MED 151 : MEDICAL BILLING AND CODING II

Medical assisting students receive advanced training in procedural and diagnostic coding and medical billing practices. Topics covered include ICD-9, ICD-10, and CPT coding, and hospital billing and coding procedures. Students will be instructed in the use of an educational electronic medical record (EMR) system. NOTE: Students need to have entry codes to register.

Course Outcomes

1. Interpret information on an insurance card
2. Verify eligibility for services including documentation
3. Obtain precertification or preauthorization including documentation
4. Complete an insurance claim form
5. Interact professionally with third party representatives
6. Display tactful behavior when communicating with medical providers regarding third party requirements
7. Show sensitivity when communicating with patients regarding third party requirements
8. Describe how to use the most current procedural coding system
9. Describe how to use the most current diagnostic coding classification system
10. Describe how to use the most current HCPCS level II coding system
11. Discuss the effects of:
12. a. upcoding
13. b. downcoding
14. Define medical necessity as it applies to procedural and diagnostic coding
15. Perform procedural coding
16. Perform diagnostic coding
17. Utilize medical necessity guidelines
18. Utilize tactful communication skills with medical providers to ensure accurate code selection