Medical billing and coding professionals keep records, calculate patient charges and review files. Duties include: reviewing records; calculating charges for a patient’s procedure and service and preparing itemized statements and submitting claims to third party payers. Medical Coders are responsible for the collection of physician charges and patient data to ensure that claims are submitted to insurance carriers accurately and in the most efficient and expeditious manner. Additionally, Medical Coders determine codes for physician procedures and diagnosis - using ICD-9 and CPT-4 coding protocols - for third party billing purposes.
This billing and coding course offers the skills needed to perform complex coding and billing procedures. The course covers: CPT (Introduction, Guidelines, Evaluation and Management), specialty fields (such as surgery, radiology and laboratory), ICD-9 (Introduction and Guidelines) and basic claims processes for insurance reimbursements. Program also includes an optional clinical externship at a local healthcare provider!
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 and the insurance industry
- The organization and use of the ICD-9-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
- Detailed review and practice coding examples from all sections within the CPT
- Basic claims processes for medical insurance and third-party reimbursements
- Completing common insurance forms, tracing delinq
Detailed Course Topics
- Introduction to International Classification of Diseases,
- Clinical Modifications and Coding Guidelines
- Introduction to the organization and use of the ICD-9-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 procedures of the integumentary system
- Coding surgical and medical procedures of the cardiovascular system
- Coding procedures related to the female genital system and maternity care and delivery
- Coding for general surgery, radiology, pathology and laboratory services
- Coding for diagnostic and therapeutic services and the Level II National Codes
- Tracing delinquent claims and insurance problem solving Third-party reimbursement issues
What You Can Expect
Our courses are highly interactive and provide students with an enriched learning experience.
Each course was developed to ensure that students gain the necessary skills to excel in a professional healthcare environment. Additionally, these programs include access to an online community with interactive content and robust student services. Each course includes:
- 24X7 instructor support and course mentoring
- Online healthcare content that supplements each course
- Student and instructor collaboration
- Engaging labs, student exercises, course videos and animated simulations
- Student pre and post assessments and online performance tracking
- National and state certification opportunities
- A secure Student Portal which includes: career guidance, resume writing and other career resources
- Certain programs include clinical externships
For those looking to pursue a National Certification Exam:
- Students should have or be pursuing a high school diploma or GED.
- Numerous national certification exams are available for students who complete this course including the American Academy of Professional Coders (AAPC) - Certified Professional Coder Exam (CPC or CPC-H - Apprentice); the American Health Information Management Association (AHIMA) Certified Coding Associate (CCA) exam; and/or other National Certification Exams.
- Certain national certification organizations suggest 6 months to 2 years of practical work experience prior to pursuing certain national certification exams.
Please note: national certification exams are not administered by SVSU. Our program is a preparatory course. If you would like more information regarding national certifications, please contact that organization directly.
General Cancellation Policy
- A full refund will be given to those who cancel 3 weeks prior to the start of a class.
- Cancellations made less than 3 weeks from start of class to 15 days prior to the start of class will receive refund less 25% cancellation fee.
- Cancellations made 14 days or less prior to the start of the class will be eligible for 50% refund.
- No refunds will be honored after the first day of class.
- Should the books be returned in like-new condition and with no markings prior to the start of the second class, only the applicable cancellation fee will be assessed.