Medical Coding Professional Course Curriculum

Succeed by learning how to use your Penn Foster program.

By the end of this course, you'll be able to:

• Identify skills needed to be a confident and independent online learner

This course presents an introduction to healthcare for the medical billing and coding professions. You'll develop an understanding of healthcare delivery systems, health information management professions, and healthcare settings in the United States, as well as the governing bodies involved with regulating and licensing healthcare professionals.

By the end of this course, you’ll be able to do the following:

• Identify health information management concepts common to allied health professionals
• Describe characteristics of healthcare delivery and settings in the United States
• Delineate career opportunities for health information management professionals

This course will provide you with key information about medical terminology systems. You'll learn the key elements used to build medical terms. This will help you decipher words on your own. You'll also review body structure and the main systems of the human body. You'll learn how to recognize, pronounce, build, and spell words related to body structure. You'll test your new knowledge throughout the course with activities and quizzes.

By the end of this course, you’ll be able to do the following:

• Identify the anatomy, physiology, diseases, and treatments of the cardiovascular and hematologic systems
• Identify the anatomy, physiology, diseases, and treatments of the respiratory and endocrine systems
• Identify the anatomy, physiology, diseases, and treatments of the gastrointestinal, urinary, and reproductive systems

As part of the front line of healthcare, medical office professionals have a critical need to understand medical law and ethics. This course is designed specifically to help you excel in an environment rife with legal and ethical issues and to educate you in a way that helps minimize the risk of lawsuits by discussing the concepts of the standard of care, the scope of employment, criminal and civil acts, contracts, negligence, healthcare ethics, and more.

By the end of this course, you’ll be able to do the following:

• Describe the structure of the healthcare industry and how it relates to the medical office profession
• Identify law and regulations related to the healthcare workplace
• Describe how law flows from the constitution to the courtroom
• Identify criminal acts and intentional torts
• Recognize what makes a contract and who can contract
• Identify medical malpractice and other lawsuits
• Explain the characteristics, ownership, and confidentiality of the health record
• Recognize the importance of the laws and ethics of patient confidentiality
• Explain professional ethics and how they apply to patients
• Recognize ethical issues surrounding the beginning of life
• Recognize ethical issues surrounding death and dying

For healthcare professionals a strong knowledge of anatomy & physiology is an integral aspect of caring for patients. This course introduces you to the fundamentals of the human body by studying the various "systems" of the body in detail. Using quick checks, reading and activities, this course will prepare you for a role in a healthcare setting.

By the end of this course, you’ll be able to do the following:

• Name and explain all of the systems of the body
• Describe the structure of the epidermis, dermis, and hypodermis
• Describe the process of osteogenesis
• Identify the bones in cell formation
• Describe the overall structure of the muscular system
• Describe the general functions of the nervous system
• Describe the major sources of carbohydrates, proteins, and lipids
• List the general functions of the kidney
• Identify the mechanisms of regulating water input and output
• Describe the fetal stages and prenatal period

This course presents a study of recordkeeping practices in the hospital and physician’s office. It places emphasis on hospital and medical staff organization, patient record content, procedures in filing, numbering, and retention of patient records, quantitative analysis, release of patient information, forms control and design, indexes and
registers, regulatory and accrediting agencies, and alternate healthcare delivery systems.

By the end of this course, you’ll be able to do the following:

• Explain the role of health information management in patient care documentation and medical coding and billing
• Identify types of health records and the documentation requirements, data sources, collection tools, and potential issues associated with each type
• Discuss the evolution of the electronic health record (EHR) and its administrative and clinical applications
• Describe records storage and retrieval processes, including numbering and filing systems and record storage and circulation methods
• Explain health record maintenance through the use of the master patient index and data collection, indexes, and registers
• Identify the principles, professional practice standards, and regulations related to the use of the health record as a legal business record
• Describe the processes and legal requirements for the release of personal health information

With technology advancing and patients' information safety increasingly a focal point, many physicians today insist on hiring medical administrative staff who have been trained on a broad spectrum of topics within the medical industry, including the rules and regulations of HIPAA, electronic health records and more. An EHR specialist in a more traditional Health Information Management (HIM) department may be tasked with retrieving records, microfilm, or information from electronic records, An EHR specialist may be tasked with retrieving records, microfilm, or information from electronic records. The specialist may also be responsible for preparing records and paper sheet documentation, including filing, scanning, microfilming, or indexing. In such cases, the EHR specialist will likely work with paper and electronic records. In all cases, the EHR specialist has a responsibility to protect patient information by adhering to proper disposal, storage, access, and disclosure guidelines.

By the end of this course, you’ll be able to do the following:

• Demonstrate how patient records are used and regulated
• Complete tasks required for scheduling a patient
• Clinical information reporting
• Revenue cycle and financial reporting

This course provides a foundational understanding and application of ICD-10-CM, CPT and HCPCS coding systems. This course focuses on using Official Coding guidelines to accurately assign diagnosis codes using ICD-10-CM. Coding rules for the CPT and HCPCS coding systems are enforced and applied to code patient services.

By the end of this course, you’ll be able to do the following:

• Recognize ICD-10-CM format, symbols, punctuation, and instructional notations
• Accurately assign and sequence ICD-10-CM diagnostic codes for outpatient and physician services according
  to the official to coding guidelines
• Employ both manual and electronic resources to accurately code and sequence information from patient health records using the ICD-10-CM classification system
• Describe the impact of reimbursement policies on individuals and healthcare providers
• Differentiate reimbursement systems for various programs, including private insurance and contracts, managed care, Medicare, Medicaid, Workers' Compensation, and other disability
• Recognize the difference between CPT, ICD, and HCPCS coding systems and identify their appropriate use in health records
• Identify local, state, and federal statutes and regulations surrounding the control and use of health information
• Describe the key elements of the Healthcare Insurance Portability and Accountability Act (HIPAA) and its impact on healthcare professionals
• Explain the Inpatient prospective payment system (IPPS) and the Outpatient prospective payment system (OPPS)

This course provides you with the latest code sets and guidelines to help prepare for a career in revenue management, medical billing, or insurance processing. You’ll examine key topics such as managed care, legal and regulatory issues, private and commercial insurance and coding systems. You’ll also gain knowledge in electronic claims processing and clinical quality language.

By the end of this course, you’ll be able to do the following:

• Explain health insurance careers, opportunities, and expectations
• Differentiate between major health insurance programs, government-sponsored health benefit programs, and related federal healthcare legislation
• Explain revenue cycle management
• Demonstrate basic principles of national diagnosis and procedure/service coding and compliance systems
• Explain the impact of coding compliance, clinical documentation improvement (CDI), and coding for medical necessity in healthcare settings
• Demonstrate understanding of how to complete CMS-1500 and UB-04 claims and payer-specific claims