MRT204 Reimbursement, Compliance & Coding Issues
An overview of the American healthcare system and compliance is presented. Topics covered include the requirements of our coding system in order to receive maximum reimbursement. Current reimbursement methodologies, i.e. RBRVS, APG?s, outpatient and in-patient prospective payments, as well as capitation and fee-for-service reimbursements will be covered. This course will also acquaint the student with billing formats using CMS 1500, UB-04, 83I and 837P. Medicare and the office of inspector general's policy around compliance as they relate to coding are included.
Prerequisite
MRT117 Basic Diagnosis Coding Systems Minimum Grade of: C and
MRT118 Procedure Coding Systems (CPT) Minimum Grade of: C
Corequisite
MRT217 Intermediate Diagnostic Coding Minimum Grade of: C and MRT218 Intermediate Procedural Coding Minimum Grade of: C
Major Restrictions
Medical Billing and Coding Certificate