Whether you are just starting work or transitioning from a different field, there has never been a better time to enter a career in medical billing and coding. More than one million practicing physicians in the U.S. rely on medical billers and coders to receive payment for their services. These professionals are in-demand within medical facilities, health insurance companies, specialty pharmacies, medical suppliers, consulting firms, and national medical coding and billing companies. With the right medical billing and coding certification training, the opportunities are nearly endless!
This Medical Billing and Coding course will prepare you for success as you learn about legal, ethical, and regulatory concepts central to this field, including HIPAA compliance, official coding guidelines, and third-party payer requirements. You will come to understand all phases of the revenue cycle—from patient registration through medical coding, claims submission, reimbursement, and collections.
Certification Exam Voucher Included
Included in your tuition, you will receive a voucher to sit for the medical billing and coding certification exam that best fits your career goals:
- Certified Professional Coder (CPC) exam offered by the American Academy of Professional Coders (AAPC)
- Certified Coding Associate (CCA) exam offered by the American Health Information Management Association (AHIMA)
- Certified Billing and Coding Specialist (CBCS) exam offered by the National Healthcareer Association (NHA)
If you choose and pass the CPC exam through AAPC, you will earn the CPC-A credential—the "A" stands for Apprentice, meaning you still need one year of coding experience. But here's the good news: our course includes free access to AAPC's Practicode Practicum—a hands-on training tool that simulates real-world coding across multiple specialties.
By completing Practicode, you will gain the equivalent of one year of experience, allowing you to remove the "A" and become a fully certified CPC right away. The best part? The coding experience required to remove the Apprentice status is seamlessly integrated into the course, so you will complete it as you progress. That means by the time you finish, you will have both passed the exam and fulfilled the experience requirement—qualifying you for full CPC certification right away. The course also includes a Medical Terminology component covering body systems, mental health, and special senses. A test-out option is available if you possess prior knowledge. By scoring at least 80%, you may bypass the Medical Terminology content if you choose. Note: The test-out option applies exclusively to the online Medical Terminology section and does not extend to the advanced career training portion of the course.
Upon successful completion of our medical billing and coding certification course, you will be well-prepared to launch a successful career in this rewarding healthcare field.
Funding Disclaimer: For Workforce Innovation and Opportunity Act (WIOA) funded students, please consult with your funding source representative before taking advantage of the Medical Terminology test-out feature. Different funding programs may have specific requirements and/or restrictions. If you attempt the test-out feature(s) in the Medical Terminology course without getting approval, your funding benefits may be jeopardized.
Instructor(s):Nancy Smith
Nancy Smith has over 30 years of experience in the healthcare industry. Her clinical experience includes working as a medical assistant for a network of rural health clinics, and as a medical coder, insurance claims specialist, and medical records auditor. She worked as a medical office manager for ten years, where she recruited and trained all medical assistants. Nancy holds a bachelor's degree in vocational education and has developed and taught medical assistant programs.
LaTisha Cottingham
LaTisha Cottingham has over 20 years of experience in the healthcare industry. She has six years of teaching experience in the field of medical billing and coding and Medical Assisting. Currently, she is employed as an HIM Analyst for a Long-Term Care establishment that is based out of Alabama. Previously she was employed as the lead instructor for the Allied Health Department for a local career institute. LaTisha's field of expertise is in the area of physician-based inpatient coding and Emergency Department coding. The certifications that she holds are as follows: a Registered Health Information Technician (RHIT), a Certified Professional Coder (CPC), and a Certified Clinical Medical Assistant (CCMA). In preparation for ICD-10-CM, LaTisha received her ICD-10-CM/PCS Trainer Certification from American Health Information Association (AHIMA), where she is currently a member. LaTisha is also a member of the American Academy of Professional Coders (AAPC) and the National Healthcare Association (NHA) where she is a test proctor.
Carline Dalgleish
Carline Dalgleish has worked in medical office administration for over 30 years. She holds a bachelor's degree in Business Information Systems, a master's degree in Leadership, and a post-baccalaureate certificate in Health Information Management. She is a Registered Health Information Administrator and an AHIMA Approved ICD-10-CM/PCS Trainer. Dalgleish is the author of an ICD-10 coding system and owns her own consulting firm.
Lydia S. Stewart
Lydia S. Stewart, RN, BSN, currently serves as the Revenue Cycle Manager at a large regional medical center. Lydia has been a Registered Nurse for 23 years, 15 of those years specializing in Critical Care Nu
Requirements:
Hardware Requirements:
- This course can be taken on either a PC, Mac, or Chromebook.
Software Requirements:
- PC: Windows 8 or later.
- Mac: macOS 12 or later.
- Browser: The latest version of Google Chrome or Mozilla Firefox is preferred. Microsoft Edge is also compatible.
- Microsoft Word or equivalent (not included with enrollment)
- Adobe Acrobat Reader.
- Software must be installed and fully operational before the course begins.
Other:
- Email capabilities and access to a personal email account.
Instructional Material Requirements:
The instructional materials required for this course are included in enrollment.
The following digital textbook for the Medical Terminology course is accessed via links in the course lessons:
- Comprehensive Medical Terminology for Health Professions, 1st Edition (eBook)
The following digital textbooks for Medical Billing and Coding are accessed via links in the course lessons:
- Understanding Health Insurance: A Guide to Billing and Reimbursement, by Michelle A. Green
- Accompanying Workbook: Understanding Health Insurance: A Guide to Billing and Reimbursement
The following textbooks will be shipped to you approximately 7-10 business days after enrollment in Medical Billing and Coding:
- ICD-10-CM Expert for Physicians
- CPT Professional
- HCPCS Level II Professional
Choice of study guide/voucher package upon course completion:
- Certified Professional Coder, CPC (AAPC): AAPC Membership, CPC Online Review Course, CPC Study Guide Bundle, Practice Exam Bundle, Practicode CPC-A Practicum, CPC Exam Voucher (2 exam attempts) and Codify Student (free upgrade to Codify Basic)
- Certified Coding Associate, CCA (AHIMA): AHIMA Student Membership, CCA Study Guide, and CCA Exam Voucher
- Certified Billing and Coding Specialist, CBCS (NHA): CBCS Study Guide, CBCS Practice Test, and CBCS Exam Voucher
Please note: You will receive a digital book if the physical book is on backorder.
*The course includes the current year of coding books, and you will be responsible for purchasing your updated coding books from year to year.
Hide Syllabus
Lesson 1
- Medical Terminology
- Getting Started
- How to Take This Course
- Test-Out Exam 1: Lessons 1–Midterm Exam
- Introduction to Medical Terminology and the Human Body in Health and Disease
- The Musculoskeletal System
- The Cardiovascular System
- The Lymphatic and Immune Systems
- The Respiratory System
- The Digestive System
- The Urinary System
- Midterm
- Test-Out Exam 2: Lessons 8–Final Exam
- The Nervous System
- Special Senses: The Eyes and Ears
- The Integumentary System
- The Endocrine System
- Mental Health
- Male and Female Reproductive Systems
- Diagnostic Procedures, Nuclear Medicine, and Complementary Medicine
- Final Exam
- Medical Billing and Coding
- Introduction to Medical Billing and Coding
- Career Opportunities
- Personal and Technical Qualifications
- Employment Settings
- Telecommunications
- Professional Certifications
- Introduction to Health Insurance
- Health Insurance Terminology
- Commercial and Government Payers
- Healthcare Documentation
- Electronic Health Record
- Managed Healthcare
- Types of Reimbursement
- Managed Care Providers
- Managed Care Models
- Consumer-Directed Health Plans
- Revenue Cycle Management
- Phases of Revenue Cycle Management
- Encounter Form, Chargemaster
- Insurance Claim Cycle
- New Patient Registration
- Collection Practices
- Legal Aspects of Health Insurance and Reimbursement
- Laws Affecting Healthcare
- Protected Health Information
- Health Insurance Portability and Accountability Act (HIPAA)
- Fraud and Abuse in Medical Billing and Coding
- Release of Information
- VI. ICD-10-CM Coding
- Overview of ICD-10-CM
- Key Features
- Organization of the Codebook
- Index to Diseases and Injuries
- Tabular List of Diseases and Injuries
- Coding Conventions
- Official Guidelines
- CPT Coding
- Overview of Healthcare Common Procedure Coding System (HCPCS)
- Category I, Category II, and Category III Codes
- Organization of the Codebook
- Main CPT Sections
- Evaluation and Management
- Anesthesia
- Surgery
- Radiology
- Pathology and Laboratory
- Medicine
- Code Modifiers
- HCPCS Level II Coding
- Overview of HCPCS Level II
- Organization of the Codebook
- Durable Medical Equipment
- ICD-10-PCS Coding
- Overview of ICD-10-PCS
- Code Structure
- Definitions
- Index
- Code Tables
- Coding Steps
- Pharmacology for Coders
- Pharmacodynamics and Pharmacokinetics
- Routes of Administration
- Drug Classifications
- Prescription Drugs and Over-the-Counter Drugs
- Controlled Substances
- Medication Lists and the Electronic Health Record
- MIDTERM
- Clinical Documentation Improvement (CDI)
- Deficiencies in Documentation
- Medical Necessity
- Auditing
- Coding From Patient Documentation
- Coding with Your Codify Encoder
- Insurance Claims
- National Uniform Claim Committee
- CMS-1500 Claim Form
- Patient and Insured Information
- Physician or Supplier Information
- UB-04 Claim Form
- Commercial Insurance
- Individual/Group Health Insurance, Automobile, Disability, Liability, Workers' Compensation
- Completing Commercial Health Insurance Claims
- Blue Cross Blue Shield
- History of BCBS
- Types of BCBS Plans
- Participating/Nonparticipating Providers
- BCBS Billing and Payment Guidelines
- Medicare
- Medicare Eligibility
- Medicare Part A, B, C, and D
- National Coverage Determinations/Local Coverage Determinations
- Participating/Nonparticipating Providers
- Physician Fee Schedule
- Medicare Billing and Payment Guidelines/NCCI
- Medicaid, CHIP, TRICARE, Workers' Compensation
- Medicaid
- Children's Health Insurance Program (CHIP)
- TRICARE
- Workers' Compensation
- Certification
- Selecting the Right Certification
- Study Strategies for the Certification Exam
- Prior to the Exam
- Morning of the Exam
- During the Exam
- How to Find a Job in Medical Billing and Coding
- Formulating Your Career Goals
- What Employers Want
- Showcasing Your Skills
- Resume Tips
- Cover Letter Tips
- Interview Questions
- Land the Job
- Mock Exam
- Final Exam
- ICD-11 Preview
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