthcare System Importance of Medical Coding in Healthcare Basics of ICD-10, CPT, and HCPCS Level II Key Roles and Responsibilities of a Certified Professional Coder

Module 2: Medical Terminology and Anatomy Understanding Medical Terminology Body Systems: Functions and Structure Common Medical Conditions and Terminology Anatomy Essentials for Coders

Module 3: ICD-10-CM Coding Structure and Format of ICD-10-CM Codes Coding Guidelines and Conventions Understanding Diagnosis Coding Application of ICD-10-CM in Real-World Scenarios

Module 4: CPT (Current Procedural Terminology) Coding Introduction to CPT Code Categories: Evaluation, Management, Surgery, Radiology, and More Modifier Usage in CPT Coding Procedure Coding Guidelines

Module 5: HCPCS Level II Coding Introduction to HCPCS Commonly Used HCPCS Codes Durable Medical Equipment (DME) and Supplies Coding Integration with CPT and ICD-10

Module 6: Medical Coding Compliance and Ethics HIPAA Regulations and Compliance Standards Avoiding Fraud and Abuse in Coding Ethical Considerations for Medical Coders

Module 7: Practical Coding Applications Coding Case Studies for Various Specialties: Orthopedics, Cardiology, Dermatology, etc. Abstracting Information from Medical Records Coding Exercises and Assignments

Module 8: CPC Exam Preparation Tips Exam Format and Structure Practice Exams and Test-Taking Strategies Tips for Time Management During the Exam

Module 9: Career Guidance and Next Steps How to Land Your First Job in Medical Coding Resume and Interview Tips for Coders Continuing Education and Career Development