Introduction to Medical Coding


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  • 17
    Lessons
  • 18
    Exams &
    Assignments
  • 20
    Hours
    average time
  • 2.0
    CEUs
  • 3,945
    Students
    have taken this course
 
 
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Course Description

The healthcare industry, complex and rigorous even for the most knowledgeable and thorough of professionals, requires that paperwork be submitted both in a highly accurate and very timely manner.

The area of healthcare involving the completion of paperwork outlining patients' billing histories and submission of them to the individual's insurance company for reimbursement is known as 'medical billing'. Within medical billing there exists the practice of 'medical coding' whereby codes are assigned to medical procedures and diagnoses in order to relay--in a universally accepted medical language--information to the insurance company or in some cases, governmental agencies and/or consulting firms.
 
Also known as 'insurance coding', medical billing/coding is viewed to be essential to the healthcare industry for it creates and maintains a single, unified language by which all (physicians, medical administrators, insurance companies, government healthcare officials) integrated parties are able to effectively communicate.
 
In this course, we're going to learn medical coding from the ground up. Whether you are new to medical coding, or already have experience, this course is written in 'laymen's terms' yet is comprehensive enough to help even seasoned medical coders.
 
Professional Overview

The healthcare industry, complex and rigorous even for the most knowledgeable and thorough of professionals, requires that paperwork be submitted both in a highly accurate and very timely manner.

The area of healthcare that involves the completion of paperwork outlining patients' billing histories and the submission of that paperwork to the patients' insurance companies for reimbursement is known as "medical billing."


Within medical billing exists the practice of "medical coding," whereby codes are assigned to medical procedures and diagnoses in order to relay--in a universally accepted medical language--information to the insurance company or (in some instances) governmental agencies and/or consulting firms.

Medical billers/coders help physicians' and hospital administrators' by reducing their workloads in matters pertaining to billing and reimbursements.

Essentially, the medical coder translates a physician's notes regarding a patient's medical condition and prescribed treatment(s) into the universally accepted language known as Current Procedural Terminology (CPT)discussed in greater detail within a subsequent chapter either manually or with the assistance of specialized software.

CPT codes exist for all medically-related interactions, i.e., office visits, x-rays, prescription medications, etc. International Classification of Diseases, Clinical Modification (ICD) is a second system in which alpha characters and numbers are used to identify specific diagnoses. A unique combination of both ICD and CPT relay to the third-party payer (insurance company, et al.) the patient's pronounced condition and the treatments received. (Please Note: ICD-10-CM is a separate class).

For payment purposes, there are two primary classes of medical services for which patients are billed: Procedures and Evaluation & Management (E/M) services.

Procedures are activities or treatments performed on the patient, i.e., injections/immunizations, surgery, x-rays, treatments, therapy, and laboratory/pathology services.
 
E/M services are the interactions that occur between the physician and the patient, i.e., everything from the quick customary office visit to managing a cardiac arrest situation or overseeing a patient on a ventilator in an ICU.

Formerly, medical work operated on what was known as the Usual, Customary and Reasonable system (UCR) in which the costs of procedures and E/Ms were individually determined by the physician or facility in question. However, in light of the government's desire to grant everyone access to equal quality care, standardized methods became required practice.

Therefore, along with ensuring patients are receiving a bare minimum standard of care, they can also be guaranteed that they will not have to be pay excessive fees to receive it.

Additional reasons why the standardized coding system is so important include that the specialization helps deter fraud, and it contributes to the reduction of overall healthcare administrative costs and time overruns.


In addition, medical billing/coding ensures that accurate and detailed records are kept on all patients throughout their lifetime continuum of medical care. Plus, it equips healthcare overseers with factual data from which statistics and forecasting tables can be produced.

In light of the rising costs both inside and outside of the industry, there remains a pervasive, on-going need to reduce costs.

Because they are capable of keeping healthcare costs down and freeing up physicians so that they can focus on medical issues, the future demand for medical billers/coders in the United States, as well as internationally, is anticipated to dramatically increase over the course of the next few years.

Furthermore, additional medical billers/coders are needed because of the increased number of senior citizens (thus, greater need for healthcare-related services).*

*According to the U.S. Bureau of Labor Statistics.


Specific Responsibilities of the Medical Coders' Job

Medical coders are responsible for staying current with medical terminology and correlative codes, and must possess extensive knowledge of the human body, diseases, disorders, applicable medical treatments and regularly used prescription medications.

Focused on the accurate and timely remission of reimbursement, medical billers/coders are expected to communicate well with physicians, patients, and insurance companies. In addition, they also should possess a working knowledge of medical terminology, comprehend the legal and ethical ramifications of the inaccurate labeling of treatments, and have a strong analytical aptitude for coding and decoding billable items.


Education, Training & Certification

In the past, candidates interested in becoming medical coders needed to complete either a two-year or a four-year college program. However, individuals can now acquire the necessary education in medical terminology and training through a technical or vocational school, online program, or correspondence course.

While medical coders do not officially need to be certified in order to perform the responsibilities of the job, many opt to do so as it increases their appeal to employers and their knowledge of the healthcare industry.


Organizations which offer certifications in medical coding include:

The American Health Information Management Association (AHIMA) 
offers the Certified Coding Specialist (CCS)Hospital certification, which requires that candidates have a minimum of a high school diploma and charges a fee to those who elect to take the exam.

AHIMA also offers the Certified Coding Specialist Physician Based (CCS-P) certification, specifically tailored to those interested in serving private or group practices or other physician-related environments. Eligibility requirements include: possession of a high school diploma and knowledge of specialized coding systems. The certification is supported by both the Society of Clinical Coding (SCC) and the Ambulatory Care Section (ACS). There is a fee to take the exam.

The American Academy of Professional Coders (AAPC) offers the Certified Procedural Coder (CPC) certification. It can be obtained via completion of a home coding training program or through the AAPC National Office. The AAPC offers exams throughout the United States. The AAPC requires one year of coding experience for the CPC certification. The CPC-A is an apprentice certification.
 

The AAPC also offers the Certified Procedural Coder-Hospital (CPC-H) certification, geared towards the institutional-type setting (hospital) as opposed to the private (physician) practice. The AAPC requires completion of a home training program and the completion of a certification exam given by proctors at a local chapter.

In addition, the AAPC offers a Certified Professional Coder-Payer (CPC-P) certification. This certification is for claims reviewers, utilization management staff, coordination of benefits staff, provider relations and contracting, and customer service staff. A CPC-P must have at least two years coding work experience that includes working with CPT, ICD-10-CM, or HCPCS code sets.

The AAPC requires that each certification maintain a required amount of yearly CEUs. Each examination requires a fee.  

Both the AHIMA and AAPC require that exam takers score a minimum of 70 percent or better on their exams in order to qualify for passing status and, thus, earn their respective certifications.

In addition, often times, as a follow-up to a passing grade on the CCS or CCS-P exam, the AHIMA may also conduct an in-person interview to ensure candidates are suitably well-versed in the areas of: medical terminology, coding protocols, patient charts, physiology, and medical/human anatomy.

The advantage to those with such credentials is that their qualifying organizations--the AHIMA or the AAPC--can help place them in medical coding positions with reputable organizations or medical office settings.

Regardless of which specific certification you decide to acquire (if, in fact, you decide to acquire any), the types of information you will need to be successful as a professional medical coder include:

  • Basic medical terminology
  • Basic claims process for medical insurance reimbursement
  • Methodologies for completing common insurance forms
  • Guidance for using medical billing software
  • Introduction to diagnostic and procedural coding systems
In the future you may desire to expand upon your knowledge base as there are several fields directly related to medical billing.
 

Specialties related to medical billing include:
  • Medical coding
  • Medical billers
  • Medical auditors
  • Medical claims reviewers
  • Billing coordinators
  • Reimbursement specialists
  • Patient account representatives
  • Medical claims analyst
  • Medical claims processors
  • Medical collectors

 

As anyone in the medical field can tell you, medical coding and billing might as well be considered a separate language. In order to decipher it, you’ll have to invest some pretty serious time and effort learning the secrets of medical coding.

Fortunately, your efforts won’t be in vain – they'll pay off in dividends. Job opportunities are everywhere!

Some schools and programs charge thousands of dollars to train professionals in the art of medical coding and billing.

But what if you don't have thousands of dollars to spend?

Not everyone can qualify for grants and financial aid packages. Others still can’t take time away from their schedules at work or home to attend traditional classes.

What's your situation? 

Medical coding, which is also known as insurance coding is an increasingly popular field and trained students are always in demand. And unlike so many other careers, that demand isn’t likely to diminish anytime soon. It’s an essential skill that the healthcare industry couldn’t operate without. It not only creates and maintains a unified, Universal language that doctors rely on, but one essential to administrators, insurance companies, lawyers and other officials as well.

Whether you’re looking for a new job or simply greater job security, don’t let yourself fall behind. Enrollment is always open, so there’s no reason you can’t get started right now!

Medical Coding 101 is ideal for serious students that can handle the freedom of a virtual, self-paced classroom without falling behind in their studies. In order to succeed, you’ve got to be committed and disciplined.

One of the reasons that this course is so demanding is that the field of medical coding is demanding in and of itself. That’s because the medical and healthcare industries aren’t just about patients and diagnoses – it’s also about paperwork. And there’s a lot of that!

For every doctor, there are sometimes several hundred patients. And each of those patients has medical histories, insurance plans with all the hoops and loopholes, referrals and much more. And every sheet of paper for every patient will be processed by a medical coder at some point.

Don’t let the behind-the-scenes nature of the job fool you – medical coding is vitally important – mandatory even – because it both creates AND maintains a universal language that everyone in the field needs to effectively communicate and get things done.

This is a great preparation course that will not only help you enter but excel in the complex and rigorous role of a medical coder.

Over the course of 17 in-depth lessons, you’ll immerse yourself in this new language, with all of its quirks and quips. You’ll take a look at issues and questions such as:

·        What is medical coding?

·        What is diagnosis coding?

·        ICD-10-CM: What is it and what does it do?

·        Reimbursement

·        Coding practice problems

·        Procedural terminology

·        CPT coding

·        And much, much more!

While the completion of this course doesn’t require that you buy any textbooks or class materials, the instructor does have a few recommendations to optimize your success:

  1. A working knowledge of medical terminology (which you can also learn about here at UniversalClass)
  2. A grasp of the basics of Anatomy and Physiology (also available on UniversalClass)

We’re not denying it – this course isn’t going to be easy. It’s going to take some work! But it’s more than worth the investment!

However, you can get a head start on success by getting started on this class today. Enrollment is open 24/7, so there’s no excuse to put it off any longer!

  • Completely Online
  • Self-Paced
  • 6 Months to Complete
  • 24/7 Availability
  • Start Anytime
  • PC & Mac Compatible
  • Android & iOS Friendly
  • Accredited CEUs
Universal Class is an IACET Accredited Provider
 
 

Course Lessons

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Lesson 1: Introduction to Medical Coding

The healthcare industry, complex and rigorous even for the most knowledgeable and thorough of professionals, requires that paperwork be submitted both in a highly accurate and very timely manner. 200 Total Points
  • Take Poll: Medical Billing Class
  • Complete: Lesson 1 ~ Assignment
  • Complete: Lesson Exam 1

Lesson 2: Introduction to Diagnosis Coding

"Act or process of identifying of determining the nature and cause of a disease or injury through the evaluation and examination of a patient history's and the review of subsequent laboratory data." 100 Total Points
  • Review Article: RVU flashcards
  • Take Poll: Please rate Lesson 2: Introduction to Diagnosis Coding
  • Complete: Lesson 2 ~ Assignment

Lesson 3: ICD-CM - What is it?

Introduction to ICD-CM coding. 200 Total Points
  • Review Article: Classification
  • Take Poll: Please rate Lesson 3: ICD-CM - What is it?
  • Complete: Lesson 3 ~ Assignment
  • Complete: Lesson Exam 3

Lesson 4: ICD-CM Coding and Structure

Formally known as the International Classification of Diseases, Ninth Revision, Clinical Modification, most within the healthcare industry tend to call it by its acronym, ICD-9-CM. 100 Total Points
  • Review Article: How to Use ICD Codes
  • Take Poll: Please rate Lesson 4: ICD-CM Coding and Structure
  • Complete: Lesson Exam 4

Lesson 5: Reimbursement

One of the primary purposes of medical coding, and subsequent billing, is to obtain a reimbursement from the third-party biller. 300 Total Points
  • Review 2 Articles: Medical Billing Advocates; Coding Errors
  • Take Poll: Please rate Lesson 5: Reimbursement
  • Complete: Lesson 5 ~ Assignment 2
  • Complete: Lesson 5 ~ Assignment 1
  • Complete: Lesson Exam 5

Lesson 6: Current Procedural Terminology (CPT)

What is CPT? 100 Total Points
  • Review Article: What Are CPT Codes?
  • Take Poll: Please rate Lesson 6: Current Procedural Terminology (CPT)
  • Complete: Lesson Exam 6

Lesson 7: CPT Coding and Structure

Current Procedural Terminology (CPT) as officially stated encompasses a set of codes, descriptions and guidelines used to distinguish medical procedures performed by physicians and additional healthcare providers. 200 Total Points
  • Review Article: Understand the Three CPT Code Categories
  • Take Poll: Please rate Lesson 8: CPT Coding and Structure
  • Complete: Lesson 7 ~ Assignment
  • Complete: Lesson Exam 7

Lesson 8: Evaluation and Management (E/M) Coding

In this lesson we'll be exploring E/M coding. 200 Total Points
  • Review Article: E/M Coding
  • Take Poll: Please rate Lesson 8: Evaluation and Management (E/M) Coding
  • Complete: Lesson 8 ~ E/M Assignment
  • Complete: Lesson Exam 8

Lesson 9: Surgery and Integumentary System Coding

In this lesson we'll explore surgery and integumentary system coding. 100 Total Points
  • Review Article: Code Changes
  • Take Poll: Please rate Lesson 9: Surgery and Integumentary System Coding
  • Complete: Lesson Exam 9

Lesson 10: Anesthesia CPT Codes

Let's explore the anesthesia CPT codes. 100 Total Points
  • Review Article: Anesthesia Codes
  • Take Poll: Please rate Lesson 10: Anesthesia CPT Codes
  • Complete: Lesson Exam 10

Lesson 11: Cardiovascular, Respiratory, Musculoskeletal Systems

Cardiovascular, respiratory and musculoskeletal are distinct in terms of their unique terminologies and special cases, they all share the commonality of having a range of codes correlative to anatomical surgeries. 0 Total Points
  • Take Poll: Please rate Lesson 11: Cardiovascular, Respiratory, Musculoskeletal Systems

Lesson 12: Radiology and Pathology Coding

We will now turn our attention to the two remaining CPT Manual subsections (outside of medicine and the appendices), those of radiology and pathology. 0 Total Points
  • Take Poll: Please rate Lesson 12: Radiology and Pathology Coding

Lesson 13: CPT Coding Practice Problems

Within the CPT Standard edition, there are literally tens of thousands of individual CPT codes. Thus, while it would impossible and non-productive (as they change so frequently) to memorize all of the codes, it is a good idea to understand how the ma 0 Total Points
  • Review Article: CPT Practice Tests.
  • Take Poll: Please rate Lesson 13: CPT Coding Practice Problems

Lesson 13: CPT Coding Practice Problems COPY

Within the CPT Standard edition, there are literally tens of thousands of individual CPT codes. Thus, while it would impossible and non-productive (as they change so frequently) to memorize all of the codes, it is a good idea to understand how the ma 0 Total Points

Lesson 14: Introduction to Documentation (Medical History)

Health Information Management and Documentation occupies a titanic area within the medical world. 100 Total Points
  • Take Poll: Please rate Lesson 14: Introduction to Documentation (Medical History)
  • Complete: Lesson Exam 14

Lesson 15: Medical Examination, Decision Making, Selecting the Correct Code

As a medical coder, your job will be select the most appropriate diagnostic and/or procedural code in order to report encounters, services, tests, treatments, supplies and procedures provided to a patient. 0 Total Points
  • Review 2 Articles: FAQ; Forums
  • Take Poll: Please rate Lesson 15: Medical Examination, Decision Making, Selecting the Correct Code

Lesson 16: Issues with Fraud and Abuse

Within the US, hundreds upon hundreds of cases pertaining to medical coding/billing fraud and abuse annually amount to billions of dollars lost to government programs, public and private healthcare companies and third party billers. 100 Total Points
  • Review Article: Insurance Fraud
  • Take Poll: What is your opinion of this course?
  • Complete: Lesson 16 ~ Assignment
1800
Total Course Points
 

Learning Outcomes

By successfully completing this course, students will be able to:
  • Define medical coding.
  • Know diagnosis coding.
  • Define ICD-9-CM and summarize its coding and structure.
  • Describe the reimbursement process.
  • Demonstrate solving ICD-9-CM coding practice problems.
  • Define Current Procedural Terminology (CPT) and summarize its coding and structure.
  • Demonstrate Evaluation and Management (E/M) Coding.
  • Demonstrate Surgery and Integumentary System Coding.
  • Demonstrate using Anesthesia CPT Codes.
  • Demonstrate coding for Cardiovascular, Respiratory, Musculoskeletal Systems.
  • Demonstrate Radiology and Pathology Coding.
  • Solve CPT Coding Practice Problems.
  • Know documentation procedures.
  • Know issues with fraud and abuse, and
  • Demonstrate mastery of lesson content at levels of 70% or higher.
 

Additional Course Information

Online CEU Certificate
  • Document Your Lifelong Learning Achievements
  • Earn an Official Certificate Documenting Course Hours and CEUs
  • Verify Your Certificate with a Unique Serial Number Online
  • View and Share Your Certificate Online or Download/Print as PDF
  • Display Your Certificate on Your Resume and Promote Your Achievements Using Social Media
Document Your CEUs on Your Resume
 
Course Title: Introduction to Medical Coding
Course Number: 31868
Languages: English - United States, Canada and other English speaking countries
Category:
Course Type: Professional Development (Self-Paced, Online Class)
CEU Value: 2.0 IACET CEUs (Continuing Education Units)
CE Accreditation: Universal Class, Inc. has been accredited as an Authorized Provider by the International Association for Continuing Education and Training (IACET).
Grading Policy: Earn a final grade of 70% or higher to receive an online/downloadable CEU Certification documenting CEUs earned.
Assessment Method: Lesson assignments and review exams
Instructor: Diana Wilson, CPC, CPC-I, CPMA
Syllabus: View Syllabus
Duration: Continuous: Enroll anytime!
Course Fee: $129.00 (no CEU Certification) || with Online CEU Certification: $154.00

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