Online Class: Introduction to Medical Coding

A self-paced basic medical coding

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14

Lessons
14

Exams &
Assignments
6,144

Students
have taken this course
20

Hours
average time
2.0

CEUs

Course Description

Mastering Medical Coding: Bridging Communication in Healthcare

In the intricate tapestry of the healthcare industry, the precision and punctuality of paperwork play pivotal roles. Professionals navigate an intricate maze, aiming for faultless documentation that ensures the continuity of care and streamlined reimbursement processes.

Enter the realm of 'medical billing,' a critical sector responsible for chronicling patients' billing histories and orchestrating their submissions to respective insurance companies. This is no mere clerical task. Within its folds lies 'medical coding', a specialized practice where specific codes are mapped to medical procedures and diagnoses. Think of it as translating the diverse and intricate language of medical care into a universally comprehensible dialect—a language that resonates with clinicians, healthcare administrators, insurance carriers, and even governmental agencies. Some might also recognize it as 'insurance coding'.

Such standardized communication is not merely helpful but foundational in modern healthcare. By weaving a common thread through varied medical terminologies, it allows for more transparent, efficient, and effective communication among all stakeholders.

Whether you're a novice stepping into the world of medical coding or a veteran aiming to refine your skills, this course offers a deep dive into the subject. Crafted in accessible language, it promises in-depth insights for everyone—from beginners to seasoned professionals.

Here's a brief overview of our structured lessons:

Lesson 1: Introduction to Medical Coding: Unfold the foundational aspects, the 'why' and 'how' of medical coding.
Lesson 2: Introduction to Diagnosis Coding: Begin your deep dive into the nuances of diagnostic coding.
Lesson 3: ICD-10-CM - What is it?: Understand this international statistical classification system and its relevance in coding various health conditions.
Lesson 4: Reimbursement: Explore the financial facet of medical services and how coding impacts healthcare compensation.
Lesson 5: Current Procedural Terminology (CPT): Dive into the standardized coding system for reporting medical procedures and services.
Lesson 6: CPT Coding and Structure: Understand the architecture of CPT, ensuring accurate and efficient coding.
Lesson 7: Evaluation and Management (E/M) Coding: Dive into the intricacies of patient encounters, covering different settings and services.
Lesson 8: Surgery and Integumentary System Coding: Decode the world of surgical procedures and skin-related treatments.
Lesson 9: Anesthesia CPT Codes: Delve into the unique codes associated with anesthesia administration.
Lesson 10: Cardiovascular, Respiratory, Musculoskeletal Systems: Navigate through codes pertaining to these pivotal body systems.
Lesson 11: Radiology and Pathology Coding: Journey through the imaging and laboratory aspects of medical care.
Lesson 12: Introduction to Documentation (Medical History): Understand the value and method of chronicling a patient's medical journey.
Lesson 13: Medical Examination, Decision Making, Selecting the Correct Code: Dive deeper into patient evaluation, ensuring each decision maps perfectly to the right code.
Lesson 14: Issues with Fraud and Abuse: Address the ethical dimension of medical coding, highlighting potential pitfalls and best practices.

Our lesson structures come equipped with assignments, polls, and netlinks, enhancing interactive learning and providing students with a 360-degree understanding of the subject.

In an era where healthcare stands at the crossroads of rapid evolution and rising demands, medical coding acts as a critical lynchpin. By effectively bridging the realms of clinical care and administrative processes, it enables a seamless and efficient healthcare experience for both providers and patients. Join us on this enlightening journey, and play a vital role in shaping the future of healthcare communication. Your coding expertise could be the difference that elevates patient care to new heights.

Courses Frequently Bought Together:

Anatomy and Physiology 101

Introduction to Medical Billing

Medical Terminology 101

Course Motivation

Professional Overview

The healthcare industry, complex and rigorous even for the most knowledgeable and thorough of professionals, requires that paperwork be submitted both in a highly accurate and very timely manner.

The area of healthcare that involves the completion of paperwork outlining patients' billing histories and the submission of that paperwork to the patients' insurance companies for reimbursement is known as "medical billing."

Within medical billing exists the practice of "medical coding," whereby codes are assigned to medical procedures and diagnoses in order to relay--in a universally accepted medical language--information to the insurance company or (in some instances) governmental agencies and/or consulting firms.

Medical billers/coders help physicians' and hospital administrators' by reducing their workloads in matters pertaining to billing and reimbursements.

Essentially, the medical coder translates a physician's notes regarding a patient's medical condition and prescribed treatment(s) into the universally accepted language known as Current Procedural Terminology (CPT)discussed in greater detail within a subsequent chapter either manually or with the assistance of specialized software.

CPT codes exist for all medically-related interactions, i.e., office visits, x-rays, prescription medications, etc. International Classification of Diseases, Clinical Modification (ICD) is a second system in which alpha characters and numbers are used to identify specific diagnoses. A unique combination of both ICD and CPT relay to the third-party payer (insurance company, et al.) the patient's pronounced condition and the treatments received. (Please Note: ICD-10-CM is a separate class).

For payment purposes, there are two primary classes of medical services for which patients are billed: Procedures and Evaluation & Management (E/M) services.

Procedures are activities or treatments performed on the patient, i.e., injections/immunizations, surgery, x-rays, treatments, therapy, and laboratory/pathology services.

E/M services are the interactions that occur between the physician and the patient, i.e., everything from the quick customary office visit to managing a cardiac arrest situation or overseeing a patient on a ventilator in an ICU.

Formerly, medical work operated on what was known as the Usual, Customary and Reasonable system (UCR) in which the costs of procedures and E/Ms were individually determined by the physician or facility in question. However, in light of the government's desire to grant everyone access to equal quality care, standardized methods became required practice.

Therefore, along with ensuring patients are receiving a bare minimum standard of care, they can also be guaranteed that they will not have to be pay excessive fees to receive it.

Additional reasons why the standardized coding system is so important include that the specialization helps deter fraud, and it contributes to the reduction of overall healthcare administrative costs and time overruns.

In addition, medical billing/coding ensures that accurate and detailed records are kept on all patients throughout their lifetime continuum of medical care. Plus, it equips healthcare overseers with factual data from which statistics and forecasting tables can be produced.

In light of the rising costs both inside and outside of the industry, there remains a pervasive, on-going need to reduce costs.

Because they are capable of keeping healthcare costs down and freeing up physicians so that they can focus on medical issues, the future demand for medical billers/coders in the United States, as well as internationally, is anticipated to dramatically increase over the course of the next few years.

Furthermore, additional medical billers/coders are needed because of the increased number of senior citizens (thus, greater need for healthcare-related services).*

*According to the U.S. Bureau of Labor Statistics.

Specific Responsibilities of the Medical Coders' Job

Medical coders are responsible for staying current with medical terminology and correlative codes, and must possess extensive knowledge of the human body, diseases, disorders, applicable medical treatments and regularly used prescription medications.

Focused on the accurate and timely remission of reimbursement, medical billers/coders are expected to communicate well with physicians, patients, and insurance companies. In addition, they also should possess a working knowledge of medical terminology, comprehend the legal and ethical ramifications of the inaccurate labeling of treatments, and have a strong analytical aptitude for coding and decoding billable items.

Education, Training & Certification

In the past, candidates interested in becoming medical coders needed to complete either a two-year or a four-year college program. However, individuals can now acquire the necessary education in medical terminology and training through a technical or vocational school, online program, or correspondence course.

While medical coders do not officially need to be certified in order to perform the responsibilities of the job, many opt to do so as it increases their appeal to employers and their knowledge of the healthcare industry.

Organizations which offer certifications in medical coding include:

The American Health Information Management Association (AHIMA) offers the Certified Coding Specialist (CCS)Hospital certification, which requires that candidates have a minimum of a high school diploma and charges a fee to those who elect to take the exam.

AHIMA also offers the Certified Coding Specialist Physician Based (CCS-P) certification, specifically tailored to those interested in serving private or group practices or other physician-related environments. Eligibility requirements include: possession of a high school diploma and knowledge of specialized coding systems. The certification is supported by both the Society of Clinical Coding (SCC) and the Ambulatory Care Section (ACS). There is a fee to take the exam.

The American Academy of Professional Coders (AAPC) offers the Certified Procedural Coder (CPC) certification. It can be obtained via completion of a home coding training program or through the AAPC National Office. The AAPC offers exams throughout the United States. The AAPC requires one year of coding experience for the CPC certification. The CPC-A is an apprentice certification.

The AAPC also offers the Certified Procedural Coder-Hospital (CPC-H) certification, geared towards the institutional-type setting (hospital) as opposed to the private (physician) practice. The AAPC requires completion of a home training program and the completion of a certification exam given by proctors at a local chapter.

In addition, the AAPC offers a Certified Professional Coder-Payer (CPC-P) certification. This certification is for claims reviewers, utilization management staff, coordination of benefits staff, provider relations and contracting, and customer service staff. A CPC-P must have at least two years coding work experience that includes working with CPT, ICD-10-CM, or HCPCS code sets.

The AAPC requires that each certification maintain a required amount of yearly CEUs. Each examination requires a fee.

Both the AHIMA and AAPC require that exam takers score a minimum of 70 percent or better on their exams in order to qualify for passing status and, thus, earn their respective certifications.

In addition, often times, as a follow-up to a passing grade on the CCS or CCS-P exam, the AHIMA may also conduct an in-person interview to ensure candidates are suitably well-versed in the areas of: medical terminology, coding protocols, patient charts, physiology, and medical/human anatomy.

The advantage to those with such credentials is that their qualifying organizations--the AHIMA or the AAPC--can help place them in medical coding positions with reputable organizations or medical office settings.

Regardless of which specific certification you decide to acquire (if, in fact, you decide to acquire any), the types of information you will need to be successful as a professional medical coder include:

Basic medical terminology
Basic claims process for medical insurance reimbursement
Methodologies for completing common insurance forms
Guidance for using medical billing software
Introduction to diagnostic and procedural coding systems

In the future you may desire to expand upon your knowledge base as there are several fields directly related to medical billing.

Specialties related to medical billing include:

Medical coding
Medical billers
Medical auditors
Medical claims reviewers
Billing coordinators
Reimbursement specialists
Patient account representatives
Medical claims analyst
Medical claims processors
Medical collectors

As anyone in the medical field can tell you, medical coding and billing might as well be considered a separate language. In order to decipher it, you’ll have to invest some pretty serious time and effort learning the secrets of medical coding.

Fortunately, your efforts won’t be in vain – they'll pay off in dividends. Job opportunities are everywhere!

Some schools and programs charge thousands of dollars to train professionals in the art of medical coding and billing.

But what if you don't have thousands of dollars to spend?

Not everyone can qualify for grants and financial aid packages. Others still can’t take time away from their schedules at work or home to attend traditional classes.

What's your situation?

Medical coding, which is also known as insurance coding is an increasingly popular field and trained students are always in demand. And unlike so many other careers, that demand isn’t likely to diminish anytime soon. It’s an essential skill that the healthcare industry couldn’t operate without. It not only creates and maintains a unified, Universal language that doctors rely on, but one essential to administrators, insurance companies, lawyers and other officials as well.

Whether you’re looking for a new job or simply greater job security, don’t let yourself fall behind. Enrollment is always open, so there’s no reason you can’t get started right now!

Medical Coding 101 is ideal for serious students that can handle the freedom of a virtual, self-paced classroom without falling behind in their studies. In order to succeed, you’ve got to be committed and disciplined.

One of the reasons that this course is so demanding is that the field of medical coding is demanding in and of itself. That’s because the medical and healthcare industries aren’t just about patients and diagnoses – it’s also about paperwork. And there’s a lot of that!

For every doctor, there are sometimes several hundred patients. And each of those patients has medical histories, insurance plans with all the hoops and loopholes, referrals and much more. And every sheet of paper for every patient will be processed by a medical coder at some point.

Don’t let the behind-the-scenes nature of the job fool you – medical coding is vitally important – mandatory even – because it both creates AND maintains a universal language that everyone in the field needs to effectively communicate and get things done.

This is a great preparation course that will not only help you enter but excel in the complex and rigorous role of a medical coder.

Over the course of 17 in-depth lessons, you’ll immerse yourself in this new language, with all of its quirks and quips. You’ll take a look at issues and questions such as:

· What is medical coding?

· What is diagnosis coding?

· ICD-10-CM: What is it and what does it do?

· Reimbursement

· Coding practice problems

· Procedural terminology

· CPT coding

· And much, much more!

While the completion of this course doesn’t require that you buy any textbooks or class materials, the instructor does have a few recommendations to optimize your success:

A working knowledge of medical terminology (which you can also learn about here at UniversalClass)
A grasp of the basics of Anatomy and Physiology (also available on UniversalClass)

We’re not denying it – this course isn’t going to be easy. It’s going to take some work! But it’s more than worth the investment!

However, you can get a head start on success by getting started on this class today. Enrollment is open 24/7, so there’s no excuse to put it off any longer!

Completely Online
Self-Paced
6 Months to Complete
24/7 Availability
Start Anytime
PC & Mac Compatible
Android & iOS Friendly
Accredited CEUs

Universal Class is an IACET Accredited Provider

Course Lessons

Average Lesson Rating:

"Extraordinarily Helpful"

(6,844 votes)

Lesson 1: Introduction to Medical Coding

The healthcare industry, complex and rigorous even for the most knowledgeable and thorough of professionals, requires that paperwork be submitted both in a highly accurate and very timely manner. 51 Total Points

Lesson discussions: Medical Billing Class; Reasons for Taking this Course
Complete Assignment: Course Introduction and Goals
Assessment: Lesson Exam 1

Lesson 2: Introduction to Diagnosis Coding

"Act or process of identifying of determining the nature and cause of a disease or injury through the evaluation and examination of a patient history's and the review of subsequent laboratory data." Additional lesson topics: RVU flashcards; AMA Relative-Value Units; Practice Management and RVUs 91 Total Points

Lesson discussions: Please rate Lesson 2: Introduction to Diagnosis Coding
Assessment: Lesson Exam 2

Lesson 3: ICD-10-CM - What is it?

Introduction to ICD-10-CM coding. 8 Total Points

Lesson discussions: Please rate Lesson 4: ICD-CM - What is it?
Assessment: Lesson Exam 3

Lesson 4: Reimbursement

One of the primary purposes of medical coding, and subsequent billing, is to obtain a reimbursement from the third-party biller. 90 Total Points

Lesson discussions: Please rate Lesson 5: Reimbursement
Assessment: Lesson Exam 4

Lesson 5: Current Procedural Terminology (CPT)

What is CPT? Please purchase a the CPT 2021 Professional Edition published by the American Medical Association. 40 Total Points

Lesson discussions: Please rate Lesson 6: Current Procedural Terminology (CPT)
Assessment: Lesson Exam 5

Lesson 6: CPT Coding and Structure

Current Procedural Terminology (CPT) as officially stated encompasses a set of codes, descriptions and guidelines used to distinguish medical procedures performed by physicians and additional healthcare providers. 100 Total Points

Lesson discussions: Please rate Lesson 8: CPT Coding and Structure
Assessment: Lesson Exam 6

Lesson 7: Evaluation and Management (E/M) Coding

In this lesson we'll be exploring E/M coding. 80 Total Points

Lesson discussions: Please rate Lesson 8: Evaluation and Management (E/M) Coding
Assessment: Lesson Exam 7

Lesson 8: Surgery and Integumentary System Coding

In this lesson we'll explore surgery and Integumentary System coding. Additional lesson topics: Coding for Skin Tags; Surgery Guidelines in CPT; CPT Integumentary Section Guidelines and How To Code Part 1 110 Total Points

Lesson discussions: Please rate Lesson 9: Surgery and Integumentary System Coding
Assessment: Lesson Exam 8
Assessment: Lesson 8 - Let's Code!

Lesson 9: Anesthesia CPT Codes

Let's explore the anesthesia CPT codes. Additional lesson topics: Anesthesia Coding Tips 100 Total Points

Lesson discussions: Please rate Lesson 10: Anesthesia CPT Codes
Assessment: Lesson Exam 9

Lesson 10: Cardiovascular, Respiratory, Musculoskeletal Systems

Cardiovascular, respiratory and musculoskeletal are distinct in terms of their unique terminologies and special cases, they all share the commonality of having a range of codes correlative to anatomical surgeries. 0 Total Points

Lesson discussions: Please rate Lesson 11: Cardiovascular, Respiratory, Musculoskeletal Systems

Lesson 11: Radiology and Pathology Coding

We will now turn our attention to the two remaining CPT Manual subsections (outside of medicine and the appendices), those of radiology and pathology. 100 Total Points

Lesson discussions: Please rate Lesson 12: Radiology and Pathology Coding
Assessment: Lesson Exam 11

Lesson 12: Introduction to Documentation (Medical History)

Health Information Management and Documentation occupies a titanic area within the medical world. 11 Total Points

Lesson discussions: Please rate Lesson 14: Introduction to Documentation (Medical History)
Assessment: Lesson Exam 12

Lesson 13: Medical Examination, Decision Making, Selecting the Correct Code

As a medical coder, your job will be select the most appropriate diagnostic and/or procedural code in order to report encounters, services, tests, treatments, supplies and procedures provided to a patient. 0 Total Points

Lesson discussions: Please rate Lesson 15: Medical Examination, Decision Making, Selecting the Correct Code

Lesson 14: Issues with Fraud and Abuse

Within the US, hundreds upon hundreds of cases of medical coding/billing fraud and abuse annually amount to billions of dollars lost to government programs, public and private healthcare companies, and third-party billers. 10 Total Points

Lesson discussions: What is your opinion of this course?; Program Evaluation Follow-up Survey (End of Course); Course Comments
Assessment: Lesson Exam 14

791

Total Course Points

Learning Outcomes

By successfully completing this course, students will be able to:

Define medical coding.
Summarize diagnosis coding.
Define ICD-9-CM and summarize its coding and structure.
Describe the reimbursement process.
Demonstrate solving ICD-9-CM coding practice problems.
Define Current Procedural Terminology (CPT) and summarize its coding and structure.
Demonstrate Evaluation and Management (E/M) Coding.
Demonstrate Surgery and Integumentary System Coding.
Demonstrate using Anesthesia CPT Codes.
Demonstrate coding for Cardiovascular, Respiratory, Musculoskeletal Systems.
Demonstrate Radiology and Pathology Coding.
Solve CPT Coding Practice Problems.
Summarize documentation procedures.
Summarize issues with fraud and abuse.
Demonstrate mastery of lesson content at levels of 70% or higher.

Additional Course Information

Document Your Lifelong Learning Achievements
Earn an Official Certificate Documenting Course Hours and CEUs
Verify Your Certificate with a Unique Serial Number Online

View and Share Your Certificate Online or Download/Print as PDF
Display Your Certificate on Your Resume and Promote Your Achievements Using Social Media

Course Title: Introduction to Medical Coding

Course Number: 31868

Lessons Rating: 4.3 / 5 Stars (6,844 votes)

Languages: English - United States, Canada and other English speaking countries

Category:

UniversalClass.com > Medical Billing, Coding, Administration > Medical Coding

Availability: This course is online and available in all 50 states including: California, Florida, Georgia, Illinois, New York, Pennsylvania, Ohio, Texas, and Washington.

Last Updated: January 2024

Course Type: Self-Paced, Online Class

CEU Value: 2.0 IACET CEUs (Continuing Education Units)

CE Accreditation: Universal Class, Inc. has been accredited as an Authorized Provider by the International Association for Continuing Education and Training (IACET).

Grading Policy: Earn a final grade of 70% or higher to receive an online/downloadable CEU Certification documenting CEUs earned.

Assessment Method: Lesson assignments and review exams

Instructor: Diana Wilson, CPC-I, CPC, CPCO, CPB, CPMA, CPCO, CPPM

Syllabus: View Syllabus

Course Fee: $170.00 U.S. dollars