Medical Coding & Billing Program Outline

Elite Training (And Way More)

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Overview

Interested in medical billing and coding jobs? Sign up for our online medical coding courses. Our courses were developed by ICD-10-CM/PCS trainers and experts with decades of experience working in and teaching medical coding and billing.

Our program is reverse engineered from leading industry certifications. You’ll learn everything you need to ace the exam and get your credentials as soon as you complete your courses. Our program is also preferred by leading employers, including the top provider of healthcare services in the U.S. and one of the nation's largest managed healthcare companies.

Both use our online medical billing and coding programs to train their employees and often hire our trainees. In other words, complete our program and you’ll not only be the best of the best, but you’ll also be ready to start confidently working medical billing and coding jobs from home and earning immediately.

Program Contents

Our in-depth, three-part online program thoroughly trains you on reimbursement methods, biomedical sciences, and current code sets (CPT, HCPCS, ICD-10-CM, and the optional ICD-10-PCS-Foundation). You’ll get priceless hands-on experience with actual medical records and with the industry-standard 3M encoding software, we have the best online medical coding programs available.

390 hours of online courses

55 hours of foundations in PCS (optional)

Timeline

Our online medical coding courses are designed to be completed in just 16 weeks of full-time study—based on 8 hours a day, 5 days a week. They’re totally self-paced, so you have the flexibility to study as much or as little as your schedule allows. How long it takes to complete the program is up to you.

Have other obligations and think you may need a little extra time? No worries. You’ll have one full year of program access to complete your training. Best of all, you don’t have to wait to begin. As soon as your payment is processed, we’ll email your login and password so you can start training immediately.

4 months of full-time study

12 months of program access

Study Format

Don’t think of this as e-learning, think of it as we-learning, because we’re with you every step of the way. Real people—dedicated trainers, technical support team, and career advisors—are all committed to your success, from pre sign up to post completion.

Our accredited online medical billing and coding programs offer the flexibility you need to create your own study schedule.

Learn from home (or anywhere)

Study online (anytime)

Materials

In addition to expert-created training and one-on-one support, you'll get several industry textbooks. In order to provide the most up-to-date coding information (codes change every year), these books are shipped out as you reach certain milestones in the program.

ICD-10-CM The Complete Official Codebook

CPT Professional Edition

HCPCS Level II Professional

ICD-10-PCS The Complete Official Codebook

ICD-10-CM & ICD-10-PCS Coding Handbook

Comprehensive Medical Terminology

Support

Don’t think of this as e-learning, think of it as we-learning, because we’re with you every step of the way. Real people—dedicated trainers, technical support team, and career advisors—are all committed to your success, from pre sign up to post completion.

One-on-one support

Phone, live chat, and email

AHIMA membership and mentor program

Medical Coding & Billing Training Modules

Our program is divided into three courses consisting of 15 bite-size modules. Think of each module as a class. An optional fourth course consisting of three modules is also available. Click each module to see what you’ll learn.

Program Orientation (1 Hour)

  • Identify the elements, expectations, and requirements of the program.
  • Navigate the program using the pages, menus, and buttons provided.
  • Use the program tools, including the study planner, gradebook, and completion report as well as be able to contact CareerStep using via phone, email, forums, chat rooms, and social media.
  • Identify program-specific resources, including the 3M Encoder, as well as be able to order your coding books with an understanding of the yearly coding update schedule.

Computer Fundamentals (Optional) (7 Hours)

  • Identify basic computer hardware and interpret system requirements.
  • Navigate a Windows operating system environment, as well as install and operate basic software utilities.
  • Use a web browser to navigate between websites in multiple tabs or windows, send and receive email, and access search engines to find information and troubleshoot basic computer problems.
  • Recognize basic technologies related to an office environment.

Health Information Management (14 Hours)

  • Identify data sources by describing types of medical records and the information found in each record.
  • Describe the role medical records take in coding and billing.
  • Describe the structure and use of health information.
  • Identify record data collection tools.
  • Discuss healthcare data sets.
  • Discuss appropriate health record documentation.
  • Describe data quality and integrity.
  • Discuss health information systems, including specialty coding systems.
  • Describe the archival, retrieval, and imaging systems used in health information.
  • Identify data retrieval, maintenance, security, and integrity processes.
  • Discuss the evolution of the electronic health record (EHR) and the personal health record (PHR).

Healthcare Delivery Systems (4 Hours)

  • Explain the main structure and organization of healthcare services in the United States.
  • Differentiate between the various healthcare settings.
  • Differentiate between healthcare providers.
  • Identify the structure of hospitals in the United States.
  • Explain the purpose of healthcare licensure, certification, and accreditation in healthcare facilities.
  • Differentiate between healthcare registries and the purpose of each.
  • Identify the various stakeholders throughout the healthcare delivery systems.
  • Describe current trends in healthcare delivery.

Legal and Compliance (5 Hours)

  • Explain the legislative and regulatory processes in the United States.
  • Describe the laws and regulations pertaining to health information.
  • Define the Health Insurance Portability and Accountability Act (HIPAA).
  • Adhere to privacy and security policies.
  • Identify the components of the Code of Ethics and Standards of Ethical Coding.

Reimbursement Methodologies (21 Hours)

  • Define commercial, managed care, and federal insurance plans.
  • Identify various compliance strategies and reporting.
  • Define and list payment methodologies and systems (such as capitation, prospective payment systems, RBRVS, MS-DRGs).
  • Describe the billing processes and procedures (such as claims, EOB, ABN, electronic data interchange).
  • Explain chargemaster maintenance.
  • Describe regulatory guidelines.
  • Discuss reimbursement monitoring and reporting.

Medical Terminology (50 Hours)

  • Spell, define, and pronounce medical terms.
  • Engage in supplemental online and/or CD tools to enhance learning.
  • Discuss concepts of building medical words using root/suffix/prefix.
  • Define common medical terms of major disease processes.
  • Define common abbreviations.

Anatomy and Physiology (45 Hours)

  • Identify and describe the basic structure, organization, and functions of human body systems.
  • Identify anatomical structures of the body using anatomical orientation tools such as labels and assessment.
  • Use anatomical plate work to enhance the learning experience.

Introduction to Coding (16 Hours)

  • Discuss use of official coding guidelines.
  • Define the difference between inpatient and outpatient coding guidelines.
  • Discuss coding compliance strategies, including the physician query process.
  • Identify auditing methods.
  • Identify the principles and application of coding systems.
  • Review classifications, nomenclatures, and clinical vocabularies.
  • Discuss automated coding software systems (CAC, encoders).
  • Describe natural language processing.
  • Compare classifications, nomenclatures, terminologies, and clinical vocabularies (SNOMED-CT, ICD-O, CPT, DSM-IV).
  • Describe the relationship between the Systematized Nomenclature of Medicine (SNOMED) and the electronic health record.
  • Apply ethical coding to practice cases.
  • Discuss severity of illness systems, including MS-DRGs.
  • Describe coding quality monitors.

ICD-10 Coding (55 Hours)

  • Describe the use of official coding guidelines and reporting requirements.
  • Define the background of ICD-10-CM and ICD-10-PCS.
  • Define and apply the General ICD-10-CM conventions and guidelines.
  • Define the Uniform Hospital Discharge Data Set (UHDDS).
  • Practice basic coding process steps.
  • Define and apply the ICD-10-CM chapter-specific coding guidelines to all 21 chapters in ICD-10-CM.
  • Practice assigning ICD-10-CM codes in many practice exercises.
  • Navigate the ICD-10-CM codebook.
  • Locate and accurately construct diagnosis codes using the Alphabetic Index to Diseases, the Tabular List, the Table of Neoplasms, the Table of Drugs and Chemicals, and the Index to External Causes.
  • Identify the components of the Code of Ethics and Standards of Ethical Coding.
  • Apply ethical coding to practice cases.

CPT/HCPCS Coding – Block 1 (40 Hours)

  • Navigate the CPT code book and identify the uses of the conventions, index, numeric section, and appendices.
  • Recognize modifiers that can be appended to CPT procedure codes as well as identify when their use is appropriate.
  • Calculate and assign CPT Evaluation and Management codes.

CPT/HCPCS Coding – Block 2 (40 Hours)

  • Identify the meaning and purposes of procedural code audits and how to apply them.
  • Apply the guidelines for the six main sections of the CPT code book and assign codes from each section.
  • Identify the uses of CPT Category II and Category III codes.
  • Navigate the HCPCS Level II code book and apply its contents, including the conventions, index, tabular list, levels of use, Table of Drugs and Biologicals, and appendices.
  • Describe the use of coding guidelines and reporting requirements.
  • Practice case studies and more complex code assignments using CPT and HCPCS Level II codes.
  • Review examples of RBRVS, APCs, ASCs, and E/M services.

Advanced ICD-10 Coding (11 Hours)

  • Assign ICD-10-CM diagnosis codes to a variety of coding scenarios and case studies.
  • Apply official coding guidelines and reporting requirements for coding scenarios.
  • When appropriate, sequence coding assignments according to guidelines.

Coding Practicum (80 Hours)

  • Apply knowledge of coding to a variety of authentic coding scenarios to build speed and accuracy.
  • Demonstrate hands-on encoder use.
  • Practice resolving code edits.
  • Practice the use of official coding guidelines and reporting requirements.
  • Assign codes for outpatient settings including, physician, emergency room, and same-day surgery.

Final Exam Preparation (1 Hour)

  • Identify the steps needed to be eligible and prepared for the final exam.
  • Identify the format, restrictions, and policies of final exams, including scoring, retakes, allowed resources, and time limits.

ICD-10 Coding - Optional (10 Hours)

  • Describe the use of official coding guidelines and reporting requirements.
  • Define the background of ICD-10-CM and ICD-10-PCS.
  • Define and apply the General ICD-10-CM and ICD-10-PCS conventions and guidelines.
  • Define the Uniform Hospital Discharge Data Set (UHDDS).
  • Practice basic coding process steps.
  • Define and apply the ICD-10-CM chapter-specific coding guidelines to all 21 chapters in ICD-10-CM.
  • Practice assigning ICD-10-CM codes in many practice exercises.
  • Navigate the ICD-10-CM codebook.
  • Locate and accurately construct diagnosis codes using the Alphabetic Index to Diseases, the Tabular List, the Table of Neoplasms, the Table of Drugs and Chemicals, and the Index to External Causes.
  • Identify the components of the Code of Ethics and Standards of Ethical Coding.
  • Apply ethical coding to practice cases.

Advanced ICD-10 Coding - Optional (5 Hours)

  • Assign ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes to a variety of coding scenarios.
  • Apply official coding guidelines and reporting requirements for coding scenarios.
  • When appropriate, sequence code assignments according to guidelines.

Inpatient Coding Practicum - Optional (40 Hours)

  • Define and apply ICD-10-PCS conventions and guidelines.
  • Define and apply the root operation guidelines in ICD-10-PCS.
  • Discuss the Present on Admission Indicator (POA).
  • Define ICD-10-PCS definitions and apply to coding common procedure codes.
  • Navigate the ICD-10-PCS codebook.
  • Locate and accurately construct procedure codes using the Alphabetic Index and Tables in the ICD-10-PCS classification.
  • Assign ICD-10-PCS procedure codes to a variety of coding scenarios and case studies.
  • Assign diagnostic groupings.

ICD-10-PCS Foundations (55 Hours)

  • Define and apply ICD-10-PCS conventions and guidelines.
  • Define and apply the root operation guidelines in ICD-10-PCS.
  • Discuss the Present on Admission Indicator (POA).
  • Define ICD-10-PCS definitions and apply to coding common procedure codes.
  • Navigate the ICD-10-PCS codebook.
  • Locate and accurately construct procedure codes using the Alphabetic Index and Tables in the ICD-10-PCS classification.
  • Assign ICD-10-PCS procedure codes to a variety of coding scenarios and case studies.
  • Assign diagnostic groupings.
  • Assign codes for inpatient admissions.

ICD-10-PCS Coding Foundations Course Exam

Medical Coding and Billing Certifications

Inspire confidence in employers and set yourself apart from other job seekers by earning industry certifications. (Generally, the more certifications you earn, the more income you can earn.) Our online medical coding courses include a free voucher to take the CPC or COC national certification exam upon completion, up to a $425 value. We can help you decide which certification is best for you.

Certified Professional Coder (CPC®)

Certified Outpatient Coder (COC™)

Certified Billing and Coding Specialist (CBCS)

Certified Coding Associate (CCA®)