Medical Billing and Coding (Voucher Included)

Medical coders translate patient care into current procedural terminology (CPT) codes. Their primary responsibility is to ensure that the medical services provided are accurately coded. Medical billers are responsible for creating a claim based on the codes a medical coder provides.

Entry-level positions typically require completion of a certificate or an associate degree program in medical billing and coding. Additionally, medical billing and coding professionals must understand the Health Insurance Portability and Accountability Act (HIPAA).

In most cases, it takes between one and three years to become a medical biller and coder. Earning a medical billing and coding certification can take up to one year. While earning an associate degree can take up to three years.

Yes. However, this will vary depending on the healthcare organization that one works for and their level of experience within the medical billing and coding profession.

U.S. News and World Report ranked medical records technician (professionals that perform medical billing, medical coding or both) as #9 on its list of “25 Best Jobs that Don’t Require a College Degree," #12 in “Best Health Care Support Jobs” and on the “The 100 Best Jobs” list.

1. Medical Terminology
   1. Introduction to Medical Terminology
   2. The Musculoskeletal System
   3. The Cardiovascular System
   4. The Lymphatic and Immune Systems
   5. The Respiratory System
   6. The Digestive System
   7. The Urinary System
   8. The Nervous System
   9. The Special Senses The Eyes and Ears
   10. The Integumentary System
   11. The Endocrine System
   12. The Reproductive System
   13. Diagnostic Procedures, Nuclear Medicine, Pharmacology
2. Medical Billing and Coding
   1. Introduction to Medical Billing and Coding
      1. Career Opportunities
      2. Personal and Technical Qualifications
      3. Employment Settings
      4. Telecommunications
      5. Professional Certifications
   2. Introduction to Health Insurance
      1. Health Insurance Terminology
      2. Commercial and Government Payers
      3. Healthcare Documentation
      4. Electronic Health Record
   3. Managed Healthcare
      1. Types of Reimbursement
      2. Managed Care Providers
      3. Managed Care Models
      4. Consumer-Directed Health Plans
   4. Revenue Cycle Management
      1. Phases of Revenue Cycle Management
      2. Encounter Form, Chargemaster
      3. Insurance Claim Cycle
      4. New Patient Registration
      5. Collection Practices
   5. Legal Aspects of Health Insurance and Reimbursement
      1. Laws Affecting Healthcare
      2. Protected Health Information
      3. Health Insurance Portability and Accountability Act (HIPAA)
      4. Fraud and Abuse in Medical Billing and Coding
      5. Release of Information
   6. VI. ICD-10-CM Coding
      1. Overview of ICD-10-CM
      2. Key Features
      3. Organization of the Codebook
      4. Index to Diseases and Injuries
      5. Tabular List of Diseases and Injuries
      6. Coding Conventions
      7. Official Guidelines
   7. CPT Coding
      1. Overview of Healthcare Common Procedure Coding System (HCPCS)
      2. Category I, Category II, and Category III Codes
      3. Organization of the Codebook
      4. Main CPT Sections
      5. Evaluation and Management
      6. Anesthesia
      7. Surgery
      8. Radiology
      9. Pathology and Laboratory
      10. Medicine
      11. Code Modifiers
   8. HCPCS Level II Coding
      1. Overview of HCPCS Level II
      2. Organization of the Codebook
      3. Durable Medical Equipment
   9. ICD-10-PCS Coding
      1. Overview of ICD-10-PCS
      2. Code Structure
      3. Definitions
      4. Index
      5. Code Tables
      6. Coding Steps
   10. Pharmacology for Coders
       1. Pharmacodynamics and Pharmacokinetics
       2. Routes of Administration
       3. Drug Classifications
       4. Prescription Drugs and Over-the-Counter Drugs
       5. Controlled Substances
       6. Medication Lists and the Electronic Health Record
   11. Clinical Documentation Improvement (CDI)
       1. Deficiencies in Documentation
       2. Medical Necessity
       3. Auditing
       4. Coding From Patient Documentation
   12. Insurance Claims
       1. National Uniform Claim Committee
       2. CMS-1500 Claim Form
       3. Patient and Insured Information
       4. Physician or Supplier Information
       5. UB-04 Claim Form
   13. Commercial Insurance
       1. Individual/Group Health Insurance, Automobile, Disability, Liability, Workers' Compensation
       2. Completing Commercial Health Insurance Claims
   14. Blue Cross Blue Shield
       1. History of BCBS
       2. Types of BCBS Plans
       3. Participating/Nonparticipating Providers
       4. BCBS Billing and Payment Guidelines
   15. Medicare
       1. Medicare Eligibility
       2. Medicare Part A, B, C, and D
       3. National Coverage Determinations/Local Coverage Determinations
       4. Participating/Nonparticipating Providers
       5. Physician Fee Schedule
       6. Medicare Billing and Payment Guidelines/NCCI
   16. Medicaid, CHIP, TRICARE, Workers' Compensation
       1. Medicaid
       2. Children's Health Insurance Program (CHIP)
       3. TRICARE
       4. Workers' Compensation
   17. Certification
       1. Selecting the Right Certification
       2. Study Strategies for the Certification Exam
       3. Prior to the Exam
       4. Morning of the Exam
       5. During the Exam
   18. How to Find a Job in Medical Billing and Coding
       1. Formulating Your Career Goals
       2. What Employers Want
       3. Showcasing Your Skills
       4. Resume Tips
       5. Cover Letter Tips
       6. Interview Questions
3. FINAL