Medical Coding and Billing

Medical Coding and Billing-Provider Emphasis - Diploma

You're organized and great with numbers and enjoy the office environment.

Work with information related to medical coding, chart auditing, and insurance reimbursement in this program.

Our medical coding and billing program provides the latest information related to medical coding, chart auditing and insurance reimbursement. Students in our medical coding classes learn the theory of medical coding, gain an understanding of medical coding fundamentals and incorporate this by using a laboratory practicum to work medical coding reports.

The students will be trained in ICD-10, CPT, and HCPCS coding language. The medical billing and coding field continues to grow as new government regulations influence physician reimbursement.

This program is affiliated with the American Academy of Professional Coders (AAPC). Upon completion of the program students will be eligible to sit for certification as a Certified Professional Coder (CPC).

American Association of Professional Coders certification exam: Southeastern Community College’s Coding and Billing Provider Emphasis graduates had an 81% average certification pass rate for the last 3 years.

For specific information regarding program rules and expectations, please view the handbook. View the Program Handbook here.

West Burlington campus

Program Information

Medical Coding and Billing - Provider Emphasis

Admission standards apply to this program. Please contact Enrollment Services for more details.

A) ACT reading score of 19, SAT reading score of 330, Classic ACCUPLACER reading score of 73 or Next-Gen ACCUPLACER reading score of 248.
B) ACT numerical score of 19, SAT math score of 510, or ALEKS score of 14 or higher.
C) Students will be required to achieve a 35 net words per minutes on a typing test.
D) Satisfy "Iowa Core Performance Standards".
E) Standardized placement scores must be current (completed within 24 months) at time of enrollment.
F) Must successfully complete a course in Anatomy and Physiology Essentials with a grade of "C" or above.
G) Students will be required to pass a mandatory background check.
H) Students will be required to submit (at their own expense) a completed physical examination form and immunizations.

All health career programs require students to earn a grade of "C" (2.0) or above in all coursework within the program. All other eligibility requirements must be met.

Summary Sheet

The summary sheet provides a program overview and other information.

Download the summary sheet.

Curriculum Information

Curriculum Sequence
Prerequisite	Course Title	Credit
BIO-163	ESSENTIALS OF ANATOMY AND PHYSIOLOGY	4
	Semester Total:	4
Fall Semester I	Course Title	Credit
CPC-110	ESSENTIALS OF MEDICAL CODING AND BILLING	2
CPC-121	INTRODUCTION TO MEDICAL PROCEDURAL CODING	5.5
CPC-126	DIAGNOSTIC CODING	4
CPC-128	INTRODUCTION TO MEDICAL INSURANCE & BILLING	3
HSC-114	MEDICAL TERMINOLOGY	3
	Semester Total:	17.5
Spring Semester I	Course Title	Credit
CPC-131	MEDICAL INSURANCE AND BILLING II	3
CPC-150	MEDICAL PROCEDURAL CODING	3
CPC-160	APPLICATIONS OF PROCEDURAL CODING	2
ENG-131	BUSINESS ENGLISH	3
MAP-401	MEDICAL LAW AND ETHICS	1
MAP-431	HUMAN RELATIONS	1
MAP-532	HUMAN BODY: HEALTH AND DISEASE	3
	Semester Total:	16
Summer Semester	Course Title	Credit
CPC-810	MEDICAL CODING AND BILLING EXTERNSHIP	2.5
CPC-945	MEDICAL CODING AND BILLING SEMINAR	1
	Semester Total:	3.5
	PROGRAM TOTAL:	41

Course Descriptions

BIO-163 - ESSENTIALS OF ANATOMY AND PHYSIOLOGY
Lecture: 3	Lab: 2		Credit: 4
This introductory course is designed for the student needing a one-semester combined anatomy and physiology course with laboratory. All systems will be covered with greater emphasis on the cardiovascular, respiratory, immune and urinary systems. This course also provides background for the more advanced courses BIO-168 and BIO-173
CPC-110 - ESSENTIALS OF MEDICAL CODING AND BILLING
Lecture: 1	Lab: 2		Credit: 2
This is an introductory Course which will introduce the student to the essential components of Medical Coding and Billing. The student will identify the basics of Electronic Health Records (EHR). Students will also learn the purpose, terminology, documentation requirements, and functionality along with the legal and regulatory guidelines. This will include practice exercises to provide hands-on experience using EHR software to complete medical coding and billing tasks in the health care provider office setting. The course will also provide information on the uses of common brand and generic drug names. This information will help coders understand how to use medication information to identify situations in which further inquiry about comorbidities or complications may be necessary and ensure accurate reporting of chronic healthcare conditions.
CPC-121 - INTRODUCTION TO MEDICAL PROCEDURAL CODING
Lecture: 5	Lab: 1		Credit: 5.5
This course prepares students for a career in medical coding in the medical office. Introduction to current procedural terminology (CPT) manual, HCPCS and medical coding compliance and guidelines. Corequisites: CPC-126; CPC-128
CPC-126 - DIAGNOSTIC CODING
Lecture: 3	Lab: 2		Credit: 4
The course will prepare the student for application coding nuances and guidelines along with compliance as it is related to diagnostic coding. The student will be able to assign diagnostic codes reporting all applicable codes and sequence in accordance with the guidelines. Corequisites: CPC-121; CPC-128
CPC-128 - INTRODUCTION TO MEDICAL INSURANCE & BILLING
Lecture: 3			Credit: 3
This course is designed to assist students in understanding the complexities of current insurance and billing procedures in the medical office or clinic setting. The student will obtain a sound foundation of the nuances, guidelines and requirements involved. The student will be familiarized with claims submission for major medical insurance/reimbursement programs. Corequisites: CPC-121 & CPC-126.
HSC-114 - MEDICAL TERMINOLOGY
Lecture: 2	Lab: 2		Credit: 3
This course is designed to study the basic language related to medical science with emphasis on word analysis, construction, definitions, pronunciations, spelling and standard abbreviations.
CPC-131 - MEDICAL INSURANCE AND BILLING II
Lecture: 2	Lab: 2		Credit: 3
This course will discuss all aspects of insurance billing for today's health care plans. The latest information on HIPAA and OIG regulations, diagnostic and procedural coding, and office and insurance collection strategies will be covered, ensuring preparation for real-world situations. Also covered will be the importance of the medical insurance specialist's role in filing clean claims, solving problems that do occur and collecting overdue payments. Prerequisites: HSC-114, MAP-431, CPC-121, CPC-126 and CPC-128. Corequisites: CPC-150 and CPC-160.
CPC-150 - MEDICAL PROCEDURAL CODING
Lecture: 3			Credit: 3
This course will discuss the background of CPT, HCPCS coding, modifier assignment, CPT guidelines and the assignment of codes, ICD-10 selection, medical necessity regulations, documentation guidelines, HIPAA law, and how to read, interpret, and audit a chart or operative record. Prerequisites: HSC-114, MAP-431, CPC-121, MAP-105 and BIO-163. Corequisite: CPC-160.
CPC-160 - APPLICATIONS OF PROCEDURAL CODING
Lecture: 0	Lab: 4		Credit: 2
This course allows the student to apply knowledge of CPT, modifier assignment, HCPCS, ICD-10 selection, with medical necessity. Prerequisites: HSC-114, MAP-431, CPC-121, MAP-105 and BIO-163. Corequisite: CPC-150.
ENG-131 - BUSINESS ENGLISH
Lecture: 3			Credit: 3
This course teaches the fundamentals of written communication with focus on the elements of effectively written business documents. The emphasis is on the development of writing skills through a) exercises in grammar, mechanics, usage, and spelling and b) application of these skills in a variety of written business documents. Prerequisites: Meet minimum placement test score requirement. No waivers.
MAP-401 - MEDICAL LAW AND ETHICS
Lecture: 1			Credit: 1
This course is designed to expose the student to legal concepts of standard of care, scope of employment, criminal and civil acts, contract, negligence and ethical concepts.
MAP-431 - HUMAN RELATIONS
Lecture: 1			Credit: 1
This course includes the study of the fundamental principles related to human relations, self-improvement, professional appearance and attitudes, limitations, and behaviors. Principles of individualized client care and etiquette of the medical practice are emphasized.
MAP-532 - HUMAN BODY: HEALTH AND DISEASE
Lecture: 3			Credit: 3
This course is designed to acquaint the student with the basic concepts and characteristics of disease processes, to impart basic knowledge of the etiology of the disease and to enable the student to understand the relationship between clinical signs and the disease process. Diagnostic tests and common treatments will be discussed. Concepts of health promotion and client education will be emphasized. Prerequisite: BIO-163.
CPC-810 - MEDICAL CODING AND BILLING EXTERNSHIP
Lecture: 0		OJT: 10	Credit: 2.5
The student will be placed in a predetermined medical office, clinic or related facility, and work under the supervision of an office manager or coding/billing supervisor, and the program coordinator for a 160 hour minimum required practicum. Prerequisites: CPC-110, CPC-121, CPC-126, CPC-128, CPC-131, CPC-150, CPC-160, HSC-114, MAP-401, MAP-431, MAP-532. Corequisite: CPC-945.
CPC-945 - MEDICAL CODING AND BILLING SEMINAR
Lecture: 1			Credit: 1
This course prepares students for job readiness skills needed in their chosen career of medical coding and billing. The student will also be prepared to take a mock certification examination. Prerequisites: CPC-110, CPC-121, CPC-126, CPC-128, CPC-131, CPC-150, CPC-160, HSC-114, MAP-401, MAP-431, MAP-532 Corequisite: CPC-810.