PACE NONCREDIT COURSE:
Medical Billing and Coding (Voucher Included)
Areas of Study
Course Type
Overview
Hours: 370 | Duration: 12 months
Whether you’re just starting work or transitioning into a different field, there has never been a better time to enter a career in Medical Billing and Coding. This course will prepare you for success in this rewarding career as you learn about legal, ethical, and regulatory concepts central to this field, including HIPAA compliance, official coding guidelines, and third-party payer requirements. You will also be able to choose a voucher for the professional certification that best aligns with your interests and career goals.
More than one million practicing physicians in the United States rely on medical billers and coders to receive payment for their services. Besides medical facilities, positions are available with health insurance companies, specialty pharmacies, medical suppliers, consulting firms, and national medical coding and billing companies, so the opportunities are nearly endless!
Medical billers and coders are in high demand. This course offers valuable training in legal, ethical, and regulatory concepts central to this field, including HIPAA compliance, official coding guidelines, and third-party payer requirements. You will also come to understand all phases of the revenue cycle—from patient registration through medical coding, claims submission, reimbursement, and collections. You will also learn common medical terminology to help you converse with others in healthcare easily and with confidence. You will study word parts and the structures and functions of the human body. Also presented are the disorders and medical procedures common to each body system, including musculoskeletal, cardiovascular, respiratory, digestive, nervous, endocrine, integumentary, genitourinary, lymphatic, and immune.
After successfully completing the course requirements, you should be well prepared to find your place in this rewarding healthcare career. You will receive a Certificate of Completion from the school through which you enrolled, and you will also be able to choose a voucher for the professional certification that best aligns with your interests and career goals.
- Certified Professional Coder (CPC) exam offered by the American Academy of Professional Coders (AAPC)
- Certified Coding Associate (CCA) exam offered by the American Health Information Management Association (AHIMA)
- Certified Billing and Coding Specialist (CBCS) exam offered by the National Healthcareer Association (NHA)
Disclaimer: To qualify for the externship applications process, students must successfully complete the online course content and have account balances up to date (at a minimum). Going through the externship application process does not guarantee an externship. COVID may be affecting the externship process or site availability in your area. Students can begin researching the steps of the application process 2 weeks prior to completing courses.
Curriculum
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- Medical Terminology
- Introduction to Medical Terminology
- The Musculoskeletal System
- The Cardiovascular System
- The Lymphatic and Immune Systems
- The Respiratory System
- The Digestive System
- The Urinary System
- The Nervous System
- The Special Senses The Eyes and Ears
- The Integumentary System
- The Endocrine System
- The Reproductive System
- Diagnostic Procedures, Nuclear Medicine, Pharmacology
- Medical Billing and Coding
- Introduction to Medical Billing and Coding
- Career Opportunities
- Personal and Technical Qualifications
- Employment Settings
- Telecommunications
- Professional Certifications
- Introduction to Health Insurance
- Health Insurance Terminology
- Commercial and Government Payers
- Healthcare Documentation
- Electronic Health Record
- Managed Healthcare
- Types of Reimbursement
- Managed Care Providers
- Managed Care Models
- Consumer-Directed Health Plans
- Revenue Cycle Management
- Phases of Revenue Cycle Management
- Encounter Form, Chargemaster
- Insurance Claim Cycle
- New Patient Registration
- Collection Practices
- Legal Aspects of Health Insurance and Reimbursement
- Laws Affecting Healthcare
- Protected Health Information
- Health Insurance Portability and Accountability Act (HIPAA)
- Fraud and Abuse in Medical Billing and Coding
- Release of Information
- VI. ICD-10-CM Coding
- Overview of ICD-10-CM
- Key Features
- Organization of the Codebook
- Index to Diseases and Injuries
- Tabular List of Diseases and Injuries
- Coding Conventions
- Official Guidelines
- CPT Coding
- Overview of Healthcare Common Procedure Coding System (HCPCS)
- Category I, Category II, and Category III Codes
- Organization of the Codebook
- Main CPT Sections
- Evaluation and Management
- Anesthesia
- Surgery
- Radiology
- Pathology and Laboratory
- Medicine
- Code Modifiers
- HCPCS Level II Coding
- Overview of HCPCS Level II
- Organization of the Codebook
- Durable Medical Equipment
- ICD-10-PCS Coding
- Overview of ICD-10-PCS
- Code Structure
- Definitions
- Index
- Code Tables
- Coding Steps
- Pharmacology for Coders
- Pharmacodynamics and Pharmacokinetics
- Routes of Administration
- Drug Classifications
- Prescription Drugs and Over-the-Counter Drugs
- Controlled Substances
- Medication Lists and the Electronic Health Record
MIDTERM
- Clinical Documentation Improvement (CDI)
- Deficiencies in Documentation
- Medical Necessity
- Auditing
- Coding From Patient Documentation
- Insurance Claims
- National Uniform Claim Committee
- CMS-1500 Claim Form
- Patient and Insured Information
- Physician or Supplier Information
- UB-04 Claim Form
- Commercial Insurance
- Individual/Group Health Insurance, Automobile, Disability, Liability, Workers’ Compensation
- Completing Commercial Health Insurance Claims
- Blue Cross Blue Shield
- History of BCBS
- Types of BCBS Plans
- Participating/Nonparticipating Providers
- BCBS Billing and Payment Guidelines
- Medicare
- Medicare Eligibility
- Medicare Part A, B, C, and D
- National Coverage Determinations/Local Coverage Determinations
- Participating/Nonparticipating Providers
- Physician Fee Schedule
- Medicare Billing and Payment Guidelines/NCCI
- Medicaid, CHIP, TRICARE, Workers’ Compensation
- Medicaid
- Children’s Health Insurance Program (CHIP)
- TRICARE
- Workers’ Compensation
- Certification
- Selecting the Right Certification
- Study Strategies for the Certification Exam
- Prior to the Exam
- Morning of the Exam
- During the Exam
- How to Find a Job in Medical Billing and Coding
- Formulating Your Career Goals
- What Employers Want
- Showcasing Your Skills
- Resume Tips
- Cover Letter Tips
- Interview Questions
- Introduction to Medical Billing and Coding
- Medical Terminology
FINAL
Course Requirements
Requirements: Hardware Requirements: Software Requirements: Other: Instructional Material Requirements: The instructional materials required for this course are included in enrollment. The following textbook, workbook, and codebooks will be shipped to you approximately 7-10 business days after enrollment: Choice of study guide/voucher package upon course completion: Please Note: You will receive a digital book if the physical book is on backorder. *The course includes the current year of coding books, and you will be responsible for purchasing your updated coding books from year to year.