Introduction to Medical Billing and Coding - PowerPoint PPT Presentation

1 / 19
About This Presentation
Title:

Introduction to Medical Billing and Coding

Description:

AHIMA recognizes that the demand for coders has never been greater and this need ... A Certified Professional Coder (CPC ) is an individual of high professional ... – PowerPoint PPT presentation

Number of Views:4325
Avg rating:3.0/5.0
Slides: 20
Provided by: Afric7
Category:

less

Transcript and Presenter's Notes

Title: Introduction to Medical Billing and Coding


1
Introduction to Medical Billing and Coding
2
Introduction to Medical Billing and Coding
  • Course Description
  • 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.
  •  

3
Truman CollegeMedical Billing and CodingCourse
Outline
  • Instructional Units
  • 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
  •  

4
Truman 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.

5
Truman 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.

6
Truman 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.

7
Truman 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.

8
Truman 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.

9
Truman 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.

10
Truman 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.

11
Truman 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.

12
Truman 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)
  •  

13
Truman 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.

14
Truman CollegeMedical Billing and Coding
  • Salary 2006

15
Truman 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.

16
Truman CollegeMedical Billing and Coding
  • Employment
  • Physicians' offices Outpatient Clinics,
    Ambulatory Surgery Centers
  • Hospitals, Public Health Departments, and Medical
    Centers
  • Medical Insurance Companies

17
Truman CollegeMedical Billing and Coding
  • Job Outlook
  •  
  • Prospects should be very good Medical Billers
    and Medical Coders are expected to grow much
    faster than average
  •  

18
Truman 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.
  •  

19
Questions on Medical Billing and Coding
Continuing Education Program
Write a Comment
User Comments (0)
About PowerShow.com