This billing and coding course offers the skills needed to perform complex coding and billing procedures. The course covers: CPT (Introduction, Guidelines, Evaluation and Management), specialty fields (such as surgery, radiology and laboratory), the ICD-10 for both diagnosis and procedure coding, ICD-9 (Introduction and Guidelines) and basic claims processes for insurance reimbursements. This billing and coding program delivers the skills students need to solve insurance billing and coding problems. It details proper assignment of codes and the process to file claims for reimbursement. This course covers the following key areas and topics:
- An overview of health care and the insurance industry
- The organization and use of the ICD-9-CM, ICD-10-PCS, CPT, and HCPCS manuals to identify correct codes
- Detailed review and practice using the alphabetic index and tabular list of the ICD-9-CM
- Comparison between ICD-10 and ICD-9
- Basic claims processes for medical insurance and third-party reimbursements
- Completing common insurance forms, tracing delinquent claims, and appealing denied claims
Education and Certifications
- Students should have or be pursuing a high school diploma or GED.
- There are no state approval and/or state requirements associated with this program.
- There are several National Certification exams that are available to students who successfully complete this program:
- American Academy of Professional Coders (AAPC) Certified Professional Coder Exam (CPC or CPC-H Apprentice)
- American Health Information Association (AHIMA) Certified Coding Associate (CCA) exam
- National Health career Association (NHA) Billing and Coding Specialist Certification (CBCS)
- Introduction to International Classification of Diseases, Clinical Modifications, Coding Guidelines,
- Basics of diagnostic and procedural coding
- Introduction to the organization and use of the ICD-10, ICD-9-CM and CPT manuals
- The Health Insurance Claim Form (CMS 1500)
- Reviews of both ICD-10 (diagnostic coding) and ICD-10-PCS (inpatient procedural coding)
- Various issues surrounding the implementation of ICD-10
- HIPAA and Electronic Data Interchange (EDI)
- Review and practice coding Evaluation and Management (E&M) services
- Review and practice coding from anesthesia, surgery, radiology, medicine, and then pathology/laboratory sections of the CPT, CPT Modifiers, E and V Codes
- Coding surgical procedures of the integumentary system
- Coding procedures related to the female genital system and maternity care and delivery
- Coding for general surgery, radiology, pathology and laboratory services
- Coding for diagnostic and therapeutic services and the Level II National Codes
- Tracing delinquent claims, insurance problems & third-party reimbursement issues
Clinical Externship / Hands on Training / Practicum
Although not a requirement of this program, once students complete the Medical Billing & Coding program they have the ability to participate in a clinical externship and/or hands on practicum so as
to practice the skills necessary to perform the job requirements of a Medical Billing & Coding
professional. Students will be assisted with completing a resume and/or other requirements
necessary to work in a hospital, physicians practice, clinic and/or with other healthcare
organizations. All students who complete this program are eligible to participate in an externship
and will be placed in a healthcare organization near their location. Columbia Southern University
works with national healthcare organizations and has the ability to place students in clinical
externship opportunities nationwide.
Optional Volunteer Externship Opportunity
Learners who complete this program are eligible to participate in an optional volunteer externship opportunity with a local company/agency/organization whose work aligns with this area of study in order to gain valuable hands-on experience. As learners progress through their eLearning program, an Externship Coordinator will reach out to coordinate placement.
Note: Additional documentation including health records, immunizations, drug-screening, criminal background checks, etc. may be required by the externship facility.