Medical Coder and Biller

PROGRAM DESCRIPTION

The Medical Coder and Biller Training Program is a 14-week program of part time instruction with a total of 300 clock hours designed to prepare students for certification as a medical coder and biller. The focus of this program is learning the coding rules for the CPT, ICD-10-CM, and Level II (HCPCS) coding systems and then applying the rules to code patient services. In addition, a variety of payment systems is presented. The medical topics of Medicare fraud/abuse, HMOs, and QIOs are also reviewed. This program is licensed by the Arizona State Board for Private Postsecondary Education.

ADMISSION REQUIREMENTS

All interested participants must submit a completed admission application. Participants must have the following:

• High School diploma or GED
• Score 8.0 on the Test Adult Basic Education (TABE)
• 18 years of age or older
• Ability to pay or qualify for sponsorship from area employment partners/governmental agencies.
• Ability to fully participate in classroom, laboratory, or clinical setting program activities.
• Students will test for the American Academy of Professional Coders certification.

GRADUATION REQUIREMENTS

To graduate from the Medical Coder and Biller Training Program the student must:

• Pass all required programs of study
• File a completed application for graduation
• Clear any indebtedness to the College 

REQUIRED CLASSROOM HOURS

A total of 300 clock hours which includes 241 lecture, 48 computer lab, and 11 examination.

Orientation

Clock Hours: 0 Lecture. Prerequisites: None.
Students will be provided an overall orientation of Regional Center for Border Health, Inc. College of Health Careers, and complete required student file forms. During this orientation, student will be provided a short Medical Terminology course with an evaluation at the end of the course to measure understanding. Student will be taught how to “break down” medical terms using prefixes, root words and suffix’s to promote a basic understanding of the terminology used in the medical field.

Healthcare Delivery

Clock Hours: 16 Lecture. Prerequisites: Orientation.
Students are introduced to the business of medicine in different organizations such coding as a profession, physician office and hospital services and different type of payers, government regulations in healthcare and HIPAA. Students learn Medical Terminology, Anatomy and Disease Processes as well as analysis of the information generated.

Introduction to ICD-10-CM

Clock Hours: 32 Lecture. Prerequisites: Healthcare Delivery.
Students learn to translate medical terminology for diseases and diagnosis into numeric codes. Students practice the coding guidelines and common diagnoses in each ICD-9-CM.

Introduction CPT

Clock Hours: 8 Lecture. Prerequisites: Introduction to ICD-10-CM.
Students learn the Current Procedural Terminology (CPT) guidelines, codes, and descriptions to report healthcare services and procedures performed by healthcare providers.

Medical Procedures

Clock Hours: 35 Lecture. Prerequisites: Introduction to CPT.
Students study the medical terminology and anatomy applicable to the Organ System applying the appropriate guidelines and modifiers to ensure accurate reporting and reimbursement.

Mid-Term Examination

Clock Hours: 5. Prerequisites: Healthcare Delivery, Intro to ICD-10-CM, Intro to CPT, Medical Procedures.
Mid Term examination consists of knowledge of all previously covered chapters in the text, medical terminology, how to obtain appropriate ICD-10 & CPT codes.

Respiratory & Cardiovascular Procedures

Clock Hours: 32 Lecture. Prerequisites: Medical Procedures & passing the Mid-Term Examination.
Student study CPT, ICD-10-CM & HCPCS Level II coding for the Respiratory, Hemic & Lymphatic Systems, Mediastinum & Diaphragm, Cardiovascular & Surgical procedures. Students practice hand on examples.

Human Body System

Clock Hours: 24 Lecture. Prerequisites: AAPC, Medical Coding Training, chapters 1-10 & successfully  passing the Mid-Term examination.
Students study key terms associated with the digestive tract and procedures performed on the patients. Students learn to assign appropriate CPT surgery codes from the digestive subsections as well as the components of the ICD-10-CM specific to the genitourinary, male & female reproductive systems.

Endocrine System

Clock Hours: 12 Lecture. Prerequisites: Human Body System. 
Students learn the procedural coding for the Endocrine and Nervous System which includes EndocrineS, Nutritional, and Metabolic Diseases, and Immunity Disorders as well as the Sense Organs.

Nervous System

Clock Hours: 10 Lecture. Prerequisites: Endocrine System.
Students identify the CPT and ICD-10 codes in the Ocular, Adnexa, Auditory System.

Anesthesia

Clock Hours: 8 Lecture. Prerequisites: Nervious System.
Students learn the basic concepts for assigning an anesthesia code anatomically and by description. Students understand the unique anesthesia coding guidelines.

Radiology and Pathology & Laboratory

Clock Hours: 24 Lecture. Prerequisites: Anesthesia.
Students understand the Anatomical Planes, Anatomical directions, and positioning in Radiology. They learn the importance of the assigned parenthetic instructions, concepts specific to pathology and laboratory coding. Students learn the assigning codes for diagnostic service and identify specific codes helpful to describe the medical necessity and outcomes of specific lab tests, including when to apply the appropriate HCPCS Level II modifiers.

Evaluation and Management

Clock Hours: 24 Lecture. Prerequisites: Radiology, Pathology & Laboratory.
Students understand the requirements for the different levels of service and how to select the appropriate code concept based on location, physician work and medical decision making.

Medicine

Clock Hours: 8 Lecture. Evaluation & Management.
Students learn steps to correct coding concepts, proper application of modifiers, diagnosis coding tips and some applicable HCPCS Level II reference for non-invasive or minimally invasive procedures.

Expansion of the Healthcare Industry

Clock Hours: 8 Lecture. Prerequisites: Medicine.
Students learn how to utilize the new ICD-10-CM and the associated 5010 transaction standard. Students are introduced to electronic medical records and documentation.

Computer Software Laboratory

Clock Hours: 48 Lecture. Prerequisities: AAPC, Medical Coding Training, Chapters 1-15& successfully passing the Mid-Term examination.
Students are introduced to the Office Ally Practice Management Software, which is an Electronic Health Record & Billing Software. Once students are comfortable with using this software, any other software package will be much easier to learn. Students get to practice the creation of claims by abstracting diagnostic/procedure statements & assigning appropriate codes. Students will create these claims for submission using the software training area that does not impact actual patient records.

Final Examination

Clock Hours: 6. Prerequisites: AAPC, Medical Coding Training, chapter 1-15, succesfully passin the Mid-Term Examination & completion of Computer Software Laboratory.