Medical Coding and Billing

Students learn the fundamentals of medical coding and are prepared to take the Certified Professional Coder (CPC®) exam from the American Association of Professional Coders (AAPC). Course topics include medical terminology, anatomy and physiology, pathophysiology and pharmacology, computer applications in healthcare technologies, insurance plans; medical ethics; HIPAA; diagnostic and procedural coding; coding compliance and auditing; physician and hospital billing; Medicare, Medicaid, and TRICARE. Students receive training on ICD-10-CM/PCS, CPT, and HCPCS code assignments.

After completing the Medical Coding & Billing courses, students will be able to: 

• Outline the typical responsibilities of a medical biller/coder, describe the personal and professional ethics required for success in this profession, and describe the career opportunities available to appropriately trained personnel. 
• Describe how to build a strong base of medical terminology and use this terminology to accurately identify and describe body planes, anatomical directions, and the major structures, functions, and pathologies of all body systems. 
• Describe the purpose and impact of the Healthcare Portability and Accountability Act (HIPAA) and explain how professionals can learn about changes to the laws and regulations that affect them. 
• Compare and contrast the major types of government and commercial insurance health plans, including Medicare, Medicaid, Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Point-of-Service (POS) plans. 
• Explain the purpose of medical coding and accurately code diagnoses and procedures using industry-standard coding systems published by the World Health Organization (WHO) and the American Medical Association (AMA). 
• Accurately assign ICD-10-CM/PCS, CPT, and HCPCS codes for diagnoses, procedures, and medical services as part of the insurance reimbursement process. 
• Summarize the life cycle of a typical insurance claim and explain the processing steps that must be completed before claims and other forms can be submitted to the insurance company. 
• Describe the typical billing guidelines for inpatient