Medical Billing and Coding Curriculum
Our Medical Billing and Coding program teaches the skills you need to pass the Certified Billing and Coding Specialist (CBCS) exam from the National Healthcareer Association. What’s more, we cover your exam fee! You’ll also be prepared to take the Certified Professional Coder (CPC®) exam from the American Academy of Professional Coders (AAPC) and the Certified Coding Associate (CCA®) exam from the American Health Information Management Association (AHIMA) should you choose to pursue those credentials. Graduate with practical knowledge of how to process medical claims with the correct diagnostic and treatment codes.
Students learn the fundamentals of medical billing and coding and are prepared to take the Certified Billing and Coding Specialist (CBCS) exam from the National Healthcareer Association, the Certified Professional Coder (CPC®) exam from the American Academy of Professional Coders (AAPC), and the Certified Coding Associate (CCA®) exam from the American Health Information Management Association (AHIMA). Program topics include medical terminology; insurance plans; medical ethics; HIPAA; diagnostic and procedural coding; coding compliance and auditing; physician and hospital billing; Medicare, Medicaid, and TRICARE; EOBs, refunds, and appeals; workers’ compensation; and electronic claims processing. Students receive in-depth training on ICD-10-CM/PCS, CPT, and HCPCS code assignment.
After completing the Medical Billing and Coding program, students will be able to:
- Outline the typical responsibilities of a medical biller/coder, describe the personal and professional ethics required for success in this profession, and describe the career opportunities available to appropriately trained personnel.
- Describe how to build a strong base of medical terminology and use this terminology to accurately identify and describe body planes, anatomical directions, and the major structures, functions, and pathologies of all body systems.
- Describe the purpose and impact of the Healthcare Portability and Accountability Act (HIPAA) and explain how professionals can learn about changes to the laws and regulations that affect them.
- Compare and contrast the major types of government and commercial insurance health plans, including Medicare, Medicaid, Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), and Point-of-Service (POS) plans.
- Describe the typical billing guidelines for inpatient medical, inpatient/outpatient global surgery, medical/surgical, and minor surgical procedures.
- Summarize the life cycle of a typical insurance claim and explain the processing steps that must be completed before claims and other forms can be submitted to the insurance company.
- Explain the purpose of medical coding and accurately code diagnoses and procedures using industry-standard coding systems published by the World Health Organization (WHO) and the American Medical Association (AMA).
- Accurately assign ICD-10-CM/PCS, CPT, and HCPCS codes for diagnoses, procedures, and medical services as part of the insurance reimbursement process.
*Certification Exam Requirements: Certification exam prerequisites vary. Please check with NHA for their requirements.