Cost:

Free for HFMA Members
$399 for Non-members

Delivery Method:

Self Study

Course Availability:

12 Months

Recommended for:

Auditing
Claims
Healthcare Revenue Integrity
Managed Care
Reimbursement

Career level:

Experienced Professional

Audience:

Business Partners
Health Plans
Hospitals and Other Providers
Physicians and Other Practitioners

Advance Preparation:

The coursework to prepare for the CICA assessment is available through Career Step LLC

Prerequisites:

Is intended for experienced coding professionals with at least 3 years of acute care inpatient codin
Q&A | Coding

Common coding pitfalls and best practices for accountable care organizations are discussed in this Q&A.

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Trend | Coding

What are highlights of the ICD-10 FY19 changes?

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In 2019, changes to ICD-10 coding can impact healthcare provider payments going forward.

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Certification | Advanced | Coding

Certified Inpatient Coding Auditor (CICA)

Certification | Advanced | Coding

Certified Inpatient Coding Auditor (CICA)

Description

The HFMA Certified Inpatient Coding Auditor (CICA) certification validates and acknowledges the expertise of the inpatient coding auditor professional. Certified inpatient coding auditors can help your organization ensure coding accuracy, increase reimbursements, and improve overall revenue cycle performance. The CICA certification is the only certification currently available to impatient coding auditors and it tests across all coding auditor responsibilities, including:
  • Documentation and coding accuracy and specificity
  • DRG assignment, case mix index, quality initiatives, MACs, RACs
  • The impact of accurate documentation and coding on overall revenue cycle
  • Compliance

The coursework to prepare for the Certified Impatient Coding Auditor assessment is available through HFMA's collaboration with Career Step LLC. The fee for this coursework is processed by Career Step LLC and is not included as part of your HFMA membership.

The CICA certification assessment is hosted by HFMA. It is comprised on 150 multiple choice questions and must be completed within 3 hours. If participants do not pass the certification assessment on the first attempt, participants can have another attempt after a mandatory 30-day waiting period. A certificate of completion suitable for framing may be downloaded upon successful completion of the assessment. Recertification is required every two years (a minimal fee is charged for non-members).
After this program, you'll be able to..
  • Apply ICD-10-CM coding guidelines
  • Apply ICD-10-CM documentation requirements
  • Review skills required for complete ICD-10-CM coding and accurate reimbursement
  • Apply ICD-10-PCS coding guidelines
  • Apply ICD-10-PCS documentation requirements
  • Review skills required for completed ICD-10-PCS coding and accurate reimbursement
  • Describe the fundamentals of hospital inpatient auditing
  • Identify various audit types including internal and external, and random versus focused
  • Explain how to scope an audit based on audit type
  • Articulate how to analyze data and look for problem areas for targeted audits
  • Explain the impact of documentation on quality and reimbursement
  • Describe the difference between optimization and maximization
  • Understand clinical indicators, common treatments, and documentation requirements for common conditions in the major diagnostic categories (MDCs).
  • Identify HACs
  • Describe the high-risk, error-prone MS-DRGs
  • Understand what it takes to complete a successful audit
  • Understand the common, high-risk errors identified during an audit
  • Understand what impacts an MS/APR DRG
  • Explain the difference between Comorbidities (CCs) and Major Comorbidities (MCCs) and their impact on DRG assignment
  • Understand Case Mix Index (CMI) and how it is affected by DRGs
  • Explain the importance of Severity of Illness (SOI) and Risk of Mortality (ROM) and the impact on hospital/physician profiling
  • Understand the documentation requirements to support ICD-10 code specificity 
  • Understand and explain DRG hierarchy and optimization
  • Understand specific DRG scenarios and documentation requirements
  • Explain the impatient prospective payment system
  • Understand the Medicare Base Rate and how it is used with DRG calculations
  • Define HIPAA
  • Identify components of the Code of Ethics and Standards of Ethical Coding
  • Describe compliance risks
  • Sharpen written communication skills in a business context
  • Analyze information for clearly describe problems
  • Identify appropriate solutions
  • Communicate effectively using verbal and non-verbal technique
  • Develop key leadership skills, including techniques, for coaching, motivating, and delivering feedback
  • Describe healthcare law fundamentals
  • Explain upcoming and other high-risk billing practices

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