Medical Coder and Biller

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PROGRAM OBJECTIVE

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.

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Orientation

Clock Hours: 0 Lecture
Students will be provided an overall orientation of Regional Center for Border Health, Inc./Health Education Career Institute and complete required student file forms. During this orientation, students will be provided a short overview of the course. Orientation to the computer lab and online medical library PubMed will be provided.

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Healthcare Delivery

Clock Hours: 16 Lecture
Students are introduced to the business of medicine in different organizations such as 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.

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Introduction to ICD-9-CM

Clock Hours: 32 Lecture
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.

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Introduction CPT

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

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Medical Procedures

Clock Hours: 35 Lecture
Students study the medical terminology and anatomy applicable to the organ system applying the appropriate guidelines and modifiers to ensure accurate reporting and reimbursement.

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Midterm Exam

Clock Hours: 5

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Respiratory and Cardiovascular Procedures

Clock Hours: 32 Lecture
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.

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Human Body System

Clock Hours: 24 Lecture
Students study the key terms associated with the digestive tract and procedures performed on patients. Students learn to assign appropriate CPT surgery codes from the digestive subsections as well as the components of the CPT-9-CM manual specific to the genitourinary system, male genital system, and female reproductive system.

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Endocrine System

Clock Hours: 12 Lecture
Students learn the procedural coding for the endocrine and nervous system which includes endocrine, nutritional, and metabolic diseases, and immunity disorders as well as the sensory organs.

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Nervous System

Clock Hours: 10 Lecture
Students identify the CPT and ICD-9 codes in the ocular, adnexa, auditory system.

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Anesthesia

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

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Radiology and Pathology/Laboratory

Clock Hours: 24 Lecture
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 services, and identify specific codes helpful to describing the medical necessity and outcomes of specific lab tests including when to apply the appropriate HCPCS level II modifiers.

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Evaluation and Management

Clock Hours: 24 Lecture
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.

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Medicine

Clock Hours: 8 Lecture
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.

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Introduction to ICD10 and The Expansion of the Healthcare Industry

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

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Final Exam

Clock Hours: 6