Medical Billing and Coding Program Curriculum
Our medical billing and coding program curriculum teaches you how to apply the correct coding to medical diagnoses and treatments for billing purposes. This is a specialized and practical skill needed by medical facilities everywhere in the U.S. Upon graduation, you’ll be prepped for the certification exam.
Orientation: Learning at AshworthLesson: Learning at Ashworth
This course covers the goals and values of Ashworth College; time management; creating a realistic weekly and monthly study schedule; the nature and purpose of assessments; how to study effectively to prepare for and take an online examination; developing the skill sets necessary for success in the twenty-first century
Lesson Group 1: Introduction to Allied HealthLesson: Allied Health Careers
This lesson covers healthcare, the healthcare industry in the United States, and the roles that healthcare workers play in that industry.
- Describe the United States healthcare system and settings
- Compare the professional roles of healthcare workers within various community settings
- Compare the professional roles of healthcare workers within hospital practices
- Distinguish among government (public) and private health insurance plans
- Explain the primary elements of the Affordable Care Act
- Describe the proper legal and ethical behaviors of a healthcare worker
- Identify the characteristics of professional behavior and issues related to cultural differences
- Identify communication methods within the healthcare field and teamwork strategies
Lesson Group 2: Law, Ethics, and Confidentiality in Allied HealthLesson: Law in Allied Health
In this lesson, you’ll study how law affects medical offices, the origin of law that affects medical professionals, and some basics about the process of litigation and its alternatives. In addition, you’ll be exposed to the elements of a medical malpractice case, and learn how criminal law and torts are relevant to the health profession.
- Describe civil and criminal law, sources of law, and the steps of litigation
- Distinguish between liability, negligence, and malpractice in relation to healthcare
- Determine medical malpractice and criminal charge defenses
In this lesson, you’ll study contemporary medical issues, such as medical care access, experimentation, paternalism and autonomy, and organ transplants. You’ll review ethical issues related to reproductive rights, such as artificially-assisted reproduction, abortion, and genetic testing. Lastly, you’ll address the ethical issues regarding death, the right to die, and assisted suicide.
- Identify the various ethical issues that healthcare professionals face
- Examine contemporary medical ethical issues
- Analyze ethical reproductive health issues
- Recognize ethical end of life issues
In this lesson, you’ll examine the common-law basis for the confidentiality of healthcare information and the laws regulating healthcare information collected and maintained by government agencies. You’ll also study the Health Insurance Portability and Accountability Act (HIPAA), which covers the circumstances under which health information may be released or disclosed. You’ll study how the management of medical information affects the management and measurement of quality in healthcare. Lastly, you’ll read about some special considerations for creating, maintaining, storing, and accessing electronic medical records.
- Analyze the court's role in healthcare information and litigation
- Examine patient's medical record requirements and common issues
- Summarize the common-law basis for confidentiality
- Apply privacy rules to patient information
- Describe OSHA's safety rules
- Identify special types of health information
- Recognize special rules and social-policy issues of HIV patients
- Evaluate risk management's effect on quality and electronic medical records
Medical Billing & Coding Program Description
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. Students receive training on ICD-10-CM/PCS, CPT, and HCPCS code assignment.
NOTE: Ashworth covers the cost of the CBCS exam within the tuition. Candidates for the CBCS and CCA must be High School graduates. Additional requirements such as membership and applications can be found with each certifying agency. CBCS, CPC®, CCA®
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.
Decoding your career path
Ashworth College API Program Name Career Diploma program help you develop the confidence you need to reach for your career goals because we integrate job search prep into your studies. With the online tools at the Ashworth College Central Network, you’ll get step-by-step guidance as you create polished, professional resumes and letters. After you graduate, you’ll keep your Ashworth College Central Network account so you can revisit the tools any time you need to make a good impression on a potential employer. Learn more about it at the Career Services page.