Course Code: REL-RCC-CDI-STNEO
Hours: 1.5
Type: Online Course
Content Expiration Date: 12/31/2027
Learning Objectives:
Identify documentation that supports the assignment of neoplasm-related procedure codes.
Describe the clinical documentation needed from providers to specifically support neoplasm diagnoses for coding and reporting.
Formulate appropriate queries to the provider to clarify neoplasm documentation for coding and reporting.
Apply the guidelines, conventions, and chapter-level instructional notes to assign neoplasm diagnosis codes.
Recall the documentation needed to support Medicare severity diagnosis-related group (MS-DRG), severity of illness (SOI), and present on admission (POA) assignment.
Outline:
Section 1: Introduction
Course Overview
Section 2: Neoplasm Documentation
Importance of Clinical Documentation
Locating Neoplasm Documentation
Medical Necessity Criteria
Review
Key Takeaways
Section 3: Documenting Neoplasms
Neoplasm Terminology, Characteristics, and Behavior
Identifying Sites and Relationships
Review
Key Takeaways
Section 4: Neoplasm Coding and Documentation Requirements
Neoplasms: Problematic Terminology
Neoplasm Coding and Documentation
Neoplasm Staging
Associated Conditions and Complications
Treatments and Complications
Review
Key Takeaways
Section 5: Neoplasms Coding Guidelines
Neoplasm Sequencing
Neoplasm Sequencing Exceptions
Review
Key Takeaways
Section 6: Neoplasm Reimbursement and Quality Reporting
Documentation, Reimbursement, and Quality Reporting
Review
DRG Validation
Chemotherapy, Immunotherapy, and Radiotherapy MS-DRGs
Review
Key Takeaways
Section 7: Conclusion
Course Summary
Course Contributor(s)
Resources
References
Writer: Sarah A. Serling, CCS, CPC, COC, CRC, CCS-P, CEMC, CPC-I, ICD-10-CM/PCS Trainer
Sarah is a Subject Matter Expert/Writer for Relias's Revenue Cycle and Coding online education. Sarah is credentialed by AHIMA as a Certified Coding Specialist (CCS) and Certified Coding Specialist Physician-based (CCS-P), as well as an approved ICD-10-CM/PCS Trainer. She is also credentialed by AAPC as a Certified Professional Coding Instructor (CPC-I), a certified professional coder (CPC), a certified outpatient hospital coder (COC), and a Certified Risk Adjustment Coder (CRC), with specialty certification in Evaluation and Management Services (CEMC). Sarah extensive experience in both professional and facility ICD-10-CM/PCS, CPT, and HCPCS coding, education, auditing, and revenue cycle management. She has clinical experience as an Emergency Medical Technician (EMT) and Medical Assistant (MA) and has served as Director of Physician Billing and Reimbursement for a regional health system, Manager of Coding and Compliance for a hospital and cancer center, and Business Manager of Physician Practices at a teaching hospital, as well as a coding auditor and consultant. Sarah has also authored several coding textbooks, and other instructional resources.
Subject Matter Expert: Daniel Migliaccio, MD, FPD, FAAEM
Dr. Daniel Migliaccio is currently a Clinical Associate Professor of Emergency Medicine and Director of Emergency Ultrasound as well as the Ultrasound Fellowship Director at the University of North Carolina at Chapel Hill. He completed his residency in Emergency Medicine at Stanford University. During Residency, Dr. Migliaccio was able to obtain an Honors Certificate in Medical Education from the Clinical Teaching Scholars Honors Program. He was also fortunate enough to be able to focus on his ultrasound skills, leading to an award for Outstanding Achievement in Ultrasound. Dr. Migliaccio is passionate about medical education, point-of-care ultrasound, and optimizing patient care using current literature. He is currently board-certified in point-of-care ultrasound with a Focused Practice Designation in advanced point-of-care ultrasound through the American Board of Emergency Medicine and is enthusiastic about promoting Emergency Medicine and patient care nationally. Recently, he has obtained a certificate for course work and training with Diversity, Equity, and Inclusion through the University of North Carolina School of Medicine and is passionate about providing unbiased, equitable patient-centered care.
Target Audience:
The target audience for this course is: Healthcare Billing and Coding; in the following settings: Hospitals: Acute.
Relias Learning will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Relias Learning has a grievance policy in place to facilitate reports of dissatisfaction. Relias Learning will make every effort to resolve each grievance in a mutually satisfactory manner. In order to report a complaint or grievance please contact Relias Learning at support@reliaslearning.com.
All courses offered by Relias Learning, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Course Delivery Method and Format
Asynchronous Distance Learning with interactivity which includes quizzes with questions/answers, and posttests.