Medical Billing and Coding
Introduction
If you’re looking to pursue a career on the administrative side of healthcare, then the field of medical billing and coding could be a great option for you. And unlike some other career paths within the healthcare industry, it’s possible to prepare for pursuing entry-level jobs in medical billing and coding in months—not years.
Certification is often required for medical billing and coding positions—and even employers that don’t require it up-front may expect you to earn it shortly after being hired.2 Becoming certified could provide a foundation for pursuing additional certifications, education and opportunities for advancement.
Begin your journey toward seeking a rewarding career in the healthcare field with Trident University International’s Medical Billing and Coding certification prep course.
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Why Prepare
Preparing for medical billing and coding certification could be a significant first step on the path to seeking a rewarding career.
- $40,350 median wage for medical billing and coding specialists3
- Earn 39% more as a certified professional coder compared to non-certified colleagues4
- 68% of employers report that their medical billing and coding specialists are certified3
About Certification
Demonstrate your level of expertise in your career pursuit by seeking medical billing and coding certification. Trident’s certification prep course can help you prepare to sit for the following certifications:
Certified Professional Coder (CPC®)
A well-recognized, advanced credential for medical coders in physician’s office settings—administered by the American Academy of Professional Coders (AAPC)
Certified Coding Associate (CCA®)
A credential that indicates entry-level proficiency in medical coding in hospital and office settings—administered by the American Health Information Management Association (AHIMA)
Certified Billing and Coding Specialist (CBCS)
A credential that demonstrates competency in managing patient data, preventing fraud, assigning diagnostic/procedural codes and other common medical billing and coding tasks—administered by the National Healthcareer Association (NHA).
Importantly, no matter which certification you pursue, you’ll be required to recertify every two years by earning a specified number of Continuing Education Units (CEUs), also known as Continuing Education Credits (CECs). These Continuing Education requirements vary by certification body, so be sure to verify these requirements with the relevant organization (i.e., AAPC, AHIMA or NHA) to ensure that you keep your credentials current!
Course Overview
Trident University International offers a self-paced medical billing and coding certification prep course5 designed to cover knowledge, skills and abilities that can help you prepare to pursue industry certification.
Our medical billing and coding course focuses on the legal, ethical and regulatory concepts integral to the medical billing and coding field. The course includes subjects like medical terminology, disorders and medical procedures common to each body system. Additionally, you will have the opportunity to gain practical experience in medical billing and coding while working with the main coding manuals.
After successful completion of the course, you will receive a voucher to take one of the following professional certification exams:
- Certified Professional Coder (CPC®) offered by the American Academy of Professional Coders (AAPC)
- Certified Coding Associate (CCA®) offered by the American Health Information Management Association (AHIMA)
- Certified Billing and Coding Specialist (CBCS) offered by the National Healthcareer Association (NHA)
Details & Objectives
Course Code: PCE MBCO
- Medical coding terminology, including the structures and functions of the human body
- Common disorders and medical procedures for each body system
- Legal, ethical and regulatory concepts central to the field, such as HIPAA compliance and third-party compliance for filing insurance claims
- The main coding manuals: ICD-10-CM, ICD-10-PCS, CPT®, and HCPCS Level II
- How to code diagnoses, services, and procedures for all systems of the body
- Fundamentals of medical billing & coding and medical terminology
- Word parts and the structures and functions of the human body
- Self-paced, online course
- 12 months to complete
- 370 course hours
- Open enrollment, begin anytime
- This course does not award credit
- Gain practical knowledge in medical billing and coding
- Receive a Certificate of Completion and prepare to sit for the professional certification that best aligns with your interests and goals
- Receive a voucher for the professional certification exam of your choice:
- 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 Heathcareer Association (NHA)
- Receive access to the study materials that align with the exam option you choose (including lessons designed to help you with your choice)
Outline
Details
- Medical Terminology
- Introduction to Medical Terminology
- The Musculoskeletal System
- The Cardiovascular System
- The Lymphatic and Immune Systems
- The Respiratory System
- The Digestive System
- The Urinary System
- The Nervous System
- The Special Senses: The Eyes and Ears
- The Integumentary System
- The Endocrine System
- The Reproductive System
- Diagnostic Procedures, Nuclear Medicine, Pharmacology
- 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
- ICD-10-CM Coding
- Overview of ICD-10-CM
- Key Features
- Organization of the Codebook
- Index of 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 MIDTERM
- Pharmacodynamics and Pharmacokinetics
- Routes of Administration
- Drug Classifications
- Prescription Drugs and Over-the-Counter Drugs
- Controlled Substances
- Medication Lists and the Electronic Health Record
- Clinical Documentation Improvement (CDI)
- Deficiencies in Documentation
- Medical Necessity
- Auditing
- Coding from Patient Documentation
- 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
- Introduction to Medical Billing and Coding
- Final
Requirements
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 in this course.
Requirements:
Hardware Requirements:
- This course can be taken on either a PC or Mac.
Software Requirements:
- PC: Windows 8 or later.
- Mac: OS X Snow Leopard 10.6 or later.
- Browser: The latest version of Google Chrome or Mozilla Firefox is preferred. Microsoft Edge and Safari are also compatible.
- Microsoft Word or an equivalent word-processing program, such as OpenOffice.
- Windows Media Player or a similar program.
- 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 Materials
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
- Accompanying Workbook: Understanding Health Insurance: A Guide to Billing and Reimbursement
- ICD-10-CM Expert for Physicians
- CPT Professional
- HCPCS Level II Professional
- ICD-10-PCS: Professional
Choice of study guide/voucher package upon course completion:
- CBCS Study Guide - A digital student guide for the CBCS exam
- Professional Review Guide for the CCA Examination - A digital study guide for the CCA® exam
- Official CPC Certification Study Guide, - A physical book that is shipped for the CPC® exam
FAQs
What is medical billing and coding?
Medical billers and coders are responsible for processing patient data, including medical records and related insurance. They code a patient's diagnosis and request payment from the patient's insurance company. Medical billers and coders play an important role in ensuring that healthcare providers are quickly and accurately paid for the treatment they give patients.
Where do medical billers and coders work?
Medical billers and coders work in a variety of settings. The most common settings include hospitals and doctors' offices. Some medical billing and coding professionals may work for nursing care facilities, companies that provide administrative and support services, and companies that offer professional, scientific, and technical services.2
What is a day in the life of a medical biller and coder like?
Medical billers and coders typically do the following:2
- Review patients’ records for timeliness, completeness, accuracy, and appropriateness of data
- Organize and maintain data for clinical databases and registries
- Track patient outcomes for quality assessment
- Use classification software to assign clinical codes for insurance reimbursement and data analysis
- Electronically record data for collection, storage, analysis, retrieval, and reporting
- Maintain confidentiality of patients’ records
- Review patient information for preexisting conditions so patient data can be coded properly
- Assign appropriate diagnoses and procedure codes for patient care, population health statistics, and billing purposes
- Work as a liaison between the healthcare providers and billing offices
How long is the certification prep course?
Our Medical Billing and Coding preparation course is self-paced and can be completed in 12 months or less. After successfully completing the course, you will have the option to prepare and sit for one of the following national certifications: (1) NHA's Certified Billing and Coding Specialist (CBCS), (2) AAPC's Certified Professional Coder (CPC®) or (3) AHIMA's Certified Coding Associate (CCA®).
How do I become a medical coder without experience?
There are different medical billing and coding certifications offered through certifying bodies, so it is important to choose which one is right for you. The Certified Professional Coder (CPC®) certification, offered by the American Academy of Professional Coders (AAPC), demonstrates a broad knowledge of medical coding techniques, including assigning diagnosis, procedure, and supply codes to cases and services.
How do I get a medical coding certification online?
To become a Certified Medical Coder, you need to take an online training course that teaches you the CPT®, ICD-10-CM, and HCPCS Level II code sets. Most employers are looking for applicants to have a medical coding certification.3 After successfully completing this course, you should have the knowledge and skillset to sit for one of three national certification exams: (1) NHA's Certified Billing and Coding Specialist (CBCS), (2) AAPC's Certified Professional Coder (CPC®), or (3) AHIMA's Certified Coding Associate (CCA®). Although the topics and skills covered in the course are designed to help you prepare to sit for the exam, it does not guarantee a passing score. Trident cannot guarantee that students who complete this course will be eligible to take third party certification examinations. Certification requirements for taking and passing these exams are controlled by outside entities and are subject to change without notice to Trident.
Can I register for a course if I am an international student?
Yes, certification preparation courses are entirely online. However, keep in mind that not all certifying bodies or industry-specific certifications are recognized internationally. Please review your country's regulations before enrolling in courses that prepare you for certification.
Does this course prepare students for a certification?
This course is designed to help you prepare to sit for one of three certification exams: (1) Certified Billing and Coding Specialist (CBCS) exam offered by the National Healthcareer Association (NHA); (2) Certified Professional Coder (CPC®) exam offered by the American Academy of Professional Coders (AAPC); and (3) Certified Coding Associate (CCA®) exam offered by AHIMA. You will receive a voucher for the certification exam of your choosing after successfully completing the course and your financial obligation. Although the topics and skills covered in the course are designed to help you prepare to sit for the exam, it does not guarantee a passing score. Trident cannot guarantee that students who complete this course will be eligible to take third party certification examinations. Certification requirements for taking and passing these exams are controlled by outside entities and are subject to change without notice to Trident.
When can I start the certification prep course?
This course is open enrollment, so you can register and start the course as soon as you are ready. Access to your course can take 24-48 business hours.
How long does it take to complete this course?
This course is self-paced and open enrollment, so you can start when you want and finish at your own pace. When you register, you'll receive twelve (12) months to complete the course.
What if I don’t have enough time to complete my course within the time frame provided?
The time allotted for course completion has been calculated based on the number of course hours. However, if you cannot complete the course, contact your Student Advisor to help you work out a suitable completion date. Please note that an extension fee may be charged.
What kind of support will I receive?
You may be assigned an instructor or team of industry professionals for support. Your support will be available via email to answer any questions you may have and provide feedback on your performance. All instructors are working professionals in the fields in which they teach. You will be assigned to a Student Advisor for academic support.
What happens when I complete the course?
Upon successful completion of the course, you will be awarded a Certificate of Completion. In addition, you will receive an exam voucher and appropriate study materials for your choice of the following national certification exams: (1) NHA's Certified Billing and Coding Specialist (CBCS), (2) AAPC's Certified Professional Coder (CPC®), or (3) AHIMA's Certified Coding Associate (CCA®).
Am I guaranteed a job or career advancement?
No. This course is designed to provide you with the skills utilized in entry-level positions in most cases. However, potential students should always research the job market in their area before registering.
Am I eligible for financial assistance?
This course is non-credit bearing, so it does not qualify for federal financial aid, (Pell Grant and Direct Stafford Loans). In some states, vocational rehab or workforce development boards will pay for qualified students to take these courses.
About the Certifier
American Academy of Professional Coders (AAPC)
The American Academy of Professional Coders (AAPC) was founded in 1988 to provide education and professional certification to physician-based medical coders and to elevate the standards of medical coding by providing training, certification, networking and job opportunities. Since then, AAPC has grown to over 200,000 members worldwide and offers 28 certifications encompassing the entire business side of healthcare, including professional service coding ( CPC®), professional billing (CPB™), medical auditing (CPMA™), clinical documentation (CDEO™), medical compliance (CPCO™) and physician practice management (CPPM™). Certifications demonstrate a professional’s working knowledge to support cleaner claim submission, faster reimbursement, fewer denials and better run practices and facilities.
National Healthcareer Association
The National Healthcareer Association (NHA) is a respected healthcare certification provider that aims to empower people to access a better future. The organization develops nationally-recognized certifications that demonstrate both a proven level of knowledge and a relentless desire for real-world application. NHA looks to increase the knowledge, skills and competency of healthcare professionals to enable improved patient care and better efficiency in the healthcare industry. Learn more at https://www.nhanow.com.
American Health Information Management Association
The American Health Information Management Association (AHIMA) is a leading voice and authority in health information. As the global nonprofit association of health information professionals, their mission is empowering people to impact health. AHIMA-certified professionals are leading healthcare organizations through meaningful innovation. In an industry that values education and experience, AHIMA credentials are proof of a robust education and an ongoing commitment to staying relevant in a complex and evolving space. Find out more at https://www.ahima.org.
1 Certification exam pricing is subject to change. Visit the following pages to learn more about certification exam pricing:
- AAPC, “Certified Professional Coder CPC® Certification Exam,” https://www.aapc.com/certification/cpc/
- AHIMA, “Certified Coding Associate (CCA®),” https://www.ahima.org/certification-careers/certification-exams/cca/
- NHA, “How to Get Certified,” https://www.nhanow.com/get-certified
2 Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, “Medical Records and Health Information Specialists,”
https://www.bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm (visited June 21, 2021).
3 NHA, “Industry Outlook 2020,” https://www.mywccc.org/Downloads/NHAIndustryOutlook2020.pdf.
4 AAPC, “Your Guide to Medical Coding and Billing Salaries,” https://www.aapc.com/resources/research/medical-coding-salary-survey/ (visited July 2, 2021).
5 Trident cannot guarantee that graduates of this program will be eligible to take third-party certification examinations. Certification requirements for taking and passing these exams are controlled by outside entities and are subject to change without notice to Trident.