Medical Coding Certificate : IUPUI Bulletins

Students completing the Medical Coding Certificate will aquire competencies in several domains.

Anatomy and Physiology
- Identify the structures and functions of the human body
- Locate anatomical online lookups (Adam, etc.)
Medical Terminology
- Demonstrate their ability to spell, define, and pronounce medical terms of major disease processes, diagnostic procedures, laboratory tests, abbreviations, drugs, and treatment modalities
- Demonstrate knowledge of root/suffix/prefix word build concepts and common medical terms
Pathophysiology
- Identify specific disease processes by human body system
- Identify cause, diagnosis, and treatment for each disease process
Pharmacotherapy & Laboratory Findings
- Recognize the action of drugs such as: absorption, distribution, metabolism and excretion by the body.
- Differentiate between drug classifications
- Identify the most commonly prescribed drugs
- Describe a formulary
- Match drugs to common conditions
- Match drugs to lab findings

Introduction to Desktop Applications
- Demonstrate keyboard and web access skills
- Identify concepts related to hardware and software
- Demonstrate knowledge of Microsoft Office Suite applications
Computer Software Applications in Healthcare
- Recognize commonly used software in healthcare
- Compile public reporting for disease and disease trends
- Describe how acute care organizations store and retrieve electronic health records
- Analyze different types of encoder software
- Analyze online coding tools (coding reference tools)
- Evaluate Computer Assisted Coding (CAC) software
- Identify the issues involving the migration from a paper-based Health Information Management department to an electronic Health Information Management department
- Summarize acute care environment vendors and their system strengths.
- Evaluate an Electronic Health Record (EHR)
- Evaluate a Personal Health Record (PHR)
- Evaluate Heath Information Exchanges (HIE)

Introduction to Health Information Management
- Recognize the content & structure of healthcare data
- List the content of medical records
- State the documentation requirements for medical records
- Identify legal/ethics issues in Health Information Management such as privacy, security, and the Health Insurance Portability & Accountability Act
- Recognize release of Information issues
- Identify the Code of Ethics for Health Information Management
Healthcare Delivery Systems
- Identify types of healthcare organizations
- Identify types of healthcare workers
- Identify healthcare settings that employ coders
- Understand the types and levels of Healthcare Delivery Systems in the U.S., and of the governing bodies that regulate the Health Information Management processes, and an understanding how eHIM will change this environment
- Recognize the organization of healthcare delivery
- Interpret accreditation standards
- Discuss licensure/regulatory agencies

Basic Diagnosis Coding Systems
- Demonstrate knowledge of the International Classification of Diseases ICD-9-CM
- Recognize diagnostic based prospective payment groups such as DRG, APR-DRG, & RUGS.
- Recognize the International Classification of Diseases ICD-10-CM
- Recognize the Systematized Nomenclature of Medicine (SNOMED)
- Demonstrate knowledge of Current Procedural Terminology (CPT)
- Recognize procedure based payment systems such as Resource Based Relative Value (RBRV), Evaluation &Management and Ambulatory Payment Classification (APC)
- Identify the impact that coding and sequencing has on reimbursement
Reimbursement Methodologies
- Identify Ambulatory Surgery Center reimbursement
- Identify third party payers
- Describe billing and insurance procedures
- Discuss an explanation of benefits
- Recognize Quality Improvement Organizations (QIO) and their role in the payment process
- Identify charge master description and maintenance
- Describe managed care/capitation
- Recognize compliance issues
- Audit and monitor the coding process for regulatory compliance

IUPUI Campus Bulletin 2012-2014