ࡱ>  V[ bjbj## D,AA  PPPPPddd8D,d) ^jjjj6 )))))))$+d.=)P=)PPjj4R)FPjPj))K""j`+F_::c")h)0)k",.t."".P"X=)=),). : BULLETIN 2018-10  DATE \@ "MMMM d, yyyy" November 17, 2017 U.S. Department of Labor Employment and Training Administration Office of Apprenticeship (OA) Washington, D.C. 20210Distribution: A-541 Headquarters A-544 All Field Tech A-547 SD+RD+SAA+; Lab.Com Subject: New Apprenticeable Occupation: Professional Fee Coder Code: 200.1  Symbols: DPQSP/RCG Action: Immediate PURPOSE: To inform the staff of OA, State Apprenticeship Agencies (SAA), Registered Apprenticeship program sponsors, and other Registered Apprenticeship partners of a new apprenticeable occupation: Professional Fee Coder O*NET-SOC Code: 29-2071.00 RAPIDS Code: 2063CB Training Term: Competency-Based Type of Training: Competency-Based BACKGROUND: Ms. Barbara Glondys, Apprenticeship Navigator and SME, American Health Information Management Association (AHIMA), submitted the following occupation: Professional Fee Coder for apprenticeability determination. The Professional Services Coder accurately codes and charges for professional billing, and performs charge entry for facility fees associated with services. In addition, the Professional Fee Coder ensures compliance of coding and documentation for reimbursement according to federal regulations and guidelines. Professional Fee Coder will be added to the List of Occupations Recognized as Apprenticeable by OA when the list is reissued. A suggested Work Process Schedule and Related Instruction Outlines are attached. If you have any questions, please, contact Ms. Donna Scalia, Program Specialist at (732) 750-0776, or  HYPERLINK "mailto:Scalia.Donna@dol.gov" Scalia.Donna@dol.gov or Dr. Ricky Godbolt, (ATR) at 202-693-3815 or  HYPERLINK "mailto:Godbolt.Ricky.C@dol.gov" Godbolt.Ricky.C@dol.gov. ACTION: OA staff should familiarize themselves with this bulletin and the attached Work Process Schedule and Related Instruction Outline, as a source for developing apprenticeship standards and/or providing technical assistance. NOTE: This bulletin is being sent via electronic mail. 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GoodsonRamos, Tiffany -ETAH            !#$%'()*+-/01345789  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q@   F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q  bDbjbj## .AAP<FFFFFZZZ8LdZSCBBBBB& BBBBBBB$mEHBFBFFBBHB>RFBFBBB6<x@BI W^=$BC<SC=@HtHH@@HF&@dBB&|SCH : WORK PROCESS SCHEDULE HEALTH INFORMATION MANAGEMENT (HIM) PROFESSIONAL FEE CODER APPRENTICESHIP O*NET-SOC CODE: 29-2071.00 RAPIDS CODE: 2063CB Position Description: The Health Information Management (HIM) Professional Fee Coder will use coding conventions and guidelines to abstract, analyze and accurately assign ICD (International Classification of Diseases) first-listed and secondary diagnostic codes and CPT (Current Procedural Terminology) first-listed and secondary procedural codes to ambulatory, clinic, outpatient, and provider services. The HIM Professional Fee Coder will query physicians when diagnosis is unclear, audit records, and perform peer reviews. This position may utilize encoder, grouper, and other Health Information Management software often including Electronic Health Records. Minimum job requirements include a current credential as a CCA (Certified Coding Associate) from the American Health Information Management Association or CPC (Certified Professional Coder) from the American Academy of Professional Coders (AAPC) or other designated credential from a nationally recognized organization to include potential candidates that may have RHIT (Registered Health Information Technician), RHIA (Registered Health Information Administrator), COC (Certified Outpatient Coder), CIC (Certified Inpatient Coder), etc. . WORK PROCESS SCHEDULE COMPETENCYMEASURED BYScoreCOMMENTSUse and maintain electronic applications and work processes to support clinical classification and coding (for example, encoding and grouping software) Demonstrates understanding in use and application of encoder and grouper software1 2 3 4 51 Below expectation in the use of electronic applications (encoder and grouper software) 2 Needs improvement in use of electronic applications (encoder and grouper software) 3 Satisfactory use of electronic applications (encoder and grouper software) 4 Proficient in electronic applications (encoder and grouper software) 5 Exceeds expectation in use of electronic applicationsApply outpatient diagnosis and procedure codes according to current nomenclature and demonstrate adherence to current regulations and established guidelines in code assignment (focus on assignment of first listed diagnosis, and sequencing as well as other clinical coding guidelines)Audits indicate appropriate code and sequencing use following regulations and guidelines1 2 3 4 5 N/A1 Below expectation in the application of outpatient coding guidelines and regulations 2 Needs improvement in the application of outpatient coding guidelines and regulations 3 Demonstrates basic understanding of outpatient coding guidelines and regulations 4 Demonstrates proficiency in outpatient coding guidelines and regulations 5 Excels in application of outpatient coding guidelines and regulationsCOMPETENCYMEASURED BYScoreCOMMENTSEnsure accuracy of diagnostic/procedural APC (Ambulatory Payment Classification) system Audits indicate accuracy of APC assignment1 2 3 4 5 1 Below expectation in the accuracy of APC assignment 2 Needs improvement in the accuracy of APC assignment 3 Demonstrates basic understanding APC assignment 4 Demonstrates proficiency in APC assignment 5 Excels in application of APC assignmentValidate outpatient coding accuracy using clinical information found in the health recordAudits indicate accuracy of diagnostic and procedural coding1 2 3 4 5 Audit score1 Below expectation in the accuracy of applying outpatient codes 2 Needs improvement in the accuracy of applying outpatient codes 3 Satisfactorily demonstrates accuracy in the application of outpatient codes 4 Demonstrates proficiency in the application of outpatient codes 5 Exceeds expectations in the accuracy of applying outpatient codesUse and maintain applications and processes to support other clinical classification and nomenclature as appropriate to the work setting (e.g., DSM V (Diagnostic and Statistical Manual of Mental Disorders), SNOMED-CT (Systematized Nomenclature of Medicine Clinical Terms)Identifies correct coding nomenclature for patient type and locationMeets or Does not MeetComment on Does Not MeetResolve discrepancies between coded data and supporting documentation. Communicates with providers to ensure appropriate documentation. Creates compliant physician queries1 2 3 4 5 N/A1 Queries reviewed did not meet facility criteria 2 Queries reviewed met facility criteria at least 25% of the time 3 Queries reviewed met facility criteria at least 50% of the time 4 Queries reviewed met facility criteria at least 80% of the time 5 Queries reviewed met all facility criteria for compliance 100% of the timeApply policies and procedures for the use of clinical data required in reimbursement and outpatient prospective payment systems (OPPS) in healthcare delivery as well as changing regulations among various payment systems for healthcare services such as Medicare, Medicaid, managed care, etc.Adheres to national, regional and facility-specific requirements for accurate reimbursement by payer typeMeets or Does not MeetComment on Does Not MeetSupport accurate billing through coding, chargemaster, claims management, and bill reconciliation processesReviews codes identified manually and by the chargemaster to ensure compliant billingMeets or Does not MeetComment on Does Not MeetUse established guidelines to comply with reimbursement and outpatient reporting requirements such as the National Correct Coding Initiative and othersFollows coding edits for compliance with NCCI1 2 3 4 51 Not compliant with coding edits 2 Needs improvement in monitoring of coding edits 3 Satisfactorily monitors coding edits 4 Proficient in the monitoring of coding edits 5 Proactive in resolving NCCI edits prior to billingCompile patient data and perform data quality reviews to validate code assignment and compliance with reporting requirements such as outpatient prospective payment systemsParticipates in coding auditsMeets or Does not MeetComment on Does Not MeetParticipate in compliance (fraud and abuse), HIPAA (Health Insurance Portability and Accountability Act of 1996), and other organization specific training. Attends required compliance training Meets or Does not MeetComment on Does Not MeetTotal Approximate hours Note: On the job competencies will be evaluated as competency-based achievements. Each of the competencies will have objectives and all competencies will be verified and signed off by assigned journeyworker/mentors/trainers/supervisors. All related instruction and supplementary training will be structured in accordance with professional coding certification domains. RELATED INSTRUCTION OUTLINE HEALTH INFORMATION MANAGEMENT (HIM) PROFESSIONAL FEE CODER APPRENTICESHIP O*NET-SOC CODE: 29-2071.00 RAPIDS CODE: 2063CB Related instruction - This instruction is customized at point of hire by the Employer and Sponsor. ItemTypeContentHoursProgram orientationTeleconferenceProgram overview1VLab tutorialTeleconferenceVLab training1Pre-immersion assessmentOnline assessmentQuestions from CCS-P exam domains4Chapters 1, 2 and 3 in Procedure Coding & Reimbursement for Physician Services textbook. Complete online assessments.Online and self-directedIntroduction to Coding Basics, E&M coding, anesthesia coding20Chapter 4 in Procedure Coding & Reimbursement for Physician Services textbook. Complete online assessment.Online and self-directed In-depth review of surgery coding with CPT by body system20Chapters 5, 6, and 7 in Procedure Coding & Reimbursement for Physician Services textbook. Complete online assessments.Online and self-directedReview of radiology, pathology, laboratory and medicine coding 20Chapters 8, 9 and 10 in Procedure Coding & Reimbursement for Physician Services textbook. Complete online assessments.Online and self-directedReview of HCPCS Level II coding, modifiers, and reimbursement process for outpatient coding20Chapters 11 and 12 in Procedure Coding & Reimbursement for Physician Services textbook. Complete online assessments.Online and self-directedReview of coding and reimbursement reports and databases and evaluation of coding quality16Review Exercises in Procedure Coding & Reimbursement for Physician Services textbook.OnlineOffice visit, operative reports, surgical case auditing and E&M auditing4Hands on coding practice on redacted original medical records.VLab onlineOutpatient clinic, outpatient surgery, emergency department, and observation cases.20Common employability modulesOnline self-directedCommon employability skills to include: Communication skills Analysis and problem-solving Behavioral characteristics Business knowledge Teamwork10Post-immersion assessmentOnline assessmentQuestions from CCS-P exam domains4Meetings with Coding TrainersTeleconferenceReview activities, provide feedback and instruction4Total Immersion/Related Instruction hours144 TOTAL MINIMUM HOURS 144 Immersion Skill Training Curriculum Professional Fee Coder Apprenticeship NOTE: This is a recommended course outline that is customizable based on the apprentice scores in their pre-assessment and the needs of the Employer. Orientation Teleconference: Introduction to the AHIMA Apprenticeship Program Orientation to Immersion Program Training Structure: Program expectations Program length, goals, deliverables Directions on how to navigate the technical components Contact Information for concerns etc. Resources Training Teleconference: PowerPoint/Video/LMS Tutorial VLab AHIMA Academy Pre- immersion Coding Assessment for Professional Skills Training: CCS-P Exam Data Bank randomized questions (Not Timed) Multiple Choice *Mentor Checkpoint Clinical Coding Review utilizing Procedural Coding and Reimbursement for Physician Services textbook. Complete assessments online. *Mentor Checkpoint Chapter 1 - Online and self-directed Introduction to Coding Basics Describe the health record and standard health record formats Identify organizations that direct health record format Recognize basic elements of health record documentation Understand the resources used to assign diagnostic and procedure codes Understand CPT structure and coding conventions Identify the sources of documentation that generate physician codes and charges Identify codable diagnostic and procedural statements (in physician office documentation) Understand the Ambulatory Coding Guidelines for ICD-10-CM Chapter 2 Online and self-directed - Evaluation and Management Coding Understand documentation guidelines Define evaluation and management services Understand terms commonly used in reporting E/M Services Define the levels of E/M Services Understand modifiers Define the various E/M categories Identify the HCPCS codes used in evaluation and management coding Chapter 3 - Online and self-directed Anesthesia Coding Describe the format and arrangement of codes in the anesthesia section Explain the anesthesia package Identify and apply the modifiers commonly used in reporting anesthesia services Identify codes used in reporting qualifying circumstances Perform the steps used in coding anesthesia services Calculate fees for anesthesia services Chapter 4 Online and self-directed Surgery Coding Identify coding used in the surgery section Explain the use of modifiers used in surgery coding Assign codes used in all surgery sections Chapter 5 Online and self-directed Radiology Describe the Radiology surgery section format and arrangement Identify and apply the modifiers used in Radiology coding Chapter 6 Online and self-directed Pathology and Laboratory Describe the pathology and laboratory section structure and content Understand the Clinical laboratory Improvement Amendments of 1988 (CLIA) Interpret quantitative and qualitative studies Understand the Guidelines Pertaining to Pathology and Laboratory subsections Identify and apply the modifiers used in Pathology and Laboratory coding Chapter 7 Online and self-directed Medicine Understand the Medicine section content and code structure for all specialties Identify and assign the appropriate modifiers used in coding Medicine services Identify and assign the appropriate HCPCS codes used in coding Medicine services Chapter 8 Online and self-directed HCPCS Level II Coding Understand the HCPCS code assignment hierarchy and the steps in HCPCS code assignment Understand the effect of HIPAA on HCPCS Identify the Level II codes that are inappropriate for professional billing Chapter 9 Online and self-directed Modifiers Understand the types of Modifiers Identify and assign modifiers Chapter 10 Online and self-directed Reimbursement Process Understand the reimbursement process and mechanisms Describe Fee Schedule management Identify sources of coding and reimbursement guidelines Identify payer-specific guidelines Understand how to submit claims and the claims process Identify the data elements of a computerized internal Fee Schedule Chapter 11 Online and self-directed Coding and Reimbursement Reports and Databases Perform data evaluation Interpret computerized internal Fee Schedule Reports Analyze Payer Remittance Reports Chapter 12 Online and self-directed Evaluation of Coding Quality Understand the tools for evaluating coding quality Perform internal audits Clinical coding practice coding original redacted medical records (55 records): - 25 Outpatient clinic cases - 16 Emergency department cases - 14 Outpatient surgery cases *Mentor Checkpoint Clinical coding practice coding original redacted medical records (35) records in VLab/Solcom EDCO: - 4 ambulatory surgery cases - 26 emergency department cases - 5 outpatient cases *Mentor Checkpoint Common Employability Resources & Toolkit Module 1: Analysis and Problem Solving Provide instruction to help apprentices identify and assess business problems and develop effective solutions that meet the needs of their employers. Module 2: Behavioral Characteristics The curriculum will include modules on developing effective working relationships, whether onsite or online. The program will also focus on integrity in the work place and cover essential qualities such as ethics, trustworthiness, and personal organization. Module 3: Business Knowledge Module will include instruction in general business practices and environmental awareness. Module 4: Leadership Communication Provide instruction in perception, communication objectives, and communication formats. Module 5: Teamwork Focus on working with key stakeholders and their employer to meet shared objectives and facilitating desired outcomes. 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