AHEA 124 - Advanced Medical Billing and Coding

5 CR

This course expands on intermediate medical billing & coding procedures by providing the knowledge and skills to assess, evaluate, and trouble shoot these systems. This course will also include some industry certification preparation.

Prerequisite(s): Successful completion of both AHEA 120 and AHEA 122 with a C or better at BC, or permission of the instructor.

Course Outcomes
Differentiate cause and effects for the rejected claims troubleshooting process. Explain industry certification options. Critique a variety of coding systems, including CPT, HCPCS, ICD-9, ICD-10, as well as DRG. Assess the rules for a variety of insurance systems and scenarios (Medicare vs. commercial insurance, for example). Support the impact of correct vs. incorrect coding on reimbursement outcomes. Evaluate correct procedural and diagnostic codes for both outpatient and inpatient medical reports. Interpret appropriate communication strategies for a variety of scenarios in the Medical Billing & Coding profession.

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