Medical Coding Course Curriculum

This chapter will introduce you to the inner workings of the human body. A comprehensive knowledge of human anatomy and the ability to understand medical terminology is crucial to your success as a professional medical coder.
Medical Terminology and Anatomy Review includes:
• Medical Terminology
• Musculoskeletal system
• Cardiovascular system
• Reproductive system
• Nervous system
• And more!

In this section of your studies you will begin to understand how to use the ICD-10-CM, everything from the layout, how to look up a diagnosis code, and guidelines for coding and reporting. This section will prepare you to use the right code for any medical situation. Chapters 1-11 cover neoplasms, diseases of the blood and blood-forming organs, mental, behavioral and neurodevelopmental disorders, diseases of the circulatory, respiratory, and digestive systems. In coding chapters 12-21 you will come to understand the coding systems for diseases of the skin and subcutaneous tissues, musculoskeletal system, connective tissues, injury, poisoning and many more.
Introduction to the ICD-10-CM, Coding Chapters 1-11, and Coding Chapters 12-21 include:
• Introduction Overview of ICD-10-CM
• Layout Steps to Look Up a Diagnosis Code ICD-10-CM
• Official Guidelines for Coding and Reporting ICD-10-CM
• Coding Chapters 1-11 ICD-10-CM Coding Chapters 12-21

CPT® (Current Procedural Terminology) Codes are provided by the American Medical Association (AMA). CPT® codes are listed in 3 categories; services, performance measures, and emerging technologies. CPT® codes are also included in the Healthcare Common Procedure Coding System (HCPCS).
CPT® Surgery Guidelines, HCPCS, and Modifiers includes:
• National Correct Coding Initiative (NCCI)
• Sequencing CPT® Codes
• Resource-Based Relative Value Scale (RBRVS)
• Category II Codes and a Brief Overview of the Physician Quality Reporting System (PQRS)
• CPT® Category III Codes
• HCPCS Level II
• HCPCS Level II Modifiers HCPCS Reimbursement

The integumentary system consists of the glands, hair, skin, nails, and nerves. Its job is to protect the body from the outside world, against disease, retain body fluids, eliminate waste products, and regulate body temperature.

In this chapter we’ll focus on how muscles and bones work together to provide support, movement of the body, to maintain posture and circulate blood throughout the body. Here we will discuss the main procedures used to keep this system in shape.

The respiratory system is comprised of organs responsible for carrying out the exchange of gases that we breathe. It is the role of your lungs to take in oxygen and expel carbon dioxide.
The word “hemic,” means blood, the hemic system includes organs involved in the production of blood.
The lymphatic system is a network of tissues and organs that help rid the body of toxins, waste and other unwanted materials. Lymph nodes act as a blood filter and are invaluable in the storage of B and T cells, which are the frontline fighters of the immune system.

It is up to your heart, blood vessels, and blood to transport nutrients, oxygen, and hormones to cells throughout the body along with removal of metabolic wastes. Codes relevant to this system are found in several sections of the CPT codebook especially relating to surgery, radiology, and medicine. The cardiovascular system is also found throughout the ICD-10-CM and the HCPCS Level II codebooks.

Digestion is the breakdown of food into small molecules so that they can be readily absorbed into the body.

The female reproductive system includes internal and external sex organs that reproduce offspring. This chapter includes coding for labor, delivery, unplanned pregnancy, and infertility services. Here you will learn to describe the structures associated with the female reproductive system.

Your objective will be to master anatomical concepts and understand the endocrine and nervous systems. The endocrine system releases hormones into blood and other body fluids, including chemicals important for growth, metabolism, water and mineral balance, and the response to stress. The nervous system is comprised of two parts, the first being the brain and spinal cord, the second being the remaining network of nerves throughout the body.

Ocular is your sensory system for vision. Auditory is your sensory system for hearing. This chapter will cover eyes and ears according to the CPT and ICD-10-CM which treat these parts of the body as separate from the rest of the nervous system codes. These sense organs are vital to our overall well-being and deserve special concern.

This section of your studies will include the necessary information to understand correct anesthetic coding. Your goals with this chapter:

• Understanding anesthesia coding guidelines
• Defining key terms related to anesthesia
• Recognize acronyms for anesthesia coding
• Identify when other services may be billed in conjunction with anesthesia
• Distinguishing between anesthesia services and moderate sedation

This branch of medicine uses ionizing radionuclides, ultrasound, radiation and nuclear magnetic resonance. Physicians can use radiographs to visualize and identify structures inside of the body. X-ray technology includes a variety of sophisticated medical applications such as CAT scans, CT scans, MRI, ultrasound technology, nuclear medicine, and more.

Pathology is the study of the causes and effects of disease. These services include necropsies and autopsies. Studies relating to this field include cytopathology, cytogenetics and more. In this chapter we will discuss CPT, ICD-10-CM, and HCPCS Level II codes related to pathology and laboratory services. Here your goals will be to:

• Define terms and concepts specific to pathology and laboratory coding
• Apply the ICD-10-CM guidelines when assigning codes for diagnostic services and identify specific codes helpful in describing medical necessity and outcomes of specific lab tests
• Select CPT and HCPCS Level II codes describing the services and procedures for pathology and laboratory services
• Apply CPT and HCPCS Level II modifiers, when appropriate

Evaluation and management coding is a medical coding process in support of medical billing. The E/M services provide physicians with the opportunity to evaluate their patients’ symptoms, illnesses and disease. Physicians in the United States must use Evaluation and Management coding to be reimbursed by Medicaid programs, Medicare, or private insurance.

The objective for this chapter is to introduce you to a diverse group of noninvasive or minimally invasive services. You will learn correct coding concepts, proper application of modifiers, diagnosis coding tips, and some applicable HCPCS Level II references.

The medical industry is ever changing with new treatment methods and medications being intruded every year. Students will learn the importance of continued education and learning new regulatory changes. In this section students will also review payment systems based on value healthcare, a physician’s evolving role, technology advancements, fraud and abuse prevention, and mandatory compliance.