Medical Coding and Billing - Provider Emphasis

The Medical Coding and Billing-Provider Emphasis Diploma provides the latest information related to medical coding, chart auditing and insurance reimbursement.

The Medical Coding and Billing-Provider Emphasis Diploma 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 Association of Professional Coders (CPC). 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% certification pass rate for the last 3 years.

West Burlington campus

Curriculum Sequence

Prerequisite Course Title Credit
BIO-163 ESSENTIALS OF ANATOMY AND PHYSIOLOGY 4
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
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
TOTAL 16
Summer Semester Course Title Credit
CPC-810 MEDICAL CODING AND BILLING EXTERNSHIP 2.5
CPC-945 MEDICAL CODING AND BILLING SEMINAR 1
TOTAL 3.5

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

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

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.

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

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

Carla Pilkington - Assistant Professor, (319) 524-3221 ext. 1986

Email: cpilkington@scciowa.edu
AA, Southeastern Community College
BA, Buena Vista University

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

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

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