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Key Areas and Course Topics

This billing and coding program delivers the skills students need to solve insurance billing and coding problems. It details proper assignment of codes and the process to file claims for reimbursement. This course covers the following key areas and topics:

  • An overview of healthcare & insurance industry
  • The organization and use of the ICD-9-CM, ICD-10-CM, CPT, and HCPCS manuals to identify correct codes
  • Detailed review and practice using the alphabetic index and tabular list of the ICD-9-CM, ICD-10-CM, and practice coding examples within the CPT
  • Basic claims processes for medical insurance and third-party reimbursements
  • Completing common insurance forms, tracing delinquent claims, and appealing denied claims
  • ICD-10-CM Overview

Detailed Course Topics Covered

  • Intro to International Classification of Diseases, Clinical Modifications & Coding Guidelines
  • Introduction to the organization and use of the ICD-9-CM, ICD-10-CM, and CPT manuals
  • Basics of diagnostic and procedural coding
  • The Health Insurance Claim Form (CMS 1500)
  • HIPAA and Electronic Data Interchange (EDI)
  • Review and practice coding Evaluation and Management (E&M) services
  • Review and practice coding from anesthesia, surgery, radiology, medicine, and the pathology/laboratory sections of the CPT
  • CPT Modifiers, E and V Codes, and Late Effects
  • Coding surgical procedure and medical procedures for the cardiovascular, integumentary, male/female reproductive systems, maternity care and delivery
  • Coding for general surgery, radiology, pathology, diagnostic, therapeutic and laboratory services and the Level II National Codes
  • Tracing delinquent claims & insurance issues
  • Third-party reimbursement issues
  • Development of and Improvements to the ICD-10-CM Coding Manual
  • Examination of the ICD-10-PCS system