Medical Billing & Coding Professional Program

Price: 
$3,000.00
Category: 
Medical & Healthcare
Combined Hours: 
540
Course Type: 
Mentor Supported
  • Description
  • Objectives
  • Outline
  • Materials
  • Certification
  • System Requirements
  • Watch a Demo

Our Medical Billing & Coding Professional program prepares individuals for a rewarding career in the medical billing field, while also teaching about the anatomy and physiology of the body. 

Medical Billing

Medical Billing is listed as one of the fastest growing professions in allied health. The medical industry is experiencing a tremendous demand for individuals with knowledge of medical office operations, which includes diagnostic and procedural insurance forms processing. This Medical Billing course covers all the plans that are most commonly encountered in clinics and physicians' offices. An emphasis on the role of the medical insurance specialist prepares you for success in the workplace, including areas such as diagnostic coding, procedural coding, Medicare, HIPAA and bill collection strategies. Our Medical Billing course will give you the skills you need to be competitive in the healthcare marketplace.

Prerequisite(s): None

Medical Coding

Medical Coding is listed as one of the fastest growing professions in allied health. The medical industry is experiencing a tremendous demand for individuals with knowledge of medical office operations, which includes diagnostic and procedural coding. Take your first step toward a successful career in medical coding with comprehensive coverage from one of the most trusted programs in the field! This Medical Coding course is practical and shows you exactly how to code using all of today's coding systems by providing an in-depth introduction to essential coding concepts. In addition to coverage of reimbursement, CPT, HCPCS, and inpatient coding, this course offers complete coverage of the ICD-10-CM diagnosis coding system. No other course on the market so thoroughly prepares you for all coding systems in one course!

Prerequisite: Solid knowledge of Medical Terminology and Anatomy & Physiology. If you do not know Medical Terminology or Anatomy & Physiology you can take one or both of our additional courses.

** Course Subject to Change.

Medical Billing

After completing this course, you should be able to:

  • Identify the core elements of health insurance
  • List features of the different coding systems and their documentation
  • Define the features of processing claim forms both electronic and paper
  • Recall the basics of fee and insurance collection
  • Recognize the features of various health care payer types

Medical Coding

After completing this course, you should be able to:

  • Identify the core elements of the ICD-10-CM coding system
  • Recognize the conventions and guidelines of the ICD-10-CM coding system
  • List the conventions and guidelines of the HCPCS coding system
  • Define the fundamental uses and guidelines of the CPT coding system
  • Recall the use of modifiers and evaluation and management services (E/M)

Medical Billing

Medical Billing Module 1
Career Role and Responsibilities
Background of Insurance Claims, Coding, and Billing
Role of The Insurance Billing Specialist
Professionalism
Health Insurance Portability and Accountability Act
Transactions and Code Sets
National Identifiers
Compliance Defined
Fraud and Abuse Laws
Compliance Audits and Oversight
 
Medical Billing Module 2
Basics of Health Insurance, Medicare, and Medicaid
History of Health Insurance in the United States
Health Care Reform
Private Health Insurance
Managed Care
Medicare Policies and Regulations
Additional Insurance Programs
Medicaid Programs
Medicaid Eligibility
 
Medical Billing Module 3
Tricare, Workers’ Compensation, and Disability Income Insurance
History of Tricare
Tricare Authorized Providers
Tricare Health Plans
Workers’ Compensation Defined
Workers’ Compensation Insurance Programs
Workers’ Compensation Eligibility
Disability Income Insurance Defined
History of Disability Income Insurance
Disability Income Insurance Policies
 
Medical Billing Module 4
Medical Documentation and Coding Part I
The Documentation Process
Release and Retention of Records
Abstracting from Health Records
Review and Audit of Health Records
Diagnosis Coding Overview
International Classification of Diseases
Assigning a Diagnosis Code
Organization and Format of ICD-10-CM
 
Medical Billing Module 5
Coding Part II
Understanding the Importance of Procedural Coding Skills
Current Procedural Terminology Content and Format
Surgery Guidelines
Code Modifiers
Healthcare Common Procedure Coding System
HCPCS Level II Code Categories
Modifiers
Reimbursement for HCPCS Codes
 
Medical Billing Module 6
Claims Submission
The Paper Claim CMS 1500
Types of Submitted Claims
Abstracting from Medical Records
Basic Guidelines for Submitting a Health Insurance Claim Form (CMS 1500)
The Electronic Claim
Standard Unique Identifiers
Building the Electronic Claim
Follow-Up of Electronic Claims Processing
 
Medical Billing Module 7
Revenue Cycle Management
Claim Policy Guidelines
Explanation of Benefits
Claim Management Techniques
Claim Inquiries
Collection Strategies
Patient Education
Collecting Fees
Self-Pay Billing
 
Medical Billing Module 8
Health Care Facility Billing and Employment
History of Health Care Facilities
Types of Health Care Facilities
Regulation of Health Care Facilities
Introduction to Facility Billing
Outpatient and Inpatient Diagnosis Coding Guidelines
Introduction to Inpatient Facility Procedure Coding
Employment Opportunities
Professional Organizations
Self-Employment

**Outlines are subject to change, as courses and materials are updated.**

Medical Coding

Medical Coding Module 1
Overview of ICD-10-CM

  • Reimbursement, HIPAA and Compliance
  • Basic Structure of the Medicare Program
  • Improvements to the ICD-10-CM
  • ICD-10-CM Format
  • Mapping
  • Outpatient Coding and Reporting Guidelines
  • Unconfirmed Diagnosis
  • Z Codes
  • Chronic Diseases
  • Therapeutic Services

Medical Coding Module 2     
Using ICD-10-CM

  • Accurate Coding
  • Alphabetic Index and Tabular List
  • Level of Specificity
  • Integral Conditions
  • Multiple Coding
  • Chapter Specific Guidelines Chapters 1-10
  • Endocrine, Nutritional and Metabolic Diseases
  • Diseases of the Nervous System
  • Diseases of the Circulatory System
  • Diseases of the Respiratory System

Medical Coding Module 3     
Chapter-Specific Guidelines

  • Diseases of the Digestive System
  • Diseases of the Skin and Subcutaneous Tissue
  • Diseases of the Musculoskeletal System and Connective Tissue
  • Pregnancy, Childbirth and Puerperium
  • Congenital Malformations, Deformations and Chromosomal Abnormalities
  • Symptoms, Signs and Abnormal Clinical and Laboratory Findings
  • Injury and Poisoning

Medical Coding Module 4    
CPT, HCPCS and Modifiers

  • The Purpose of the CPT Manual
  • Updating the CPT Manual
  • CPT Manual Format
  • Level II National Codes (HCPCS)
  • History of National Level Codes
  • Updating the HCPCS Manual
  • National Physician Fee Schedule
  • CPT Modifiers

Medical Coding Module 5  
E/M Services and Anesthesia

  • Contents of the E/M Section
  • Three Factors of E/M Codes
  • Various Levels of E/M Service
  • An E/M Code Example
  • Using the E/M Codes
  • Documentation Guidelines
  • Types of Anesthesia
  • Anesthesia Section Format
  • Formula for Anesthesia Payment
  • Concurrent Modifiers

Medical Coding Module 6   
Surgery Guidelines and Integumentary System

  • Surgery Section
  • Notes and Guidelines
  • Special Reports
  • Separate Procedure
  • Surgical Package
  • Skin, Subcutaneous and Accessory Structures
  • Burns
  • Destruction
  • Breast Procedures

Medical Coding Module 7
Musculoskeletal and Respiratory Systems

  • Fractures and Dislocations
  • Application of Casts and Strapping
  • Endoscopy
  • Arthroscopy
  • Accessory Sinuses
  • Larynx
  • Trachea
  • Bronchi Lungs and Pleura

Medical Coding Module 8
Cardiovascular, Hemic, Lymphatic and Digestive Systems

  • Cardiovascular Coding in the Surgery Section
  • Cardiovascular Coding in the Medicine Section
  • Cardiovascular Coding in the Radiology Section
  • Hemic and Lymphatic Systems
  • Mediastinum and Diaphragm
  • Lips
  • Vestibule of Mouth
  • Salivary Glands and Ducts
  • Pharynx, Adenoids and Tonsils
  • Intestines

Medical Coding Module 9
Urinary, Reproductive and Genital Systems

  • Urinary System
  • Male Genital System
  • Intersex Surgery
  • Reproductive System Procedures
  • Male and Female Genital Systems
  • Maternity Care and Delivery

Medical Coding Module 10
Endocrine System, Eye, Ocular Adnexa and Radiology

  • Nervous System
  • Auditory System
  • Operating Microscope
  • Radiology Terminology
  • Diagnostic Radiology
  • Breast Mammography
  • Diagnostic Ultrasound
  • Radiation Oncology

Medical Coding Module 11
Pathology/Laboratory, Medicine and Inpatient Coding

  • Organ or Disease Oriented Panels
  • Therapeutic Drug Assays
  • Urinalysis, Molecular Pathology and Chemistry
  • Immunizations
  • Gastroenterology
  • Allergy and Clinical Immunology
  • Medical Nutrition Therapy
  • Medication Therapy Management Services
  • Differences between Inpatient and Outpatient Coding
  • Present on Admission (POA)

**Outlines are subject to change, as courses and materials are updated.**

Ed4Career is committed to being both environmentally conscious and making it easier for you to study! We’re making your education mobile! All of our textbooks are now provided as eTextbooks*. You can access them on your laptop, tablet, or mobile device and can study anytime, anywhere.

The move away from physical books to eTextbooks means you get the latest, most up-to-date version available. This also makes your training more accessible, so you can study anywhere you have your phone or tablet. The best part is that all materials are included in your training cost so there are NO extra fees for books!**

*A few courses still have physical materials.
 

Medical Billing

Upon successful completion of our Medical Billing course, students will be prepared for an entry-level position doing medical billing in a medical office setting and will be prepared to sit for the Med-Certification exam to become a Certified Medical Billing Specialist (CBS) or the AAPC certification exam to become a Certified Professional Biller (CPB).

Medical Coding

Upon successful completion of our Medical Coding course, students will be prepared for an entry-level position doing medical coding in a medical office setting and will be prepared to sit for the AHIMA national certification exam to become a Certified Coding Associate (CCA).

** Certification exams are not included in the cost of the course.**

Internet Connection

  • Broadband or High-Speed - DSL, Cable, and Wireless Connections

*Dial-Up internet connections will result in a diminished online experience. Classroom pages may load slowly and viewing large audio and video files may not be possible.

Hardware Requirements

  • Processor - 2GHz Processor or Higher
  • Memory - 1 GB RAM Minimum Recommended

 

PC Software Requirements

  • Operating Systems - Windows 7 or higher
  • Microsoft Office 2013 or higher. Also, you could use a general Word Processing application to save and open Microsoft Office formats (.doc, .docx, .xls, .xlsx, .ppt, .pptx)
  • Internet Browsers - Google Chrome is highly recommended
    • Cookies MUST be enabled
    • Pop-ups MUST be allowed (Pop-up Blocker disabled)
  • The Kindle Reader App or VitalSource Bookshelf App are needed for many of our courses (No special equipment needed. This can be downloaded for FREE onto your computer.)
  • PowerPoint Viewer (if you do not have PowerPoint)
  • Adobe PDF Reader
  • QuickTime, Windows Media Player &/or Real Player

 

MAC Software Requirements

  • Operating Systems - Mac OS x 10 or higher with Windows
  • Mac office programs or a Word Processing application to save and open Microsoft Office formats (.doc, .docx, .xls, .xlsx, .ppt, .pptx)
  • Internet Browsers- Google Chrome is highly recommended
    • Cookies MUST be enabled
    • Pop-ups MUST be allowed (Pop-up Blocker disabled)
  • The Kindle Reader App or VitalSource Bookshelf App are needed for many of our courses (No special equipment needed. This can be downloaded for FREE onto your computer.)
  • PowerPoint Viewer (if you do not have PowerPoint)
  • Adobe PDF Reader
  • Apple QuickTime Media Player