Certification
Certified Outpatient Coder
Services
Outpatient hospital/facility services
About
The Certified Outpatient Coder (COC) is the only standalone outpatient coding credential in the healthcare industry.
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The Certified Outpatient Coder (COC) is the only standalone outpatient coding credential in the healthcare industry. The COC certification exam tests the competencies required to perform the job of an outpatient facility coder. Individuals earning the credential have proven expertise in outpatient documentation review, abstract outpatient care encounters (eg, emergency department, outpatient hospitals, and ASCs), coding proficiency with CPT®, HCPCS Level II and ICD-10 CM and outpatient payment methodologies.
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Skills
- Expertise in medical record review to abstract information required to support accurate outpatient coding.
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- Expertise in medical record review to abstract information required to support accurate outpatient coding.
- Ability to identify documentation deficiencies and properly query providers for proper code capture.
- Proficiency in assigning accurate medical codes for diagnoses, procedures and services performed in the outpatient setting (emergency department visits, outpatient clinic visits, same day surgeries, diagnostic testing (radiology and laboratory), and outpatient therapies (physical therapy, occupational therapy, speech therapy, and chemotherapy).
- Proficiency across a wide range of services, including evaluation and management, surgical services, radiology, pathology, and medicine.
- Knowledge of coding rules and regulations along with proficiency on issues regarding medical coding, compliance, and reimbursement under outpatient grouping systems. COC’s can better handle issues such as medical necessity, claims denials, bundling issues, and charge capture.
- Ability to integrate coding and reimbursement rule changes in a timely manner to include updating the > Charge Description Master (CDM), fee updates, and the Field Locators (FL) on the UB04.
- Correctly completing a CMS 1500 for ASC services and UB04 for outpatient services, including the appropriate application of modifiers.
- Knowledge of anatomy, physiology, and medical terminology commensurate with ability to correctly code provider services and diagnoses.
- Superior knowledge of current rules, regulations, and issues regarding medical coding, compliance, and reimbursement under OPPS.
- Strong ability to integrate coding and reimbursement rule changes in a timely manner to include updating the Charge Description Master (CDM), code updates, and the Field Locators (FL) on the UB04 for proper reimbursement.
- Solid understanding of anatomy, physiology, and medical terminology required to correctly code facility services and diagnoses.
- Understanding of outpatient reimbursement methodologies (OPPS) and how it differs from IPPS.
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Code Sets
CPT®, HCPCS Level II and ICD-10-CM
Location
Work in a hospital/facility or ambulatory surgical center
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