The Medical Billing & Coding Profession

Medical billing and coding is one of the fastest-growing careers in the healthcare industry today! The need for professionals who understand how to code healthcare services and procedures for third-party insurance reimbursement is growing substantially. Physician practices, hospitals, pharmacies, long-term care facilities, chiropractic practices, physical therapy practices, and other healthcare providers all depend on medical billing and coding for insurance carrier reimbursement. The medical industry will have almost 50% more jobs available by 2018; therefore, a surplus of medical facilities will continue to hire candidates who specialize in medical billing and coding.


The Medical Billing & Coding Program

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), the ICD-10 for both diagnosis and procedure coding, ICD-9 (Introduction and Guidelines) and basic claims processes for insurance reimbursements. 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 delinquent claims, and appealing denied claims

Medical Billing & Coding Detailed Course Information: 

  • Introduction to International Classification of Diseases, Clinical Modifications, Coding Guidelines, Basics of diagnostic and procedural coding
  • Introduction to the organization and use of the ICD-10, ICD-9-CM and CPT manuals
  • The Health Insurance Claim Form (CMS 1500)
  • Reviews of both ICD-10 (diagnostic coding) and ICD-10-PCS (inpatient procedural coding)
  • Various issues surrounding the implementation of ICD-10
  • 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
  • Coding surgical procedures of the integumentary 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, insurance problems & third-party reimbursement issues




Education and Certifications

  • Students should have or be pursuing a high school diploma or GED.
  • There are no state approval and/or state requirements associated with this program.
  • There are several National Certification exams that are available to students who successfully complete this program:
    • American Academy of Professional Coders (AAPC) Certified Professional Coder Exam (CPC or CPC-H Apprentice)
    • American Health Information Association (AHIMA) Certified Coding Associate (CCA) exam
    • National Healthcareer Association (NHA) Billing and Coding Specialist Certification (CBCS)


National Certification

Students who complete this  Medical Billing & Coding program will be prepared to sit for the American Academy of Professional Coders (AAPC) - Certified Professional Coder Exam (CPC or CPC-H Apprentice); the American Health Information Association (AHIMA) Certified Coding Associate (CCA) exam and the National Healthcareer Association (NHA) Billing and Coding Specialist Certification (CBCS) exam. Although there is no state approval, state registration or other state requirements for this program, students who complete this Medical Billing & Coding program  will be prepared and are eligible to sit for these AAPC, AHIMA and NHA national certification exams. Students who complete this program can and do sit for these certification exams and are qualified, eligible and prepared to do so.

Clinical Externship / Hands on Training / Practicum

Although not a requirement of this program, once students complete the Medical Billing & Coding program they have the ability to participate in a clinical externship and/or hands on practicum so as to practice the skills necessary to perform the job requirements of a Medical Billing & Coding professional. Students will be assisted with completing a resume and/or other requirements necessary to work in a hospital, physicians practice, clinic and/or with other healthcare organizations. All students who complete this program are eligible to participate in an externship and will be placed in a healthcare organization near their location.

Note: No refunds can be issued after the start date published in your Financial Award document.