Medical Coding and Billing: Provider Emphasis - Diploma

West Burlington Campus

*Health professions student outcomes are available on the Consumer Information page.

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 and Billing 3
CPC-170 Patient Access to Healthcare 2
HSC-114 Medical Terminology 3
Semester Total: 19.5
Spring Semester I Course Title Credit
CPC-131 Medical Insurance and Billing II 3
CPC-151 Medical Procedural Coding 4
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: 17
Summer Semester Course Title Credit
CPC-820 Medical Coding and Billing Practicum 3.5
Semester Total: 3.5
PROGRAM TOTAL: 44

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. Corequisite: CPC-128.

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 and CPC-128.

CPC-126 - Diagnostic Coding

Lecture: 3

Lab: 2

Credit: 4

This course will prepare the student for application coding along with compliance as it is related to diagnostic coding. The student will be able to identify, assign, sequence and report all applicable diagnostic codes in accordance with the ICD-10-CM official guidelines. Corequisites: CPC-121 and CPC-128 with a minimum grade of a C.

CPC-128 - Introduction to Medical Insurance and 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 and CPC-126.

CPC-170 - Patient Access to Healthcare

Lecture: 32

Credit: 2

This course prepares the student for the front line of healthcare services for patients entering a hospital or clinic. This course places an emphasis on customer service skills, patient registration, patient scheduling, the fundamentals of the revenue cycle, billing and reimbursement, HIPAA and practical experience and understanding of electronic health records. Corequisites: HSC-114, MAP-401 and MAP-431.

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, CPC-110, CPC-121, CPC-126 and CPC-128. Corequisites: CPC-151 and CPC-160.

CPC-151 - Medical Procedural Coding

Lecture: 4

Credit: 4

This course will discuss in depth CPT and HCPCS guidelines and the assignment of codes. Modifier assignment, ICD-10 selection, medical necessity regulations, documentation guidelines, HIP AA law and chart auditing are also covered. Prerequisites: BIO-163, HSC-114 and CPC-121. 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: BIO-163, CPC-110, CPC-121,CPC-126, CPC-128 and HSC-114. Corequisites: CPC-131 and CPC-151.

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. Prerequisite: Meet minimum placement test score requirements or a minimum grade of C- in ENG-013. No Waivers.

MAP-401 - Medical Law and Ethics

Lecture: 1

Credit: 1

This course is designed to familiarize the student with legal concepts of standard of care, scope of employment, criminal and civil acts, contracts, negligence and ethical concepts.

MAP-431 - Human Relations

Lecture: 1

Credit: 1

This course includes fundamental principles related to human relations. Basic psychological and developmental theorists, factors that influence behavior, professional attitudes and behavior, self-improvement, and communication in the health care setting 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, common treatments and patient education will also be discussed. Prerequisite: BIO-163 with a C or higher.

CPC-820 - Medical Coding and Billing Practicum

Lecture: 1

Lab: 10

Credit: 3.5

This course prepares the student for job readiness skills needed in their chosen career of medical coding and billing. The student will complete an online series of modules to get real-world coding experience and test medical coding proficiency using real, redacted medical record cases from multiple specialties. A mock certification examination will be taken. Prerequisites: Students must have completed all required program courses with a "C" or above in each course and earned a cumulative program GPA of 2.0 or above before the end of the final spring semester to be eligible to enroll.

Megan Massner - Instructor/Coordinator, (319) 208-5000 ext. 5203

Email: mmassner@scciowa.edu
Diploma, Southeastern Community College

Anne Abel - Instructor, (319) 208-5000 ext. 5293

Email: aable@scciowa.edu
CPC, Certification of American Academy of Professional Coders
CPC-I, Certification of American Academy of Professional Coders

Deb Shaffer - Instructor, (319) 208-5000 ext. 5213

Email: dshaffer@scciowa.edu
AAS, Mt. St. Clare College
ADN, Southeastern Community College