Understanding facility coding is vital when working in the hospital and ambulatory surgery center (ASC) settings. When coding in the outpatient facility setting, reimbursement is based not on professional services provided, but the resources used during the patient encounter. This course will cover outpatient facilities and departments, compliance in the facility, along with the CMS payment systems which include the Outpatient Prospective Payment System (OPPS). A summary of CPT® coding and variations for the facility are also discussed. This course is recommended for anyone who currently has the CPC® certification and is preparing for a career in medical coding for an outpatient hospital/facility and ASC setting. This course prepares the current CPC® with the additional knowledge required for AAPC’s COCTM (formerly CPC‐H®) certification examination.

Course Objectives:

•  Understand outpatient facilities and their departments including outpatient services at hospitals, teaching hospitals, critical access hospitals, ambulatory surgery centers (ASCs), and comprehensive outpatient rehabilitation facilities
•  Navigate the business side of hospital outpatient services and ASCs
• Differentiate between inpatient and outpatient services and payment services (IPPS and OPPS)
• Understand the difference between MS‐DRGs and APC assignments, and how those services are reported
• Review critical pieces in the billing and revenue cycle management process
• Develop an understanding of compliance in the outpatient hospital facility
• Discuss documentation and coding standards for outpatient facilities
• Understand how clinic and ED visits and other evaluation and management services are reported in the facilitysetting
• Review and code a wide variety of patient services using CPT®, HCPCS Level II, and ICD‐10‐CM coding guidelines andcode sets for the facilityCourse Content:
  • Outpatient Facilities and Departments
  •  Business in the Facility
  •  CMS Payment Systems Overview
  • Outpatient Facility Billing
  • Compliance in the Facility
  • Documentation and Coding Standards
  • Anatomy
  • Introduction to ICD‐10‐CM Coding
  • ICD‐10‐CM Coding Guideline
  •  Introduction to CPT®, HCPCS Level II, Surgery Guidelines, and Modifiers for Facilities
  • Evaluation and Management (E/M) for Facilities
  • Accelerated Coding Review
  • CMS and Outpatient Payment Systems
  •  CMS and Inpatient Payment Systems
  •  Introduction to ICD‐10‐PCS
  •  Final Exam