Medical Billing and Coding Course Curriculum

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Program Goal and Outcomes

Program Goal

To prepare students for an entry-level career as a medical coder.

Program Outcomes

Upon completion of the program, students will be able to...

Comprehend and apply CPT, ICD-10, and HCPCS coding guidelines to identify diagnoses, procedures, and patient medical records
Identify the procedures for patient record retrieval and reimbursement
Explain the role of a medical coder as a liaison between the health clinician and billing offices
Apply computer and information literacy skills using electronic health records software
Identify terms, facts, methods, procedures, concepts, theories, principles, and processes within medical billing and coding scenarios
Recognize relationships among data and classify items within medical billing and coding scenarios
Understand laws and theories, including issues relating to ethics and confidentiality
Calculate solutions to mathematical problems related to reimbursement and medical mathematics
Interpret and evaluate information to make proper coding decisions
Review basic written and workplace communication skills

Starting Your Program

Succeed by learning how to use your Penn Foster program.

Objectives:

Understand how to use your Student Portal.
Access the Penn Foster Community and use it to find answers.
Connect with Penn Foster on various social media sites.

Introduction to Allied Health

This course gives an introduction to health care, the health information management industry, and the role that health information technicians play in that industry.

Objectives:

Describe reimbursement systems and the role health information management technicians play in reimbursement.
Describe how technology is used in health information management.
Discuss different professional organizations and certifications for health information management technicians.
Explain the different roles, opportunities, and settings for health information management technicians.

Law, Ethics, and Confidentiality in Allied Health

This course examines how law affects medical offices, the origin of law that affects medical professionals, the basics of the process of litigation and its alternatives, the common-law basis for the confidentiality of health care information, and the laws regulating health care information collected and maintained by government agencies.

Objectives:

Describe civil and criminal law, sources of law, and the steps of litigation
Distinguish between liability, negligence, and malpractice and explain how they relate to health care professionals
Explain defenses against medical malpractice and against criminal charges
Identify the various ethical issues that health care professionals face
Discuss contemporary medical issues such as medical care access, experimentation, paternalism and autonomy, and organ transplants
Discuss ethical issues regarding death, the right to die, and assisted suicide
Explain the uses and content of medical records
Describe the legal significance of confidentiality obligations
Explain the core concepts of HIPAA’s final Privacy Rule
Summarize the role of peer review in confidentiality issues
Describe confidentiality and security issues related to electronic medical records

Learning Aid: Certification Test Prep

Medical Billing and Health Insurance

This course introduces the reimbursement process and the various methodologies involved, such as fee for-service and episode-of-care methodologies. The course also covers important information regarding payment systems, fee schedules, charge masters, coding, and the internal audit process. Finally, the course explains the fundamentals and types of health insurance.

Objectives:

Describe the history of health care reimbursement
Describe fee-for-service reimbursement methodologies
Define episode-of-care reimbursement methodologies
Outline the Medicare acute care prospective payment system
Describe the Medicare skilled-nursing facility prospective payment system
Discuss the different outpatient prospective payment systems
Describe the electronic data interchange process
Name the latest changes in health care reimbursement
Explain the management of fee schedules, charge masters, and coding
Describe the internal audit process
Outline characteristics of a coding compliance program
Discuss your role as a health information professional in health care reimbursement
Define prepaid health plans
Identify characteristics of retrospective and prospective payment systems
Describe commercial insurance plans
Outline the history of Blue Cross/Blue Shield plans
Discuss the different government-sponsored health care programs
Explain how managed care works

Learning Aid: Certification Test Prep

Medical Office Procedures

This course is designed to help you develop professional relationships in the workplace and professionally administer and manage office communications and procedures. It also provides a review of basic math operations, along with a basic introduction to working with Word and Excel.

Objectives:

Identify and name decimal place values
Convert measurements in the metric system and in foreign currencies
Identify prefixes of the metric system
Use percent to calculate percent increase or decrease, interest rate, sales tax, discounts, shipping charges, and base price
Identify the six steps for problem solving
Calculate the following values: three types of averages, deductions from a paycheck, and simple and compound interest
Identify and use parts of speech
Demonstrate knowledge of the elements of sentence structure
Explain and identify subject-verb agreement
Identify and correct grammatical errors in sentences
Use end marks, commas, and other common punctuation marks
Use capitalization correctly
Identify the correct way to answer and place interoffice, long-distance, and
conference calls
List and describe at least six components of effective oral communication
Identify the correct way to process incoming and outgoing mail
Process routine information requests and correspondence
Assist in writing well-structured letters that are professional in appearance
Correctly format, compose, and address business letters
Describe the purpose and format of memos
Identify the correct way to organize an email message
Explain safe and effective uses of email
Create new Word documents and Excel spreadsheets
Edit and format existing documents and spreadsheets
Add graphics and tables to Word documents
Create charts
Use formulas and functions

Body Systems and Medical Terminology 1

In this course, you’ll become familiar with the medical terms that you'll hear on a daily basis in your new career, and you’ll examine the organization of body systems. More specifically, you’ll study terms related to the following body systems: integumentary, musculoskeletal, hematic, lymphatic and immune, and cardiovascular.

Objectives:

Explain how root words (and their combining forms), prefixes, and suffixes function in medical terms
Define many of the most common roots, prefixes, and suffixes
Determine the meaning of a given medical term by analyzing its parts
Identify the anatomical position and directional terms, as well as the three planes, four quadrants, and nine regions of the body
Describe the body science of nutrition
Explain the anatomy and function of the integumentary and musculoskeletal systems
List diseases of the integumentary and musculoskeletal systems
Identify tests and procedures to diagnose and treat diseases of the integumentary
and musculoskeletal systems
Use combining forms to build and analyze terms related to cellular anatomy, the integumentary system, and the musculoskeletal system
Explain the anatomy and function of the hematic, lymphatic, immune, and cardiovascular systems
List diseases of the hematic, lymphatic, immune, and cardiovascular systems
Identify tests and procedures to diagnose and treat diseases of the hematic,
lymphatic, immune, and cardiovascular systems
Use combining forms to build and analyze terms related to the of the hematic,
lymphatic, immune, and cardiovascular systems

Learning Aid: Certification Test Prep

Body Systems and Medical Terminology 2

In this course, you’ll become familiar with the medical terms that relate to the following body systems: respiratory, digestive, nervous, endocrine, reproductive, and excretory. You’ll also examine terms related to the sensory organs, with a concentration on the organs for hearing, sight, and smell. Finally, you’ll examine the medical specialties of oncology, radiology, nuclear medicine, genetics, surgery, and pathology.

Objectives:

Explain the anatomy and function of the respiratory, digestive, and nervous
systems
List the diseases of the respiratory, digestive, and nervous systems
Identify tests and procedures to diagnose and treat diseases of the respiratory, digestive, and nervous systems
Use combining forms to build and analyze terms related to the respiratory, digestive, and nervous systems
Explain the anatomy and function of the endocrine, reproductive and excretory systems
List diseases of the endocrine, reproductive, and excretory systems Identify tests and procedures to diagnose and treat diseases of the endocrine, reproductive, and excretory systems
Use combining forms to build and analyze terms related to the endocrine, reproductive,
and excretory systems
Explain the anatomy and function of the sensory organs
List diseases of the sensory organs
Identify tests and procedures to diagnose and treat diseases of the sensory organs and the nervous system
Use combining forms to build and analyze terms related to the sensory organs
Differentiate between tumor types and explain how cancer develops
Classify cancers and describe the major methods of cancer treatment
Identify radiographic procedures and outline the types and uses of nuclear medicine tests
Summarize surgical methods and pathological processes
Describe the application of genetics to the study of diseases

Learning Aid: Certification Test Prep

Electronic Medical Records

This course is designed to help you understand the reimbursement process and the various methodologies involved. You’ll be introduced to billing cycles and how health information technology is used in medical offices, and learn about basic accounting transaction terminology and apply this information to enter patient charges and payments.

Objectives:

Discuss the history of electronic health records
Perform administrative health information management functions
Build an electronic health record
Enter information into an electronic health record
Utilize templates to increase productivity

Textbook: The Electronic Health Record for the Physician's Office with SimChart for the Medical Office

Simulation: SimChart for the Medical Office

Learning Aid: Certification Test Prep

Pathology and Pharmacology

This course describes health-care professionals who are licensed to prescribe medications for the treatment of disease and illness, reference material most often used by pharmacists and pharmacy technicians, and pharmaceuticals that are designed to alleviate or repair any sort of malfunction in the body.

Objectives:

Define the basic elements of pharmacology
Identify common drugs, drug names, drug references, routes and forms of drug administration, and drug classification related to body systems
Understand basics of drug regulation agencies and enforcement
Define drug action and effect according to specific classifications
List common diseases of body systems
Identify tests and procedures to diagnose and treat diseases of body systems
Identify basic surgical procedures

Learning Aid: Certification Test Prep

Basic Coding Using ICD-10

The course begins with an overview of coding concepts, terms, and procedures. It explores the system that replaced the ICD-9 in October 2015, the ICD-10. Students will code diagnoses using ICD-10-CM and will code procedures uisng ICD-10-PCS. The course concludes with a brief look at the CPT.

Objectives:

Describe the purpose of coding and the documentation used in coding
Assign the equivalent ICD-10 codes using the ICD-10 coding manual
Assign ICD-10-PCS codes in appropriate coding situations

Textbooks:

Step-By-Step Medical Coding 2018
ICD-10-CM 2018
ICD-10-PCS 2018

Learning Aid: Certification Test Prep

Intermediate Medical Coding

In this course, students will concentrate on the diagnoses or procedures that don’t seem to fit into any specific coding category. Students will also learn about general coding guidelines for inpatient and outpatient procedures and physician office coding using ICD-10-CM, HCPCS Level I, and HCPCS Level II procedure coding.

Objectives:

Assign codes for services and procedures using CPT and HCPCS Level II
Describe the relationship between HCPCS Level I and HCPCS Level II
Outline the types of services and procedures described in the CPT
Describe the types of patients seen in the outpatient setting

Textbooks: CPT 2018

Learning Aid: Certification Test Prep

Advanced Medical Coding Scenarios

In this course, students will assign codes using ICD-10, CPT, and HCPCS in advanced medical coding scenarios. Students will build off of the Basic and Intermediate Medical Coding courses, using the skills developed from those courses to interpret complex medical data. Students will fine-tune their coding skills through several practice coding scenarios to prepare to take the CPC-A coding exam.

Objectives:

Accurately assign procedure codes for complex coding scenarios using ICD-10-CM
Add characters to expand ICD-10-PCS codes for complex coding scenarios
Assign codes using CPT and HCPCS Level II

Textbooks:

The Next Step 2018
Virtual Medical Office

Learning Aid: Certification Test Prep

Simulation: Online Internship for Medical Coding

Medical Billing & Coding Course Details

Program Goal and Outcomes

Additional Details

Sample Medical Billing & Coding Lesson