Outline

1. Medical Terminology
   1. Introduction to Medical Terminology
   2. The Musculoskeletal System
   3. The Cardiovascular System
   4. The Lymphatic and Immune Systems
   5. The Respiratory System
   6. The Digestive System
   7. The Urinary System
   8. The Nervous System
   9. The Special Senses The Eyes and Ears
   10. The Integumentary System
   11. The Endocrine System
   12. The Reproductive System
   13. Diagnostic Procedures, Nuclear Medicine, Pharmacology
2. Medical Billing and Coding
   1. Introduction to Medical Billing and Coding
      1. Personal Qualifications
      2. Career Opportunities
      3. Certifications
   2. Healthcare Law
      1. HIPAA Privacy Rule and Security Rule
      2. Protected Health Information
      3. Fraud and Abuse
      4. Stark Law
      5. False Claims Act
   3. Introduction to Health Insurance Terms
      1. Health Insurance Terms
      2. Managed Care
      3. Healthcare Provider Terms
      4. Third-Party Reimbursement Methods
   4. Pharmacology for Coders
      1. Definition of Pharmacology
      2. Generic and Brand Names
      3. Drug Classifications
      4. Therapeutic Uses of Medications
      5. Routes of Administration
      6. Formularies
      7. Medication Lists
   5. ICD-10-CM
      1. Overview of ICD-10-CM
      2. Format of ICD-10-CM
      3. ICD-10-CM Coding Guidelines
      4. ICD-10-CM Coding Conventions
      5. Steps for Assigning ICD-10-CM Codes
   6. CPT and HCPCS Level II Coding
      1. Healthcare Common Procedure Coding System
      2. Organization of the CPT Code Book
      3. CPT Coding Conventions
      4. Organization of the HCPCS Level II Code Book
      5. Steps for Assigning CPT and HCPCS Level II Codes
   7. Abstracting Information from Medical Documents
      1. Coding from SOAP Notes
      2. Coding from a Consultation Report
      3. Coding from Operative Reports
      4. Coding from Emergency Room Records
      5. Coding from Procedure Reports
   8. New Patients, Insurance Claims and EOBs
      1. Electronic, Paper and Hybrid Medical Records
      2. Practice Management Software
      3. Patient Portal
      4. Developing an Insurance Claim
      5. New Patient Procedures
      6. Medical Necessity
      7. Explanation of Benefits (EOB)
      8. Collection Practices
   9. Submitting Electronic Claims and CMS 1500
      1. Electronic Data Interchange (EDI)
      2. Electronic Claims Submission
      3. 1500 Claim Form
      4. National Uniform Claim Committee
   10. Blue Cross/Blue Shield
       1. Participating and Nonparticipating Providers
       2. Allowable Fee
       3. Usual, Customary and Reasonable (UCR)
       4. Blue Shield Claims Submission
   11. Medicare
       1. Medicare Parts A, B, C and D
       2. Participating and Nonparticipating Providers
       3. Advance Beneficiary Notice (ABN)
       4. Supplemental Insurance
       5. NCCI
       6. Medicare Claims Submission
   12. Other Healthcare Programs
       1. Medicaid
       2. TRICARE
       3. CHAMPVA
       4. Workers’ Compensation
       5. Claims Submission
   13. ICD-10-PCS (Optional Lesson)
       1. Overview of ICD-10-PCS
       2. ICD-10-PCS Code Structure
       3. Index and Table Conventions
       4. Code Components
       5. Definitions Used in ICD-10-PCS
   14. Survey of Hospital Billing
       1. Hospital Revenue Cycle
       2. Chargemaster
       3. Master Patient Index
       4. Prospective Payment Systems
       5. Principal Diagnosis
       6. Present On Admission
   15. Career Roadmap for Medical Billing and Coding – Find a Job Fast
       1. Introduction
       2. Succeeding in the Gig Economy
       3. Your Skills and Talents
       4. Your Résumé and Cover Letter
       5. Using Email and Social Media
       6. Connecting with Others
       7. Acing the Interview
       8. Negotiating Your Salary
       9. After You Land the Job
       10. Review and Reflect

• This course can be taken on either a PC or Mac.

Software Requirements:

• PC: Windows XP or later.
• Mac: OS X Snow Leopard 10.6 or later.
• Browser: The latest version of Google Chrome or Mozilla Firefox are preferred. Microsoft Edge and Safari are also compatible.
• Microsoft Word (not included in enrollment).
• Windows Media Player or a similar program.
• Adobe Acrobat Reader. Click here to download the Acrobat Reader.
• Software must be installed and fully operational before the course begins.

Other:

• Email capabilities and access to a personal email account.

Prerequisites:

• There are no prerequisites to take this course. However, in order to sit for national certification exams, candidates must have a high school diploma or equivalent. Therefore, it is recommended you have this before enrolling for this course.

Instructional Material Requirements:

The instructional materials required for this course are included in enrollment. The following textbooks will be shipped to you approximately 7-10 business days after enrollment:

• A Guide to Health Insurance Billing
• CPT Professional Edition
• HCPCS Level II Professional
• ICD-10-CM Expert for Physicians with Guidelines
• Medical Terminology for Health Professions

After successfully completing this course, you'll also receive access to the National Healthcare Association (NHA) online practice exams and study guide, to help you study for your certification exam.