Title: Introduction to Medical Billing and Coding
1Introduction to Medical Billing and Coding
2Introduction to Medical Billing and Coding
- The focus of this course is learning Medical
Terminology, Anatony and applying them to the
coding rules and regulations for the CPT,
ICD-9-CM, and Level II (HCPCS) coding systems and
then applying the rules to code patient services.
In addition, a variety of payment systems are
presented using the Medisoft billing software.
The medical topics of Medicare fraud/abuse, HMOs,
PPO, EPO, POS and HIPAA are also reviewed. -
3Truman CollegeMedical Billing and CodingCourse
Outline
- Unit 1, Medical Terminology
- Unit 2, Human Anatomy Physiology
- Unit 3, Current Procedural Terminology (CPT-4)
and HCPCS - Unit 4, International Classification of Diseases,
9th Revision, Clinical Modification (ICD-9-CM) - Unit 5, Overview of Medicare, Medicaid and
Commercial Billing and Reimbursement - Unit 6, Computerized Medical Billing with
Medisoft software -
4Truman CollegeMedical Billing and CodingCourse
Outline
-
- Unit 1,
- Medical Terminology
- Medical Terminology is the universal
communication language of the healthcare
profession. Terminology for common pathologies
(diseases) and diagnostic tests is also covered.
Medical terminology is used in healthcare in
direct patient care and in support services such
as coding and medical billing. This course
focuses on proper pronunciation, usage and
spelling of medical terms, and is required for
Medical Billing and Coding students.
5Truman CollegeMedical Billing and CodingCourse
Outline
- Unit 2,
- Human Anatomy Physiology
- A basic understanding of the anatomy and
physiology of the various body systems is the
sound foundation upon which all health care
careers are built, including those providing
direct patient care and those in support services
such as coding or medical billling. This course
examines basic anatomy (structure) and physiology
(function). Abnormal function (pathology) will be
discussed briefly as well as the most common
diagnostic tests used to identify it. This is a
required course for Medical Billing and Coding
students.
6Truman CollegeMedical Billing and CodingCourse
Outline
- Unit 3, Fundamentals of Medical Billing and
Coding - Current Procedural Terminology (CPT-4)
- HCPCS Coding System
- Identify the purpose of the CPT manual.
- Identify placement of CPT codes on CMS-1500
insurance form. - Recognize the symbols used in the CPT manual.
- List the major sections found in the CPT manual.
- Interpret information in section Guidelines and
notes. - Apply modifiers.
- Determine when to assign unlisted and Category
III codes. - State the purpose and contents of a special
report. - Locate terms in the CPT index.
- Identify content of CPT appendices.
7Truman CollegeMedical Billing and CodingCourse
Outline
- Unit 3, Fundamentals of Medical Billing and
Coding - Continuation, 2
- Identify and explain the three factors of E/M
code assignment. - Analyze the differences among new, established,
inpatient, and outpatient. - Explain the levels of E/M service.
- Analyze the key component and contributing
factors. - Identify critical elements of Documentation
Guidelines. - Define uses of anesthesia.
- Apply anesthesia formula.
- Identify the symbol used in the CPT manual.
- Understand separate procedure designation.
- Analyze the contents of a surgical package.
- Understand what is meant by a surgical tray.
- Distinguish between professional and facility
services. - Identify the major factors in wound repair.
- Calculate area and degree of burns.
8Truman CollegeMedical Billing and CodingCourse
Outline
- Unit 3, Fundamentals of Medical Billing and
Coding - Continuation, 3
- State the important coding considerations in
destruction. - Differentiate among fracture treatments.
- Understand elements of endoscopic procedures.
- Analyze cast application, strapping procedures,
and traction. - Differentiate among codes based on the surgical
approach. - State the coding rules of arteries and veins.
- Define the critical terms in maternity and
delivery services. - Analyze services in the global maternity and
delivery package. - Assign E/M codes to services and
procedures/Medisoft - Assign Anesthesia codes to services and
procedures/Medisoft - Assign Surgery codes to services and
procedures/Medisoft - Assign Radiology codes to services and
procedures/Medisoft - Assign Pathology and Laboratory codes to services
and procedures/Medisoft - Assign Medicine codes to services and
procedures/Medisoft - Demonstrate and understanding of radiology
terminology. - Analyze the elements of component coding in
reporting radiology services. - State the appropriate coding of contrast
material. - Understand the use of venipuncture with pathology
and laboratory services.
9Truman CollegeMedical Billing and CodingCourse
Outline
- Unit 4, Coding Applications
- International Classification of Diseases, 9th
Revision, Clinical Modification (ICD-9-CM)
- List the uses of the ICD-9-CM.
- Explain ICD-9-CM coding conventions.
- Identify the characteristics of ICD-9-CM Volume
2. - Identify the characteristics of ICD-9-CM Volume
1. - Identify the characteristics of ICD-9-CM Volume
3. - List the developers of the ICD-9-CM Official
Coding Guidelines. - Understand the application of the ICD-9-CM
Official Coding Guidelines. - Define the steps to ICD-9-CM diagnosis coding.
- Assign ICD-9-CM codes to various diagnosis
statements. - Understand the format of the ICD-10-CM.
- Distinguish between Medicare Parts A, B, and C.
- Define participating provider.
- Locate information in the Federal Register.
- Explain the RBRVS system.
- State the structure of the APC system.
- Understand the framework of Medicare Fraud and
Abuse. - Identify the major components of Managed Health
Care.
10Truman CollegeMedical Billing and CodingCourse
Outline
- Unit 5,
- Overview of Medicare, Medicaid and Commercial
Billing and Reimbursement
- Distinguish between Medicare Parts A, B, and C.
- Define participating provider.
- Locate information in the Federal Register.
- Explain the RBRVS system.
- State the structure of the APC system.
- Understand the framework of Medicare Fraud and
Abuse. - Identify the major components of Managed Health
Care.
11Truman CollegeMedical Billing and CodingCourse
Outline
- Unit 6,
- Computerized Medical Billing with Medisoft
software
- This course will allow you to acquire hands-on
practice with Medisoft, the country's most
popular health care billing software. Learn how
to complete inpatient information, and learn the
scheduling, billing, and electronic filing
features of Medisoft through computer
simulations. Prerequisites Completion of Intro
to Microcomputers and Keyboarding (or equivalent
training or experience), Human Anatomy and
Physiology, Medical Terminology, Fundamentals of
Medical Billing and Coding, and Coding
Applications.
12Truman CollegeMedical Billing and Coding
- Certification for AHIMA
- CCA-CCS
- AHIMA recognizes that the demand for coders has
never been greaterand this need is expected to
continue for some years to come. By creating an
entry-level coding credential based on job
analysis standards and state-of-the-art test
construction, AHIMA aims to increase the number
of qualified new coders who earn the CCA will
immediately demonstrate their competency in the
field, even if they don't have much job
experience. Earning a CCA demonstrates a
commitment to coding even for those who are new
in the field. CCA holders will also distinguish
themselves from non-credentialed coders and those
who hold credentials from other organizations
that do not require the higher level of expertise
necessary to earn AHIMA certification. - The CCA should be viewed as the starting point
for an individual entering a new career as a
coder. The CCS and/or CCS-P exams demonstrate the
mastery level skills that the CCA would strive
for to advance his or her career. - To ensure that its members meet professional
standards of excellence, AHIMA issues credentials
in health information management, coding, and
healthcare privacy and security. Members earn
credentials through a combination of education
and experience, and finally performance on
national certification exams. Following their
initial certification, AHIMA members must
maintain their credentials and thereby the
highest level of competency for their employers
and consumers through rigorous continuing
education requirements. - Coding
- Certified Coding Associate (CCA)
- Certified Coding Specialist (CCS)
- Certified Coding Specialist-Physician-based
(CCS-P) -
13Truman CollegeMedical Billing and Coding
- Certification for AAPC
- CPC
- A Certified Professional Coder (CPC) is an
individual of high professional integrity who has
passed a coding certification examination
sponsored by the American Academy of Professional
Coders (the AAPC). The examination consists of
questions regarding the correct application of
CPT, HCPCS procedure and supply codes and
ICD-9-CM diagnosis codes used for billing
professional medical services to insurance
companies. A CPC must have at least two years
coding experience and maintain yearly renewal as
well as submit Continuing Education Units (CEUs)
every two years. A CPC is an individual who in
addition to on the job experience as a coder has
achieved a measurable level of knowledge and
expertise in reviewing and adjudicating coding of
services, procedures and diagnoses on medical
claims.
14Truman CollegeMedical Billing and Coding
15Truman CollegeMedical Billing and Coding
- Working Conditions
-
- Medical Billing and Coding Employees usually work
- 40-hours a week- days, and evening shifts some
overtime may be required.
16Truman CollegeMedical Billing and Coding
- Employment
- Physicians' offices Outpatient Clinics,
Ambulatory Surgery Centers - Hospitals, Public Health Departments, and Medical
Centers - Medical Insurance Companies
17Truman CollegeMedical Billing and Coding
- Job Outlook
-
- Prospects should be very good Medical Billers
and Medical Coders are expected to grow much
faster than average -
18Truman CollegeMedical Billing and CodingCourse
Outline
- Summarize Training
-
- Truman College's six-course program will prepare
you for an entry-level position and you will gain
valuable hands-on experience with current
industry software. - Human Anatomy and Physiology, Medical Terminology
for Healthcare Professions, Fundamentals of
Medical Billing and Coding, Coding Applications,
Medicare, Medicaid, and Commercial Billing,
Computerized Medical Billing and Coding also the
legal aspects of health information coding data. -
19Questions on Medical Billing and Coding
Continuing Education Program