Main Content Start
Medical Billing and Coding Course
Enroll in this online Medical Billing and Coding course and train for an in-demand healthcare career in medical billing and coding and prepare for industry certification.
Overview:
In this course, you will 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 learn about all phases of the revenue cycle - from patient registration through medical coding, claims submission, reimbursement and collections.
The course will teach you common medical terminology, word parts and the structures and functions of the human body. The course also touches on the disorders and medical procedures common to each body system, including musculoskeletal, cardiovascular, respiratory, digestive, nervous, endocrine, integumentary, genitourinary, lymphatic and immune.
More than one million practicing physicians in the United States rely on medical billers and coders to receive payment for their services. Outside of 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!
Completion:
After successfully completing the course requirements, you will receive a Certificate of Completion and 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)
What You'll Learn
- Medical Billing and Coding
- Medical coding terminology is required for medical coding, including the structures and functions of the human body
- The disorders and medical procedures common to each body system
- Legal, ethical, and regulatory concepts central to the field, including HIPAA compliance and third-party guidelines for filing insurance claims
- The main coding manuals: ICD-10-CM, ICD-10-PCS, CPT, and HCPCS Level II
- How to code diagnoses, services, and procedures for all systems of the body
- Fundamentals of medical billing & coding and medical terminology
- Word parts and the structures and functions of the human body
How You Will Benefit
- Get hands-on, practical experience in medical billing and coding that will help you on the job
- Receive a certificate of completion and prepare to sit for the professional certification that best aligns with your interest and career goals
- Receive a voucher for the professional certification exam of your choice
- Receive access to study materials that align with the exam option you choose
- 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)
Syllabus
- 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
- 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
FINAL - Introduction to Medical Billing and Coding
Requirements
Hardware Requirements:
- This course can be taken on either a PC, Mac, or Chromebook.
Software Requirements:
- PC: Windows 8 or later.
- Mac: macOS 10.6 or later.
- Browser: The latest version of Google Chrome or Mozilla Firefox is preferred. Microsoft Edge is also compatible.
- Microsoft Word or equivalent (not included with enrollment)
- Adobe Acrobat Reader.
- Software must be installed and fully operational before the course begins.
Other:
- Email capabilities and access to a personal email account.
Instructional Material Requirements:
The instructional materials required for this course are included in enrollment. The following digital textbook for the Medical Terminology are accessed via links in the lessons:
- Medical Terminology for Health Professions (eBook)
The following digital textbooks for Medical Billing and Coding are accessed via links in the lessons:
- Understanding Health Insurance: A Guide to Billing and Reimbursement, by Michelle A. Green
- Accompanying Workbook: Understanding Health Insurance: A Guide to Billing and Reimbursement
The following textbooks will be shipped to you approximately 7-10 business days after enrollment in Medical Billing and Coding:
- ICD-10-CM Expert for Physicians
- CPT Professional
- HCPCS Level II Professional
Choice of study guide/voucher package upon course completion:
- CBCS Study Guide
- Professional Review Guide for the CCA Examination and ICD-10-PCS Expert
- Official CPC Certification Study Guide
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.
Certification Requirements:
In order to sit for national certification exams, candidates must have a high school diploma or equivalent. Therefore, it is recommended you have this before enrolling in this course. Certification exams offered by AAPC and NHA are only available online to candidates located in the US. AHIMA only offers in-person exams in both the US and Globally.
Prerequisites
There are no prerequisites to take this course.
Instructor
Nancy Smith
Nancy Smith has over 30 years of experience in the healthcare industry. Her clinical experience includes working as a medical assistant for a network of rural health clinics, and as a medical coder, insurance claims specialist, and medical records auditor. She worked as a medical office manager for ten years, where she recruited and trained all medical assistants. Nancy holds a bachelor's degree in vocational education and has developed and taught medical assistant programs.
LaTisha Cottingham
LaTisha Cottingham has over 20 years of experience in the healthcare industry. She has six years of teaching experience in the field of medical billing and coding and Medical Assisting. Currently, she is employed as an HIM Analyst for a Long-Term Care establishment that is based out of Alabama. Previously she was employed as the lead instructor for the Allied Health Department for a local career institute. LaTisha's field of expertise is in the area of physician-based inpatient coding and Emergency Department coding. The certifications that she holds are as follows: a Registered Health Information Technician (RHIT), a Certified Professional Coder (CPC), and a Certified Clinical Medical Assistant (CCMA). In preparation for ICD-10-CM, LaTisha received her ICD-10-CM/PCS Trainer Certification from American Health Information Association (AHIMA), where she is currently a member. LaTisha is also a member of the American Academy of Professional Coders (AAPC) and the National Healthcare Association (NHA) where she is a test proctor.
Carline Dalgleish
Carline Dalgleish has worked in medical office administration for over 30 years. She holds a bachelor's degree in Business Information Systems, a master's degree in Leadership, and a post-baccalaureate certificate in Health Information Management. She is a Registered Health Information Administrator and an AHIMA Approved ICD-10-CM/PCS Trainer. Dalgleish is the author of an ICD-10 coding system and owns her own consulting firm.
Lydia S. Stewart
Lydia S. Stewart, RN, BSN, currently serves as the Revenue Cycle Manager at a large regional medical center. Lydia has been a Registered Nurse for 23 years, 15 of those years specializing in Critical Care Nursing and supervision. She is responsible for Medical Audits, Charge Capture, and governmental compliance audits and reviews. Lydia is a member of the Louisiana Medical Auditor Association and Healthcare Financial Management Association (HFMA).
Bunny Reeves
Bunny Reeves is the senior ambulatory surgery coder at the Maimonides Medical Center in Brooklyn, New York. She trains student coders at Maimonides Medical Center and previously trained and supervised entry-level coders at Staten Island's St. Vincent Medical Center. Reeves is a Certified Coding Specialist, accredited by the American Health Information Management Association (AHIMA).
Sharon L. Blackford
Sharon L. Blackford, MA, BA, RMA, has over 30 years of experience in the medical field. She has a Master's degree in Organizational Management, a Bachelor's degree in Business Management, and has served as a Registered Medical Assistant since 1994. Sharon was an active duty Clinical Specialist in the U.S. Army for 10 years. Sharon later moved to the Gulf Coast to accept a position as the Director of Education of Blue Cliff College and was promoted to Campus Director.
Stacey O'Brien
Stacey O'Brien has more than 10 years of experience in medical coding and reimbursement. Ms. O'Brien has been a risk adjustment coder for a Medicare advantage plan, audited medical records for a consulting firm, and currently supervises the coding and electronic claims submission process for a group medical practice. She has a bachelor's degree from the University of Pittsburgh and a CPC coding certification from the AAPC.