Medical Coding Curriculum

Anatomy and Physiology

Emphasis on the structure and function of the human body.

Medical Terminology

Emphasis on how to spell, define, and pronounce medical terms as well as understanding the concepts of root/suffix/prefix word builds and on common medical terms of major disease processes, diagnostic procedures, laboratory tests, abbreviations, drugs, and treatment modalities.

Pathophysiology

Emphasis on identifying the Cause, diagnosis, and treatment on the Specific disease processes by human body system.

Pharmacology

Emphasis is placed on the understanding of the action of drugs such as: absorption, distribution, metabolism and excretion of drugs by the body and study of most commonly prescribed drugs.

Basic Diagnosis Coding

Learn to select the diagnosis that require coding and to assign the correct 

ICD-9 codes as per the coding guidelines.

Basic Procedure Coding

To learn to select the procedures that require coding and to assign the 

correct procedure codes as per the official coding guidelines with emphasis on ICD-9 and CPT-4 coding systems.

Advanced Diagnosis Coding

To learn to code complex case studies including hands-on-training coding actual patient's outpatient and in-patient charts and assignment of the right principal diagnosis and DRG and to identify which are the CCs and MCCs.

Advanced Procedure Coding

To learn to code complex procedure involving case studies and authentic coding patient's charts using the ICD-9-CM and CPT-4 coding systems.

Reimbursement Methodologies

Emphasis on Prospective payment system, Diagnosis Related Groups, Ambulatory Payment Classifications and ASC Groups

Resource Based Relative Value Scale, Third party payers, Billing and insurance procedures, Explanation of benefits

Quality Improvement Organizations (QIO) and their role in the payment process, Charge master description and maintenance

Managed care/capitation, Compliance issues and Health plan claims processing.

Introduction to Health Information Management & Healthcare Data Content and Structure

Emphasis is placed on content and components of the health record including Content of the health record, Documentation requirements, Patient Identity Management (MPI), Abstracting, Filing Systems (TD), Registries (Cancer, Trauma, etc) Primary vs. secondary records, Legal/Ethics issues, Legal HER, Privacy, confidentiality and computer security, HIPAA requirements, Release of information, Code of Ethics of the AHIMA, and Standards of Ethical Coding of the AHIMA.

Healthcare Delivery Systems

Emphasis on understanding of the types and levels of Healthcare Delivery Systems in the U.S. and of the governing bodies that regulate the HIM processes, an understanding how eHIM will change this environment, Organization of healthcare delivery, Accreditation standards, Licensure/regulatory agencies and RAC process.