Medical Coding and Billing

• Describe how the US healthcare system works.

• Describe the role of medical coders and billers in the healthcare system.

• Explain the features and functions of an electronic health record (EHR) system.

• Describe federal and state laws that help protect personal health information.

• Identify medical terms and their meanings by applying knowledge of word roots, prefixes, and suffixes.

• Identify and use medical abbreviations and acronyms related to body systems, diseases,

medical procedures, documentation, pharmacology, and healthcare regulations.

• Describe the anatomy and physiology of the human body and of the different body systems.

• Identify and describe careers and job settings for medical coders and billers.

• Identify the qualification requirements and acquire prep tips for taking the CPC exam.

• Identify the qualification requirements and acquire prep tips for taking the CCA exam.

• Use the ICD-10-CM code set to assign diagnosis codes.

• Use the CPT® code set to assign procedure codes.

• Use the HCPCS code set to assign codes for medical procedures and services.

• Use the ICD-10-PCS code set to assign codes for inpatient surgical procedures.

• Assign diagnosis and procedure codes to the highest level of specificity.

• Examine the benefits and drawbacks of using computer-assisted coding (CAC) software.

• Describe the steps and tasks in healthcare revenue cycle management.

• Demonstrate how to handle sensitive patient data and follow regulations and laws that relate to the medical billing process.

• Demonstrate how to prepare and submit clean claims for reimbursement.

• Describe the types of healthcare reimbursement methodologies.

• Explain how to create patient statements, post payments, and the collection process.