HCR 201 Entire Course

HCR/201

MEDICAL BILLING AND CODING

 

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HCR 201 Entire Course Link

https://uopcourses.com/category/hcr-201/

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HCR 201 Week 1 Medical Billing Terminology Worksheet
Complete the University of Phoenix Material: Medical Billing Terminology Worksheet.

Click the Assignment Files tab to submit your assignment.

Medical Billing Terminology

 

Part A

 

Reference: Medical Insurance

 

Complete the following table by defining each of the terms in the table. Be clear and concise, use complete sentences, and define in your own words.

 

Term
Definition
Accounts Receivable (AR)
 
Accounts Payable (AP)
 
Capitation
 
Electronic Health Record (EHR)
 
Encounter Form
 
Health Information Exchange (HIE)
 
Health Information Technology (HIT)
 
Diagnosis Code
 
Explanation of Benefits
 
Indemnity
 
Personal Health Record (PHR)
 
Practice Management Program (PMP)
 
Protected Health Information (PHI)
 
Remittance Advice (RA)
 
Revenue Cycle Management (RCM)
 
 

Part B

 

Write 150- to 350-word response to the following question. Be clear and concise, use complete sentences, and explain your answers using specific examples.

 

Cite any outside sources. For additional information on how to properly cite your sources see the Reference and Citation Generator resource in the Center for Writing Excellence.

 

Explain why, in terms of job performance and efficiency, knowing medical billing terms is critical for working in the health care field.

 

 

HCR 201 Week 1 Steps in the Medical Billing Process
Complete the University of Phoenix Material: Steps in the Medical Billing Process.

Click the Assignment Files tab to submit your assignment.

Steps in the Medical Billing Process

 

Part A

 

Reference: Ch. 1 of Medical Insurance

 

Complete the following table by identifying the 10 steps in the Medical Billing Process. Write 2 to 3 sentences describing each step. Be as specific as possible. For example, Step 1 may be, “Preregister Patients.”

 

Step
Description
Step 1:
 
Step 2:
 
Step 3:
 
Step 4:
 
Step 5:
 
Step 6:
 
Step 7:
 
Step 8:
 
Step 9:
 
Step 10:
 
 

Part B

 

Write 50- to 150-word responses to each of the following questions. Be clear and concise, use complete sentences, and explain your answers using specific examples.

 

Cite any outside sources. For additional information on how to properly cite your sources see the Reference and Citation Generator resource in the Center for Writing Excellence.

 

1.     Discuss what determines patient benefits eligibility? Explain your answer.

 

2.     What are the appropriate steps to take when insurance does not cover a planned service?

 

 

HCR 201 Week 2 Alphabetic Index and Tabular List Memo
Resource: Ch. 4 of Medical Insurance: An Integrated Claims Process Approach (6th ed.)

Imagine you are the head office clerk at a medical practice and have been asked to create a memo to explain the purpose of the Alphabetic Index and Tabular List.

Write a 150- to 350-word memo that addresses the following: 

Discuss the appropriate use and purpose of the Alphabetic Index and Tabular List.
What problems might occur if proper coding procedures are not used? Provide examples.
Cite at least 2 sources other than your textbook. For additional information on how to properly cite your sources, log onto the Reference and Citation Generator resource in the Center for Writing Excellence.

Format your assignment according to APA guidelines.

Click the Assignment Files tab to submit your assignment.

 
 

HCR 201 Week 2 Diagnostic Coding Worksheet
Complete the University of Phoenix Material: Diagnostic Coding Worksheet.

Click the Assignment Files tab to submit your assignment.

Diagnostic Coding Worksheet

 

Complete Parts A, B, C, and D of this worksheet.                                                                        

 

Resources: Ch. 4 and 18 of Medical Insurance: An Integrated Claims Process Approach, CMS.gov and internet coding resources

 

Part A: Diagnosis Code Category

 

Complete the table below.

 

Determine a diagnosis code for the following case studies and include your reference.

 

Case study
Diagnosis code/resource
A 44-year-old male presents to the office complaining of intermittent chest pain. The physician orders an EKG to rule out a possible cardiac event. Patient is diagnosed with atypical chest pain.
Atypical chest pain: ICD10 code: R07.89

 

CMS.gov

 
A 68-year-old male presents to the office complaining of pronounced weakness on the right side of his body and slurred speech for the past 24 hours. Based on the examination, the physician orders an MRI to investigate a possible transient ischemic attack (TIA). Patient is diagnosed with a TIA.
 
A 72-year-old diabetic female exhibits an open wound on her left foot.
 
A 45-year-old male patient presents to the office complaining of headaches for the past 24 hours. Based on the examination, the physician orders an MRI to investigate a possible brain tumor. The MRI was negative. The patient was diagnosed with a migraine.
 
 

Part B: More Coding

 

Determine the correct code that would be used when billing using the table of drugs and chemicals.

 

Diagnosis
Code
Unintentional Poisoning Antifreeze (Alcohol)
T44.0X1
T51.1X1
T45.8X3
T51.1X4
Patient has a diagnosis of poisoning with intent to self-harm with Nadolol
T45.8X1
T50.8X6
T48.203
T44.7X2
Patient has diagnosis of poisoning undetermined furniture polish
T65.892
T65.894
T52.8X3
T50.6X6
Patient has diagnosis under dosing Furosemide
T50.1X6
T50.1X5
T45.8X1
T62.1X1
Patient has diagnosis poisoning assault hair dye
T458X1
T50.901
T573X3
T49.4X3
 

 

Part C: Determine the correct code that would be used when referencing the Neoplasm table.

 

Diagnosis
Code
Patient has malignant primary neoplasm of the tonsil, unspecified
C11.0
C09.9
C11.8
C09.0
Patient has secondary neoplasm of the stomach (body)
C16.1
C24.0
D13.1
C78.89
Patient had benign neoplasm of the liver
D13.4
C22.8
D01.5
D49.0
Patient has malignant neoplasm of the duodenum ca in situ
D01.49
D13.2
C17.0
C17.2
Patient has unspecified neoplasm of the pancreas duct, unspecified
C78.89
C25.0
D49.0
D37.0
 

 

Part D: Define each external code. An example has been provided for you.

 

Code
Meaning
W00.0XXA
Fall due to ice and snow on same level, initial encounter.
V01.00XD
 
V95.01XA
 
X10.1XXA
 
V50.6XXA
 
 

 

 

HCR 201 Week 3 Describing CPT Coding Categories
Resource: Ch. 5 of Medical Insurance: An Integrated Claims Process Approach (6th ed.)

Imagine you are a medical office manager who wants to make the coding process easier for employees to understand.

Write a 350- to 700-word response to the following:

Develop buzzwords or slogans that would best describe the three CPT code categories.
What types of procedures or services are included in each of the CPT code categories?
Provide one example for each category in your description.
Cite at least 2 sources other than your textbook. For additional information on how to properly cite your sources, log onto the Reference and Citation Generator resource in the Center for Writing Excellence.

Format your assignment according to APA guidelines.

Click the Assignment Files tab to submit your assignment.

 
 

HCR 201 Week 3 Working With CPT Modifiers Worksheet
Complete the University of Phoenix Material: Working With CPT Modifiers Worksheet.

Click the Assignment Files tab to submit your assignment.

Working With CPT Modifiers Worksheet

 

Complete Parts A and B of this worksheet.

 

Part A

 

Resource: Table 5.2 of Medical Insurance: An Integrated Claims Process Approach

 

Complete the exercise by identifying the correct Current Procedural Terminology (CPT) modifier to its corresponding procedure for the following:

 

·         Bilateral procedures

·         Multiple procedures

·         Repeat clinical diagnostic laboratory test

·         Unusual anesthesia

·         Mandated services

 

Part B

 

Resource: Ch. 5 of Medical Insurance: An Integrated Claims Process Approach

 

Complete the following table.

 

Determine the correct modifier that would be used for billing:

 

Procedure
Modifier options
Patient had carpal tunnel surgery performed on both wrists.
56

32

47

50
Patient had a lumbar puncture at 01:00 with a repeat lumbar puncture at 05:00.
62

76

92

26
Professional component – reading radiology examination
26

25

22

99
Patient had an evaluation performed at the doctor’s office. After the evaluation, the doctor removed a lesion from the arm. Which modifier would be used to indicate a separate procedure for the lesion removal?
51

26

80

59
Patient had an evaluation performed at the doctor’s office. After the evaluation, the doctor removed a lesion from the arm. Which modifier could be used to signify a separate identifiable evaluation and management the same date of service as a procedure?
26

56

58

25
Patient had surgery last week and presents with a post-operative infection.
55

29

33

25
Patient had a mastectomy. Dr. Smith assisted Dr. James with the procedure. What modifier would be used to indicate the surgical assist code for Dr. Smith?
47

50

80

25
Patient returned to the operating room after having surgery later in the day for uncontrolled bleeding.
80

26

53

78
The biopsy was removed and sent to an outside lab for pathology. Which modifier could be used to indicate outside laboratory?
92

22

91

90
Patient had an appendectomy and total hysterectomy performed during the same surgical episode. Which modifier would be used to indicate a multiple procedure performed for the appendectomy?
54

50

51

66
 

 

HCR 201 Week 4 Applying Level II HCPCS Modifiers
Resource: Table 5.7 of Medical Insurance: An Integrated Claims Process Approach (6th ed.)

Apply the appropriate Level II Health Care Common Procedure Coding System (HCPCS) code modifier for each of the following examples. Explain your rationale for each selection.

Injection on the left hand thumb
Emergency ambulance transport and extended life support arranged for by the provider
Diagnostic mammogram, left breast
Cortisone 10 mg injection, right shoulder
Nonelectric wheelchair
Intravenous catheter line, right arm
Laboratory certification, cytology specimens
Chest x-ray
Prosthetic hip replacement, left side
Electric hospital bed
Write a 350- to 700-word response that discusses the purpose of the HCPCS codes set and its modifiers.

Cite at least 2 sources other than your textbook. For additional information on how to properly cite your sources, log onto the Reference and Citation Generator resource in the Center for Writing Excellence.

Format your assignment according to APA guidelines.

Click the Assignment Files tab to submit your assignment.

 
 

HCR 201 Week 4 Permanent and Temporary Codes
Complete the University of Phoenix Material: Permanent and Temporary Codes.

Click the Assignment Files tab to submit your assignment.

Permanent and Temporary Codes

 

Resources: Table 5.6 and p. 185 of Medical Insurance: An Integrated Claims Process Approach

 

Complete the following tables.

 

Give five examples of permanent and temporary codes and a description of what each code is used for. Be clear and concise, use complete sentences, and define in your own words.

 

Permanent codes
Description
 
 
 
 
 
 
 
 
 
 
 

Temporary codes
Description
 
 
 
 
 
 
 
 
 
 
 

 

HCR 201 Week 5 Inpatient and Outpatient Hospital Services Diagram
Resource: Ch. 17 of Medical Insurance: An Integrated Claims Process Approach (6th ed.)

Complete the University of Phoenix Material: Inpatient and Outpatient Hospital Services Diagram.

Click the Assignment Files tab to submit your assignment.

Inpatient and Outpatient Hospital Services Diagram

 

Complete the following diagram.

 

Write 2 to 4 sentences comparing the differences and similarities between the inpatient and outpatient hospital services.

 

Inpatient hospital services are equiped for patients to stay overnight.

Outpatient hospital services are often called ambulatory care

 

Write a 50- to 250-word response discussing how the differences between inpatient and outpatient hospital services affect the coding process.

 

 

HCR 201 Week 5 Billing Process Worksheet
Resources: Ch. 1 of Medical Insurance: An Integrated Claims Process Approach (6th ed.), and the Week One assignment Steps in the Medical Billing Process

Complete the University of Phoenix Materials: Billing Process Worksheet.

Click the Assignment Files tab to submit your assignment.

Billing Process Worksheet

 

Complete the following table.

 

Review the Patient Progress Note and determine the correct CPT, HCPCS, and Diagnosis codes for the charge ticket used for billing:

 

Patient Progress Note



Determine the correct Diagnosis code(s)
Determine the correct CPT code(s)
Determine the correct HCPCS code(s)
J33.0

J20.9

J21.8

J30.2

J45.901

R06.00

M45.9

A98.8
94760

94761

94640

99214

99211

94770

88174

93308
J0275

J0456

S9145

L6714

K0740

J1815

J1300

J7614/ Q4093
 
 

HCR 201 Week 5 Medical Records Documentation and Billing
Resources: Ch. 1 of Medical Insurance: An Integrated Claims Process Approach (6th ed.), and the Week One assignment Steps in the Medical Billing Process

Refer to your Week 1 Steps in the Medical Billing Process Worksheet/Assignment

Refer to your Week 5 Billing Process Worksheet/Assignment

Write a 350- to 700-word summary that discusses the following:

Describe the relationship between medical records documentation and billing.
Identify which of the steps in the medical billing process are related to medical records, documentation standards, and billing.
How do ICD, HIPAA, CPT, and HCPCS influence each of the 10 steps in the medical billing process
Cite at least 2 sources other than your textbook. For additional information on how to properly cite your sources, log onto the Reference and Citation Generator resource in the Center for Writing Excellence.

Format your assignment according to APA guidelines.

Click the Assignment Files tab to submit your assignment.

 
HCR 201 Week 5 Signature Assignment: Comprehensive Coding Worksheet
Complete the University of Phoenix Materials: Comprehensive Coding Worksheet.

Click the Assignment Files tab to submit your assignment.

Comprehensive Coding Worksheet
 

Complete Parts A through D of this worksheet.                                                                            

 

Resources: Medical Insurance: An Integrated Claims Process Approach textbook, CMS.gov and internet coding resources.

 

 

PART A
 

Complete the tables below.

 

Determine a diagnosis code for the following case studies and include your reference.

 

Case Study
Diagnosis Code or Resource
1.     Patient presents to ER with severe abdominal pain. Patient had coffee ground emesis. The diagnosis was determined to be gastritis with bleeding.
 
2.     During the initial visit to the ER, a 14 year old presents with anaphylaxis after eating a peanut butter cookie. The diagnosis is anaphylactic shock from peanuts.
 
3.     10 year old sees her pediatrician for an ear piercing for her birthday. The diagnosis is encounter for health service for piercing.
 
4.     80 year old is evaluated for some memory loss without any behavior changes. The diagnosis is unspecified dementia without behavioral disturbance.
 
 


PART B
 

Highlight the correct diagnosis code:

 

Diagnosis
Code
1.    Unspecified open wound of right great toe with damage to nail, initial visit.
A.    S91.34
B.    S91.30
C.    S91.201A
D.    S91.22
2.    Insect bite, nonvenomous of right forearm, Subsequent visit.
A.    S50.861D
B.    S50.871
C.    S51.051
D.    S50.862
3.    Other acute osteomyelitis, unspecified site
A.    M86.30
B.    M86.17
C.    M86.14
D.    M86.10
4.    Benign neoplasm right ovary
A.    D27.9
B.    D27.0
C.    D26.0
D.    D27.1
5.    Other specified arthritis, right shoulder
A.    M13.811
B.    M13.111
C.    M13.119
D.    M12.811
 

 


PART C
 

Highlight the correct HCPCS code:

 

HCPCS codes
Code
1.    Injection Digoxin up to 0.5mg
A.  J1160
B.  J1117
C.  J1162
D.  J0775
2.    Electrode transducer for use with electrical stimulation device used for cancer treatment, replacement only
A.  A4658
B.  A4604
C.  A4555
D.  A4606
3.    Power wheelchair component, actuator, replacement only.
A.  E2378
B.  E2384
C.  E2328
D.  E2358
4.    Adhesive remover, wipes, any type each
A.  A4510
B.  A4455
C.  A4450
D.  A4456
5.    Syringe with needle sterile, 1 cc or less each.
A.  A4244
B.  A4210
C.  A4206
D.  A4211
 

 


PART D
 

Highlight the correct modifier:

 

Code- Modifier
Meaning
1.    Professional component- interpreting lab pathology results.
A.    26
B.    25
C.    22
D.    99
2.    Patient had a hip replacement. Dr. Ortega assisted Dr. James with the procedure. What modifier would be used to indicate the surgical assist code for Dr. Ortega?
A.    47
B.    50
C.    80
D.    25
3.    Patient had an oophorectomy and total mastectomy performed during the same surgical episode. Which modifier would be used to indicate a multiple procedure performed?
A.    54
B.    50
C.    51
D.    66
4.    Patient had a bilateral bunionectomy. Which modifier would be used for bilateral procedure?
A.    56
B.    32
C.    47
D.    50
5.    Patient had an evaluation performed at the doctor’s office. After the evaluation, the doctor removed a lesion from the leg. Which modifier would be used to indicate a separate procedure for the lesion removal?
A.    51
B.    26
C.    80
D.    59
                                                                                                    

 

 
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