Introduction

The days of scattered and poorly organised handwritten notes to process medical claims are forever counted. Efficient and effective clinical and administrative management of all patient encounters has become an essential component of good clinical patient care and coding a critical element of effective healthcare management.   

Computers are not very efficient at storing or manipulating long descriptions which are often associated with diagnoses, procedures, medicines, materials, etc.  By coding these and other descriptors, storage and computation is much more efficient.  Coding is the transformation of verbal descriptions of diseases, injuries, procedures and consumables into numeric or alphanumeric designations to streamline the computerised processes.

Without correct coding medical aids will not be able to process the encounters and insurance claims and death certification will fall by the wayside.

The course in ICD10 will give administrators and practice managers the tools to manage the claims process in a number of clearly defined healthcare output categories. Furthermore, it purports to compare the processes, costs and related outcomes of various like/similar healthcare outputs in order to determine best practice in terms of efficiency and effectiveness.  This is the core of the Cochrane concept of evidence-based medicine (EBM).

Who Should Enrol

This course is only accessible to the employees of Rand Mutual Assurance (RMA)

Learning Outcomes

At the end of this learning experience students will be able to:

  • Have a basic understanding of role players / stakeholders within the healthcare environment.
  • Have an overall understanding of the components of clinical coding.
  • Have a basic understanding of different types of claims and claim content.
  • Have a high-level view of organisational structure and roles within RMA specific to clinical coding.
  • Have an overall basic knowledge of clinical coding and specifically ICD-10.
  • Understand the basic structure and principles of ICD-10.
  • Understand the guidelines and rules for using ICD-10 coding within the South African context.
  • Understand the ICD-10 claim requirements for reimbursement.
  • Understand the method to select ICD-10 codes.
  • Be able to apply this knowledge.

 

Course Content

The following topics are included in this course:

  • Introduction to modern healthcare management
  • Understanding clinical coding, definitions and terminology, claims processing
  • ICD10 coding worldwide and in South Africa
  • Code Ethics for Clinical coding in SA
  • Guidelines of how to use clinical coding
  • Dual and or combination coding
  • Coding definitions and conventions
  • Disease specific coding - All
  • ICD claims requirements  
  • Validation rules
  • Electronic claims submission

Assessment

Participants will be assessed by means of a multiple-choice questionnaire and a pass rate of 50% is required.

Certification

Participants will be awarded a certificate of completion upon successfully completing the assessment component and attending the virtual class.

Contact

For more information, please contact:

FPD School of Health Sciences

Email: healthscience@foundation.co.za





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