DETAILS
Prepare yourself for the CRC Certification Exam and begin a new and rewarding career path. This course teaches fundamental medical coding skills for risk adjustment coding. The course covers ICD-10-CM coding for all risk adjustment models (HCC, HHS-ACA, CDPS) and assures a broad knowledge in reviewing and assigning the correct diagnosis codes for all risk adjustment models. The registration fee for this course includes AAPC membership, CRC practice exams, and the AAPC Certified Risk Adjustment Coder (CRC™) exam.
In this course you will learn the varying risk adjustment models and the effects of predictive modeling and quality of care. This information will help you understand the impact on risk adjustment models driven by quality of care and predictive modeling. You will be able to identify common errors in diagnosis coding and determine documentation barriers encountered when coding for risk adjustment. Finally, you will utilize practical diagnosis coding skills as they complete hands-on cases throughout the course.
OUTLINE
I. Business of
Medicine
A. Coding as a Profession
B. The Difference Between Hospital and Provider
Services
C. How a Provider Office Works and How the Coder
Fits into It
D. Understanding the Hierarchy of Providers
E. The Different Types of Payers
F. The Medical Record
G. Operative Report Coding Tips
H. Medical Necessity
I. The Advance Beneficiary Notice
J. The Health Insurance Portability and
Accountability Act of 1996 (HIPAA)
K. The Need for Compliance Rules and Audits
L. The OIG Work Plan
M. What AAPC Will Do for You
II. Medical
Terminology and Anatomy Review
A. Introduction to Medical Terminology
B. Introduction to Anatomy
C. Integumentary System
D. Musculoskeletal System
E. Cardiovascular System
F. Lymphatic System
G. Respiratory System (Pulmonary System)
H. Digestive System
I. Urinary System
J. Reproductive Systems
K. Nervous System
L. Organs of Sense — Eye
M. Organs of Sense — Ear
N. Endocrine System
O. Hematologic (Hemic) System
P. Immune System
III. Introduction
to ICD-10-CM
A. Overview of ICD-10-CM Layout
B. Steps to Look Up a Diagnosis Code
C. ICD-10-CM Official Guidelines for Coding and
Reporting
IV. ICD-10-CM
Coding Chapters 1–11
A. Chapter 1: Certain Infectious and Parasitic
Diseases (Codes A00–B99)
B. Chapter 2: Neoplasms (Codes C00–D49)
C. Chapter 3: Diseases of the Blood and
Blood-Forming Organs and Certain
D. Disorders Involving the Immune Mechanism (D50-D89)
E. Chapter 4: Endocrine, Nutritional and Metabolic
Diseases (E00-E89)
F. Chapter 5: Mental, Behavioral and
Neurodevelopmental Disorders (F01-F99)
G. Chapter 6: Diseases of the Nervous System
(G00-G99)
H. Chapter 7: Diseases of the Eye and Adnexa
(H00-H59)
I. Chapter 8: Diseases of the Ear and Mastoid
Process (H60-H95)
J. Chapter 9: Diseases of the Circulatory System
(I00-I99)
K. Chapter 10: Diseases of the Respiratory System
(J00-J99)
L. Chapter 11: Diseases of the Digestive System
(K00-K95)
V. ICD-10-CM Coding
Chapters 12–21
A. Chapter 12: Diseases of the Skin and Subcutaneous
Tissue (L00-L99)
B. Chapter 13: Diseases of the Musculoskeletal
System and Connective Tissue (M00–M99)
C. Chapter 14: Diseases of Genitourinary System
(N00–N99)
D. Chapter 15: Pregnancy, Childbirth, and the
Puerperium (O00–O9A)
E. Chapter 16: Certain Conditions Originating in the
Perinatal Period (P00-P96)
F. Chapter 17: Congenital Malformations,
Deformations and Chromosomal Abnormalities (Q00–Q99)
G. Chapter 18: Symptoms, Signs and Abnormal Clinical
and Laboratory Findings, Not Elsewhere Classified (R00–R99)
H. Chapter 19: Injury, Poisoning and Certain Other
Consequences of External Causes (S00–T88)
I. Chapter 20: External Causes of Morbidity (V00-Y99)
J. Chapter 21: Factors Influencing Health Status and
Contact with Health Services (Z00–Z99)
VI. Risk Adjustment
Models
A. Types of Risk Adjustment Models
B. Medicare Hierarchal Condition Categories (HCC)
C. The Health and Human Services (HHS) Hierarchical
Condition Category Model
D. Medicaid Chronic Illness and Disability Payment
System (CDPS)
E. Hybrid Model
VII. Predictive
Modeling & Quality of Care
A. CMS Stars Ratings
B. PQRS (Physician Quality Reporting System)
C. HEDIS® (The Healthcare Effectiveness Data and
Information Set)
VIII. How Risk
Adjustment Relates to Medical Financial Matters
A. New Beneficiary Calculations
B. Annual Risk Adjustment Audits
C. ACO’s (Accountable Care Organizations)
D. Placing Providers “At-Risk”
IX. Diagnosis
Documentation & Coding
A. Data Collection Sources
B. Coding for All Diagnoses Noted in a Date of
Service (DOS)
C. ICD-10-CM Updates to the Conventions &
Official Coding Guidelines that Affect Risk Adjustment Coding
D. Coding Diagnoses from the medical documentation
E. Signature or Credential Issues
X. Clinical
Documentation Barriers
A. Signs and Symptoms
B. Uncertain Diagnosis
C. Coding Clinic Guidance
D. Risk Adjustment Diagnosis Coding Steps
E. Acute vs. Chronic
F. Differential Diagnosis
G. Risk Factors and Comorbidities
H. Late Effects
XI. Frequently
Coded Conditions in Risk Adjustment Models
REQUIREMENTS
Requirements:
Hardware Requirements:
- This course can be taken on either a PC or Mac.
Software Requirements:
- PC: Windows XP or later.
- Mac: OS X Snow Leopard 10.6 or later.
- Browser: The latest version of Google Chrome or Mozilla Firefox are preferred. Microsoft Edge and Safari are also compatible.
- Adobe Flash Player. Click here to download the Flash Player.
- Adobe Acrobat Reader. Click here to download the Acrobat Reader.
- Software must be installed and fully operational before the course begins.
Other:
- Email capabilities and access to a personal email account.
Instructional Material Requirements:
The instructional materials required for this course are included in enrollment. The following textbooks will be shipped to you approximately 7-10 business days after enrollment:
- Medical Coding Training: CRC™ (PDF Format)
- ICD-10-CM
PREREQUISITES
Prerequisites:
There are no prerequisites to take this course. However, knowledge of medical terminology and anatomy (or AAPC courses) is strongly recommended.
INSTRUCTOR
This is not an instructor facilitated course; however, support will be provided through email, online forms, and phone.
FAQS
1. Can I register for programs if I am an international student?
Yes, because ed2go programs are online you never have to actually travel to the school. Most schools offer telephone or online registration.
2. How long does it take to complete a program?
All of our programs are self-paced and open enrollment, so you can start them when you want and finish them at your own pace. When you register, you’ll receive six (6) months to complete the program.
3. What if I don't have enough time to complete my program within the time frame provided?
The time allotted to complete your program has been calculated based on the number of hours for each program, so don't worry too much about not completing in time. If, after a concerted effort, you are still unable to complete, your Student Advisor will help you work out a suitable completion date. Please note that a fee may be charged for an extension.
4. Do I have to buy additional materials?
No
5. Can I get financial assistance?
ed2go courses are non-credit courses, so they do not qualify for federal aid. In some states, vocational rehab or workforce development boards will pay for qualified students to take our courses. Additionally, some students may qualify for financial assistance when they enroll, if they meet certain requirements.
6. What happens when I complete the program?
Upon successful completion of the program, you will be awarded a certificate of completion. In addition, you will receive an exam voucher for the Certified Risk Adjustment (CRC™) Certification Exam, offered by the American Academy of Professional Coders (AAPC) after successful completion of the program and financial obligation.
7. Am I guaranteed a job?
ed2go programs will provide you with the skills you need to obtain an entry-level position in most cases. We don’t provide direct job placement services, but our facilitators and career counselors will help you build your resume and are available to give advice on finding your first job. Facilitators will also be available to use as a professional reference upon completion of the program. Potential students should always do research on the job market in their area before registering.
8. Who will be my instructor?
Each student is paired with a facilitator for one-on-one interaction. The facilitator will be available (via e-mail) to answer any questions you may have and to provide feedback on your performance. All of our facilitators are successful working professionals in the fields in which they teach.
9. What software or hardware do I need in order to take online programs and what are the system requirements?
In order to take our online programs, you must have access to a computer and the Internet. You can access the program contents from any Web-enabled computer. You don’t have to use the same computer to log-in to the program every time. We recommend that you have a word-processing program (Microsoft Word is the best) and the latest version of Internet Explorer.
10. Can I use a Mac?
Yes
11. How can I get more information about this program?
If you have questions that are not answered on our website, please feel free to contact us via LIVE chat (click the button above). If you are visiting us during non-business hours, please feel free to send us a question using the “Contact Us” form to the right. You may also call us at 1-877-221-5151. We will answer your questions promptly.
12. When can I start the program?
Our programs are all open enrollment. You can register and start the program as soon as you are ready.
Please note: Once the program curriculum is accessed online or through submission of a material shipment confirmation, refunds cannot be issued.
13. Does this program prepare for a certification?
Yes, you will be prepared to sit for the Certified Risk Adjustment (CRC™) Certification Exam offered by the American Academy of Professional Coders (AAPC). You will receive an exam voucher and AAPC membership after successful completion of the program and financial obligation.