Online Medical Billing Certificate Course

Describe the history of healthcare reimbursement; identify various reimbursement methodologies; outline the Medicare acute care prospective payment system; discuss other various payment systems; explain reimbursement claims processing and support processes; define coding quality and compliance standards.

Define prepaid health plans and commercial insurance; discuss the different government-sponsored healthcare programs; explain how managed care works.

Identify the attributes needed to become a successful medical coder; describe the evolution of the ICD-10-CM to its present structure; outline the correct method for looking up codes in the Alphabetic Index and Tabular List.

Identify the first-listed diagnosis for assigning appropriate outpatient codes; state the process of deriving a specific code for a patient's treatment.

Identify chapter-specific guidelines used to assign codes to organ systems or classifications of diseases; identify chapter-specific guidelines used to assign codes for diseases of the digestive, skin, musculoskeletal system and genitourinary system; identify chapter-specific guidelines used to assign codes to pregnancy, childbirth, and the puerperium.

Study the ICD-10-PCS; explain the role and format of the ICD-10-PCS.

Assign diagnosis and procedure codes using the ICD-10 coding manuals.

Outline the structure of the HCPCS Level I (CPT); describe the topics dealt with in the HCPCS Level II manual; list examples of modifiers used in CPT coding.

Explain the role of E/M coding; describe the process of assigning codes using the Anesthesia section of the CPT.

Explain general surgical guidelines in the CPT manual; describe common procedures performed on the integumentary system and how they’re coded; list common procedures that apply to the musculoskeletal system and how they’re coded; identify the major procedures coded in the respiratory system; describe common procedures that pertain to the cardiovascular system.

Explain the types of procedures coded in the hemic, lymphatic, mediastinum, and diaphragm systems; define the codes related to the organs of digestive system; specify the code ranges for the most common types of procedures coded in the urinary and male genital systems; describe the types of procedures and the codes assigned within the reproductive, intersex surgery, female genital system, and maternity care and delivery categories.

Describe the types of procedures coded in the Endocrine and Nervous System sec­tions of CPT; outline common procedures coded in Eye, Ocular Adnexa, Auditory, and Operating Microscope sections of CPT; explain the types of procedures coded in the Radiology section of the CPT; list common procedure codes assigned from the Pathology/Laboratory section of CPT; Describe common procedures coded using the Medicine section of CPT.

Assign CPT and HCPCS codes for physician procedures and services.