Medical Billing and Coding

At the end of this course, student should be able to: 1. identify crucial roles of the Physician Documentation in the coding process; 2. identify codeable services; 3. accurately utilise ICD Codes; 4. accurately utilise CPT codes & HCPC for supplies/DME and procedures; 5. perform hospital outpatient/inpatient coding and physician practice coding; 6. define coding from a reimbursement perspective; 7. utilise appropriate coding in anesthesia, surgery, radiology, pathology, and medical services; 8. billing and claims processing (physician practice & hospital), appeals, and collections; 9. completing CMS-1500 forms (both manual and electronic); and 10. describe electronic health records (EHR) systems.

In the traditional paper based patient record, data are available mainly as a free text. This patient record is primarily used for patient care itself. Nowadays the data presented in patient records is used for other tasks than patient cars. For example, they are used for report generation to different local and international organisation, research studies, health resource allocation, case mix management, public health education, medical billing and insurance. For all the mentioned there is a need to transfer this medical data to a standard coding using international classification systems. This course introduces the students to different clinical coding/classification and nomenclature systems such as SNOMED, CPT, HCPS and ICD-O and the essential coding concepts and phases. The course is enhanced by practical exercises to strength students' understanding of different steps for accurately select and use different coding system based on coding purpose. The course emphasis on applying those concepts to medical billing and explains to the students’ different stages for proper diagnostic and procedural coding and forms preparation for billing or reporting to the health insurance provider.