Medical Billing /Coding

Pre-Requisite: Introduction to Computers

Course Length: 12 weeks

Course Description:
The following information has been provided by the American Academy of Professional Coders. Please feel free to visit there website at www.AAPC.com.
American Academy of Professional Coders membership spans all 50 states and several foreign countries. It is supported by a National Advisory Board made up of certified members representing clinics, facilities, payers and consulting firms.
A Certified Professional Coder (CPC) is an individual of high professional integrity who has passed a coding certification examination sponsored by the American Academy of Professional Coders (the Academy). The examination consists of questions regarding the correct application of CPT-4 codes and ICD-9-CM diagnosis codes used for billing professional medical services to insurance companies. A CPC must have at least two years coding experience and maintain yearly CEU requirements.
A CPC is an individual who has achieved a certain level of knowledge and expertise in coding of services, procedures and diagnoses for physician practices. The Certified Professional Coder’s responsibilities may include:
• Determining accurate codes for diagnoses, procedures and services performed by physicians and recognized, licensed non physician providers in physician-based settings (These services may include evaluation and management services as well as reviewing operative notes)
• Keeping current with medical compliance and reimbursement policies, such as medical necessity issues and correct coding issues
• Performing various auditing duties related to physician practice management and coding to maintain compliance with payer reimbursement policies and governmental regulations as well as Medicare/CMS guidelines
• Monitoring progress resulting from periodic internal audits
• Providing training in coding and compliance issues to physicians, non physician providers and staff on an ongoing basis
• Providing physicians and staff with up-to-date coding information from reliable, accurate sources, such as specific payers, the AMA, AHA’s Coding Clinic, and CMS, to name a few sources
• Providing orientation training to include medical practice guidelines for new physicians and non-providers to the practice
• Implementing of new coding guidelines in a timely manner within the practice
• Updating encounter forms/super bills on an annual basis with respect to diagnostic, procedural and supply code changes
• Updating other patient information forms as necessary from time to time
• Updating the clinic’s fee schedule based on Relative Value Unit (RVU) updates that come out annually and based on additions and deletions to codes for procedures, services, and supplies
• Preparing and/or submitting completed HCFA-1500 forms for services and procedures performed by the practice’s physicians and non physician providers, such as CRNAs, nurse practitioners and physician assistants
• Reviewing explanations of benefits from payers, evaluating denied claims and filing appeals for denied claims
The American Academy of Professional Coders (the Academy) has prepared a program of study that is aimed at providing the most up-to-date information relating to CPT-4®, and ICD-9-CM diagnostic coding.
The course curriculum is presented in 60 hour format. Course include medical terminology, anatomy overviews, with CPT-4® and ICD-9-CM coding issues organized in a way that is consistent with the most updated American Medical Association’s Current Procedural Terminology. The course also includes training on the medical manager software program, which is the most highly used medical software used by physicians.
Course Outline:
• Overview Medical Billing and Coding
• Medical Terminology
• Word Parts
• Directional Terms
• E/M codes
Integumentary System
• Medical Terms used within this specialty.
• CPT-4 codes for this specialty
Respiratory System
• Medical Terms used within this specialty
• CPT-4 codes for this specialty
Urinary System
• Medical Terms used within this specialty
• CPT-4 codes for this specialt
Reproductive System
• (Male and female)
• Medical Terms used within this specialty
CPT-4 codes for this specialty
Cardiovascular System
• Medical Terms used within this specialty
• CPT-4 codes for this specialty
Musculoskeletal System
• Medical Terms used within this specialty
• CPT-4 codes for this specialty
• CPT-4 coding for Radiology
• Quiz on Medical terminology and CPT-4 coding
Introduction to ICD-9 codes
• ICD-9 codes
• Quiz on ICD-9 codes
Medical Manager Software
• Medical Manager, CPT-4, ICD-9 and Medical Terminology review