CCS (Certified Coding Specialist) Course
Domain 1 – Coding Knowledge and Skills
Domain 2 – Coding Documentation
Domain 3 – Provider Queries
Domain 4 – Regulatory Compliance
Domain 5 – Information Technologies
Detailed CCS curriculum :
Domain 1 – Coding Knowledge and Skills (39-41%)
Tasks:
- Assign diagnosis and procedure codes based on the provider’s documentation in the health record
- Identify the principal/first-listed diagnosis and procedure based on the respective guidelines
- Apply coding conventions/guidelines and regulatory guidance
- Attach CPT/HCPCS modifiers to outpatient procedures
- Determine appropriate sequencing of diagnoses and procedure codes based on the case scenario
- Apply present on admission (POA) guidelines
- Demonstrate knowledge of coding edits (e.g., NCCI, Medical Necessity)
- Demonstrate knowledge of reimbursement methodologies (e.g., DRG, APC)
- Abstract applicable data from the health record
- Identify major co-morbid conditions (MCC) and co-morbid conditions (CC)
Domain 2 – Coding Documentation (18-22%)
Tasks:
- Resolve conflicting documentation in the health record (e.g., admission type, laterality)
- Ensure all required documentation for assigning a specified code is available within the body of the health record
- Verify and validate documentation within the health record
Domain 3 – Provider Queries (9-11%)
Tasks:
- Identify elements of an ethical compliant query
- Determine if a provider query is compliant (e.g., non-leading, contains appropriate clinical indicators)
- Analyze current documentation to identify query opportunities
Domain 4 – Regulatory Compliance (18-22%)
Tasks:
- Ensure completeness and accuracy of health records
- Understand payer-specific guidelines
- Identify patient safety indicators (PSIs) and hospital-acquired conditions (HACs) based on the provider’s documentation
- Ensure compliance with HIPAA guidelines
- Ensure adherence to AHIMA Standards of Ethical Coding 6. Ensure compliance with the Uniform Hospital Discharge Data Set (UHDDS)
Domain 5 – Information Technologies (9-11%)
Tasks:
- Distinguish various types of Electronic Health Records (EHR)
- Demonstrate a basic understanding of encoding and grouper software
- Exhibit an understanding of computer-assisted coding (CAC) software and its impact on coding
- Ensure compliance with HITECH guidelines