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Certified Risk Adjustment Coder (Voucher Included)

You will learn principles of risk adjustment and accurate diagnosis coding.

$1,595.00 (USD)

ENROLL NOW phone Call Us: 855.520.6806

schedule
                                160 Course Hrs
                            

                                Code
                                    GES167
                            
Voucher included
calendar_today
                                6 Months
                            
grid_onOpen enrollment
speedSelf paced

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Overview

Objective

What you will learn

Learn and define different models of risk adjustment (HCC, CDPS, HHS-ACA, Hybrid)
Understand predictive modeling and its impact on risk adjustment
Survey the impact of risk adjustment on the financial well-being of an organization
Learn and apply official coding guidelines
Identify documentation deficiencies for diagnosis coding
Understand the most common conditions in risk adjustment and how to properly code in ICD-10-CM

How you will benefit

Prepare for a rewarding career and for success on the CRC certification exam
Gain a broad base of knowledge in diagnosis codes for all risk adjustment models
Become indispensable in an organization that needs quality risk adjustment coding
Get free AAPC membership, CRC practice exams, and the AAPC Certified Risk Adjustment Coder (CRC?) exam when you enroll

Outline

Business of Medicine
1. Coding as a Profession
2. The Difference Between Hospital and Provider Services
3. How a Provider Office Works and How the Coder Fits into It
4. Understanding the Hierarchy of Providers
5. The Different Types of Payers
6. The Medical Record
7. Operative Report Coding Tips
8. Medical Necessity
9. The Advance Beneficiary Notice
10. The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
11. The Need for Compliance Rules and Audits
12. The OIG Work Plan
13. What AAPC Will Do for You
Medical Terminology and Anatomy Review
1. Introduction to Medical Terminology
2. Introduction to Anatomy
3. Integumentary System
4. Musculoskeletal System
5. Cardiovascular System
6. Lymphatic System
7. Respiratory System (Pulmonary System)
8. Digestive System
9. Urinary System
10. Reproductive Systems
11. Nervous System
12. Organs of Sense—Eye
13. Organs of Sense—Ear
14. Endocrine System
15. Hematologic (Hemic) System
16. Immune System
Introduction to ICD-10-CM
1. Overview of ICD-10-CM Layout
2. Steps to Look Up a Diagnosis Code
3. ICD-10-CM Official Guidelines for Coding and Reporting
ICD-10-CM Coding Chapters 1–11
1. Chapter 1: Certain Infectious and Parasitic Diseases (Codes A00–B99)
2. Chapter 2: Neoplasms (Codes C00–D49)
3. Chapter 3: Diseases of the Blood and Blood-Forming Organs and Certain
4. Disorders Involving the Immune Mechanism (D50-D89)
5. Chapter 4: Endocrine, Nutritional and Metabolic Diseases (E00-E89)
6. Chapter 5: Mental, Behavioral and Neurodevelopmental Disorders (F01-F99)
7. Chapter 6: Diseases of the Nervous System (G00-G99)
8. Chapter 7: Diseases of the Eye and Adnexa (H00-H59)
9. Chapter 8: Diseases of the Ear and Mastoid Process (H60-H95)
10. Chapter 9: Diseases of the Circulatory System (I00-I99)
11. Chapter 10: Diseases of the Respiratory System (J00-J99)
12. Chapter 11: Diseases of the Digestive System (K00-K95)
ICD-10-CM Coding Chapters 12–21
1. Chapter 12: Diseases of the Skin and Subcutaneous Tissue (L00-L99)
2. Chapter 13: Diseases of the Musculoskeletal System and Connective Tissue (M00–M99)
3. Chapter 14: Diseases of Genitourinary System (N00–N99)
4. Chapter 15: Pregnancy, Childbirth, and the Puerperium (O00–O9A)
5. Chapter 16: Certain Conditions Originating in the Perinatal Period (P00-P96)
6. Chapter 17: Congenital Malformations, Deformations and Chromosomal Abnormalities (Q00–Q99)
7. Chapter 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings, Not Elsewhere Classified (R00–R99)
8. Chapter 19: Injury, Poisoning and Certain Other Consequences of External Causes (S00–T88)
9. Chapter 20: External Causes of Morbidity (V00-Y99)
10. Chapter 21: Factors Influencing Health Status and Contact with Health Services (Z00–Z99)
Risk Adjustment Models
1. Types of Risk Adjustment Models
2. Medicare Hierarchal Condition Categories (HCC)
3. The Health and Human Services (HHS) Hierarchical Condition Category Model
4. Medicaid Chronic Illness and Disability Payment System (CDPS)
5. Hybrid Model
Predictive Modeling & Quality of Care
1. CMS Stars Ratings
2. PQRS (Physician Quality Reporting System)
3. HEDIS® (The Healthcare Effectiveness Data and Information Set)
How Risk Adjustment Relates to Medical Financial Matters
1. New Beneficiary Calculations
2. Annual Risk Adjustment Audits
3. ACO's (Accountable Care Organizations)
4. Placing Providers "At-Risk"
Diagnosis Documentation & Coding
1. Data Collection Sources
2. Coding for All Diagnoses Noted in a Date of Service (DOS)
3. ICD-10-CM Updates to the Conventions & Official Coding Guidelines that Affect Risk Adjustment Coding
4. Coding Diagnoses from the medical documentation
5. Signature or Credential Issues
Clinical Documentation Barriers
1. Signs and Symptoms
2. Uncertain Diagnosis
3. Coding Clinic Guidance
4. Risk Adjustment Diagnosis Coding Steps
5. Acute vs. Chronic
6. Differential Diagnosis
7. Risk Factors and Comorbidities
8. Late Effects
Frequently Coded Conditions in Risk Adjustment Models

Requirements

Prerequisites

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FAQs

Does this course prepare for a certification?

Yes, you will be prepared to sit for the Certified Risk Adjustment (CRC™) Certification Exam offered by the American Academy of Professional Coders (AAPC). You will receive an exam voucher and AAPC membership after successful completion of the course and financial obligation.

When can I start the course?

This course is open enrollment, so you can register and start the course as soon as you are ready. Access to your course can take 24-48 business hours.

How long does it take to complete this course?

This course is self-paced and open enrollment, so you can start when you want and finish at your own pace. When you register, you'll receive six (6) months to complete the course.

What if I don't have enough time to complete my course within the time frame provided?

The time allotted for course completion has been calculated based on the number of course hours. However, if you are unable to complete the course, contact the student advising team to see what options you may have available to work out a suitable completion date. Please note that an extension fee may be charged.

What kind of support will I receive?

Our courses are designed to accommodate various learning preferences. Depending on the course structure, you may get different forms of support. Self-paced courses are designed to be user-friendly and independent, minimizing the need for external support. In courses with instructors, our direct platform support feature includes opportunities for questions, discussions, and remediation, with email and phone support available for select courses. Our student advising team is available to guide you on program requirements and administrative requests, but they do not provide assistance with course content. Our goal is to provide you with the necessary support for success, whether it's through self-paced exploration, direct communication, or guidance from our advising team.

What happens when I complete the course?

Upon successful completion of the course, you will be awarded a certificate of completion. In addition, you will receive an exam voucher for the Certified Risk Adjustment (CRC™) Certification Exam, offered by the American Academy of Professional Coders (AAPC) after successful completion of the course and financial obligation.

Am I guaranteed a job?

This course will provide you with the skills you need to obtain an entry-level position in most cases. Potential students should always do research on the job market in their area before registering.

Can I get financial assistance?

This course is non-credit, so it does not qualify for federal aid, FAFSA and Pell Grant. In some states, vocational rehab or workforce development boards will pay for qualified students to take our courses. Additionally, some students may qualify for financial assistance when they enroll, if they meet certain requirements. Financing is available from select schools. Learn more about financial assistance.

How can I get more information about this course?

If you have questions that are not answered on our website, representatives are available via LIVE chat. You can also call us at 1-877-221-5151 during regular business hours to have your questions promptly answered. If you are visiting us during non-business hours, please send us a question using the "Contact Us" form.

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Certified Risk Adjustment Coder (Voucher Included)

You will learn principles of risk adjustment and accurate diagnosis coding.

Overview

Objective

Outline

Requirements

Prerequisites

You've got questions.We're here to help.

Instructor

FAQs

You've got questions.We're here to help.

You've got questions.
We're here to help.

You've got questions.
We're here to help.