Mandatory Provider Education

The mandatory provider education program is comprised of the following two modules, both of which must be completed in the online HealthStream Learning Center by all billing providers on an annual basis (once each fiscal/academic year):

Module A - Evaluation and Management (E/M) Documentation Guidelines

• General medical record documentation principles
• How to determine the correct category and level of E/M services
• The global surgical package and how it relates to E/M coding
• Cautions and risks associated with using electronic health record documentation shortcuts

Module C - Billing Compliance Training

• General billing compliance principles
• Non-physician practitioner (NPP) billing rules
• Teaching physician billing rules

Separate completion timeframes apply to new/incoming attendings/non-physician practitioners (no prior modules A/C), established/returning attendings/non-physician practitioners and residents/fellows/ post-doctoral associate.

Live presentations covering any or all of the above topics relating to modules A/C in more depth, or pertaining to other more focused billing, coding, or documentation-related topics may also be requested.

Professional Medical Coding

The primary focus of the professional medical coding courses is to educate employees on the principles associated with professional service medical coding, along with certain pre-requisite concepts. The courses within the standard coding curriculum are:

• Medical terminology-word parts (9 two-hour sessions) - employees will learn hundreds of Latin and Greek word parts that come together to form medical terms — knowledge that will be vital to accurate medical coding.
• Anatomy for coding (18 two-hour sessions) - discusses the overall structure and basic function of each body system, but with a special emphasis on the knowledge needed to accurately assign CPT and ICD-10-CM codes.
• The business of healthcare (3 two-hour sessions) - provides solid foundation in general healthcare concepts, especially as they relate to billing and coding. This course will be especially helpful to employees who wish to take the professional service-focused coding courses and who may be relatively new to the healthcare environment, but we also believe the course is broad enough in scope to potentially benefit employees already having years of experience in the healthcare environment. This course will cover key concepts relating to the specialties of medicine, explanations of the credentials of providers rendering care to patients, general insurance concepts and much more.
• ICD-10-CM coding (9 two-hour sessions) - instruction regarding ICD-10-CM codes. These codes are used to describe medical conditions or other reasons patients are seen and receive provider services in the healthcare environment.
• CPT coding (18 two-hour sessions) - instruction in this course covers the CPT-4 and HCPCS Level II codes used to describe the services rendered/supplies dispensed by providers in caring for patients.

Please click here to sign up using the admission request form.

Additional Courses, Workshops and Seminars

• After a student has completed the standard coding curriculum as described above, he/she has the option to attend a final review course entitled “CPC Review” in order to prepare for the American Academy of Professional Coder’s CPC exam. The review course will reinforce concepts from all prior courses and practice exercises will be given to prepare a student for the exam.
• Employees also have the opportunity to attend advanced-level seminars and workshops offered throughout the year.

If you have any questions about the courses, seminars, workshops and/or presentations offered, please contact the CDQ education department.