ICD 9, ICD 10, ICD 11 : Medical Coding Specialist Career Path - ITU Online

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ICD 9, ICD 10, ICD 11 : Medical Coding Specialist Career Path

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The Medical Billing Specialist training series offers a detailed and comprehensive journey into the world of medical billing and ICD coding. Designed for both beginners and experienced professionals, this series covers essential topics such as ICD-9, ICD-10, and ICD-11 coding systems, medical terminology, anatomy, HIPAA compliance, and fraud prevention. Through a mix of theoretical knowledge and practical application, learners are equipped with the skills needed to navigate the complex healthcare billing landscape

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This ICD 9, ICD 10, ICD 11 : Medical Coding Specialist Career Path Features

Total Hours
37  Training Hours
ICD 9, ICD 10, ICD 11 : Medical Coding Specialist Career Path
192 On-demand Videos
Closed Caption

Closed Captions

Course Topics
44  Topics
Prep Questions
157 Prep Questions
ICD 9, ICD 10, ICD 11 : Medical Coding Specialist Career Path

Certificate of Completion

The Job Role of a Medical Coding Specialist

A Medical Billing Specialist’s role, you will be working with ICD coding and the position encompasses a range of responsibilities integral to healthcare administration. Here are some of the responsibilities they may be expected to handle:

ICD Coding and Classification: Accurately classify and code medical diagnoses and procedures using the ICD-9, ICD-10, and ICD-11 coding systems, ensuring compliance with healthcare regulations and enabling effective billing processes.

Billing and Reimbursement: Prepare and submit billing claims to insurance companies, ensuring that each claim is accurate, compliant, and submitted in a timely manner. Follow up on unpaid claims and handle billing disputes.

Medical Records Management: Maintain and manage patients’ medical records, ensuring that they are complete, accurate, and compliant with HIPAA and other privacy laws. This includes updating records with the latest diagnoses and procedures.

Compliance and Ethics: Adhere to HIPAA regulations and stay vigilant against fraud and abuse in medical billing. Implement and monitor compliance with ethical standards and legal requirements in the billing process.

Insurance and Claims Processing: Liaise with insurance companies to verify patient coverage and understand insurance contract specifics. Work on claims denials, providing necessary documentation to ensure maximum reimbursement for services rendered.

Patient Communication: Communicate with patients regarding their bills, explaining charges, and answering questions about insurance claims and payments. Provide information on payment plans and financial assistance programs if necessary.

Data Entry and Accuracy: Enter data into billing software accurately and efficiently. Ensure that all numerical and coded data in the healthcare billing system is correct to prevent errors in billing and insurance claims.

Reporting and Documentation: Generate financial and billing reports, documenting claims status, payments, denials, and outstanding balances. Use these reports to identify trends and areas for improvement in the billing process.

Continuous Education: Keep up-to-date with the latest changes in billing codes, insurance policies, and healthcare regulations. Attend training sessions and seminars related to medical billing and coding.

Team Collaboration: Work closely with healthcare providers, coding specialists, and other administrative staff to ensure a streamlined and effective billing process. Collaborate on complex cases to determine appropriate billing and coding strategies.

A Medical Billing Specialist is expected to possess a thorough understanding of medical terminology, coding systems, and billing practices, serving as a crucial link between healthcare providers, patients, and insurance companies.

Course: 1 - Estimated 2 Week(s) To Complete
1
Medical Coding and Billing ICD-9 Course Content
12 Hours 40 Minutes 103 Videos 23 Prep Questions
This course offers comprehensive training on the ICD-9 coding system, highlighting its key features and differences from the ICD-10 system. Students will learn how to effectively navigate and apply ICD-9 codes, an important skill for handling legacy medical records and billing in various healthcare settings.

Lesson 3 - Medical Terminology
   Medical Terminology

Lesson 2 - Anatomy Physiology
   Anatomy
   Anatomic Organ Systems

Lesson 4 - Introduction to ICD-9-cm
   Introduction To ICD-9-Part 1
   Introduction To ICD-9-Part 2
   Introduction To ICD-9-Part 3
   Introduction To ICD-9-Part 4
   Introduction To ICD-9-Part 5
   Introduction To ICD-9-Part 6
   Introduction To ICD-9-Part 7
   Diagnostic Procedures
   Coding And Reporting Guidelines-Part 1
   Coding And Reporting Guidelines-Part 2
   Coding And Reporting Guidelines-Part 3

Lesson 5 - Application of ICD-9-cm (Ch 1-9)
   Application Of ICD-9-CM
   Caution
   Neoplasms
   Other Metabolic And Immunity Disorders Section
   Hypertensive Heart And Chronic Kidney Disease

Lesson 7 - Introduction to ICD-10-CM
   Overview Of ICD-10-CM

Lesson 1 - Introduction to CPT and HCPCS
   Introduction To CPT And Level II National Codes-HCPCS
   CMS-1500 Form
   Categorized By
   Category I Codes
   Format

Lesson 2 - Evaluation and Management (E/M)
   Evaluation And Management-Part 1
   Evaluation And Management-Part 2
   Nature Of Evaluation And Management Services
   Example Of HPI
   Review Of Systems
   E And M Documentation Guidelines
   E And M Exam-Part 1
   E And M Exam-Part 2
   Exam
   Medical Decision Making
   Number Of Diagnoses Or Treatment Options
   Amount And Or Complexity Of Data Reviewed
   Nature Of Presenting Problem
   E And M Documentation-Level Based On TIme
   Hospital E And M Codes
   Subsequent Visits
   InitialInpatient Services
   ProlongedServices
   Modifiers

Lesson 3 - Surgery, Integumentary system, Anesthesia & Modifiers
   Anesthesia
   Physical Status Modifiers
   Medicare Policy
   Surgical Guidelines
   58 Staged Or Related Procedure
   Modifier 52-Reduced Services
   Ancillary Modifiers
   Integumentary System
   Morphology
   Integumentary-Nails
   Integumentary-Introduction
   Clinical Scenario
   Mohs Micrographic Surgury

Lesson 4 - Musculoskeletal
   Musculoskeletal System
   Rheumatism
   Endoscopy And Arthroscopy

Lesson 5 - Respiratory and Cardio
   Respiratory System
   Endoscopy
   Mediastinum And Diaphragm
   Circulatory Systems
   Associated Diagnosis
   Pacemaker Or Pacing Cardioverter-Defibrillator
   CABG
   Bypass Grafts
   Selective Catheterization
   Endovascular Revascularization
   Coronary Therapeutic Services And Procedures
   Intracardiac Electrophysiological Procedures And Studies

Lesson 6 - Female Genital System, Maternity Care and General Surgery
   Hemic And Lymphatic Systems
   Female Genitourinary And Maternity Care
   Ultrasound
   Male Genitourinary
   Bladder
   Eyes
   Ears
   Digestive System Terms
   Digestive Procedures
   Endocrine And Nervous System
   Nervous System-Part 1
   Nervous System-Part 2
   Nervous System-Part 3

Lesson 9 - Medicine
   Medicine
   Chemotherapy
   Category III Codes
   Conclusion

Lesson 1 - Introduction to Reimbursement
   Intro
   Medicare-PartB
   Fraud And Abuse

Lesson 7 - Radiology
   Radiology
   Modifiers
   Diagnostic Ultrasound
   Radiation Treatment Management

Lesson 8 - Pathology
   Regulatory Terms
   Urinalysis

Lesson 6 - Application of ICD-9-cm (Ch 10-19)
   Diseases Of The Genitourinary System
   Diabetes Mellitus In Pregnancy
   Diseases Of Musculoskeletal SystemAnd Connective Tissue
   Burns
   Adverse Effects Poisoning And Toxic Effects

Course: 2 - Estimated 0 Week(s) To Complete
2
Medical Coding and Billing ICD 10 Course Content
01 Hours 08 Minutes 26 Videos 44 Prep Questions
This course provides an in-depth understanding of the ICD-10 coding system, focusing on its structure, coding guidelines, and practical application in medical billing. It equips students with the skills needed to accurately code diagnoses and procedures according to the ICD-10 standards, essential for healthcare reimbursement and compliance.

Module 1: Certain Infectious and Parasitic Diseases
   Intro
   Certain Infectious And Parasitic Diseases

Module 2: Neoplasm
   Neoplasm

Module 3: Diseases of the Blood and Blood Forming Organs
   Diseases Of The Blood And Blood Forming Organs

Module 4: Endocrine, Nutritional and Metabolic Diseases
   Endocrine Nutritional And Metabolic Diseases

Module 5: Mental Disorders
   Mental Disorders

Module 6: Diseases of the Nervous System
   Disesases Of The Nervous System

Module 7: Diseases of the Eye and Adnexa
   Diseases Of The Eye And Adnexa

Module 8: Diseases of the Ear and Mastoid Process
   Diseases Of The Ear And Mastoid

Module 9: Diseases of the Circulatory System
   Diseases Of The Circulatory System

Module 10: Diseases of the Respiratory System
   Diseases Of The Respiratory System

Module 11: Diseases of the Digestive System
   Diseases Of The Digestive System
   Specific Coding Exercises

Module 12: Diseases of the Skin and Subcutaneous Tissue
   Diseases Of The Skin And Subcutaneous Tissue

Module 13: Diseases of the Musculoskeletal System and Connective Tissue
   Diseases Of The Musculoskeletal System And Connective Tissue

Module 14: Diseases of the Genitourinary System
   Diseases Of The Genitourinary System

Module 15: Pregnancy, Childbirth, and the Puerperium
   Pregnancy Childbirth And The Puerperium

Module 16: Newborn (Perinatal) Guidelines
   Newborn Perinatal Guidelines

Module 17: Congenital Malformations, Deformations and Chromosomal Abnormalities
   Congenital Malformations Deformations And Chromosomal Abnormalities

Module 18: Symptoms, Signs and Abnormal Clinical and Laboratory Findings
   Symptoms Signs And Abnormal Clinical And Laboratory Findings

Module 19: Injury, Poisoning and Certain Other Consequences of the External Causes
   Injury Poisoning And Certain Other Consequences Of The External Causes
   Specific Coding Questions

Module 20: External Causes of Morbidity
   External Causes Of Morbidity

Module 21: Factors Influencing Health Status
   Factors Influencing Health Status
   Case Study 1 And 2
   Outro

Course: 3 - Estimated 3 Week(s) To Complete
3
ICD 10 & 11 Medical Coding and Billing Course Content
20 Hours 03 Minutes 58 Videos 76 Prep Questions
This advanced course covers the latest updates and nuances in the ICD-10 and ICD-11 coding systems. It focuses on the transition from ICD-10 to ICD-11, providing students with forward-looking insights into the future of medical coding and billing practices, and preparing them for upcoming changes in the field.

Module 1: Anatomy
   Module 1 Workbook
   1.1 Introduction
   1.2 Human Body
   1.3 Skin
   1.4 Bones, Muscles and Joints
   1.5 Heart and Blood Vessels
   1.6 Lungs
   1.7 Stomach, Intestines and Colon
   1.8 Kidney, Bladder, Prostate and More
   1.9 Uterus, Ovaries and Female Parts
   1.10 Eye
   1.11 Glands
   1.12 Ear, Nose and Throat
   1.13 Blood
   1.14 Immune
   1.15 Brain and Spinal Cord

Module 2: Diagnosis Coding
   Module 2 Workbook
   2.1 Overview of ICD
   2.2 Outpatient Guidelines
   2.3 Infectious and Parasitic
   2.4 Neoplasms
   2.5 Diseases of the Blood and Blood Organs
   2.6 Endocrine, Nutritional and Metabolic Diseases
   2.7 Mental and Behaviroal Health
   2.8 Pregnancy, Childbirth and the Puerperium
   2.9 Conditions Originating in Perinatal Period
   2.10 Symptoms, Signs and Abnormal Clinical and Laboratory Findings
   2.11 Injury, Poisoning and Certain Other External Causes
   2.12 Diseases of the Skin and Subcutaneous Tissue
   2.13 External Causes of Morbidity
   2.14 Factors Influencing Health
   2.15 Circulatory System
   2.16 Eye
   2.17 Respiratory
   2.18 Digestive

Module 3: Procedure Coding
   Module 3 Workbook
   3.1 Evaluation and Management part 1
   3.1 Evaluation and Management part 2
   3.1 Evaluation and Management part 3
   3.1 Evaluation and Management part 4
   3.2 Anesthesia
   3.3 Modifiers
   3.4 Surgery part 1
   3.4 Surgery part 2
   3.4 Surgery part 3
   3.5 Radiology
   3.6 Pathology
   3.7 OB/GYN
   3.8 Physical Medicine part 1
   3.8 Physical Medicine part 2
   3.9 HCPCS
   3.10 Diving Into Coding part 1
   3.10 Diving Into Coding part 2
   3.10 Diving Into Coding part 3
   3.11 NCCI, MUE and GME
   3.12 CAT Codes

Module 4: Billing Guidelines and Practices
   Module 4 Workbook
   4.1 HIPAA, Compliance and Reimbursement part 1
   4.1 HIPAA, Compliance and Reimbursement part 2
   4.1 HIPAA, Compliance and Reimbursement part 3
   4.1 HIPAA, Compliance and Reimbursement part 4
   4.2 The Next Steps

Course: 4 - Estimated 1 Week(s) To Complete
4
HIPAA, Fraud, and Abuse Course Content
04 Hours 03 Minutes 5 Videos 14 Prep Questions
This critical course dives into the legal and ethical aspects of medical billing and coding, with a focus on HIPAA regulations, fraud prevention, and abuse detection. It is designed to educate students on the importance of maintaining confidentiality, accuracy, and integrity in medical billing practices to ensure compliance and protect patient rights.

Module 1: HIPAA and Privacy
   HIPAA and Privacy
   Security, Safeguards, and Controls
   Examples and Cases

Module 2: Fraud, Waste, and Abuse
   Fraud, Waste, and Abuse
   Case Examples and Law

Module 3: Compliance and Prevention
   Compliance and Prevention

The Medical Billing Specialist training series is a comprehensive educational program designed to equip learners with the essential skills and knowledge required in the field of medical billing and coding. This series encompasses a range of courses, each focusing on different yet interconnected aspects of medical billing, ensuring a well-rounded and thorough understanding of the profession. Starting with the foundational principles of medical terminology and anatomy in the “Medical Coding and Billing ICD-9” course, students gain a solid grounding in the language and structure of the human body, which is crucial for accurate coding and billing.

As the series progresses, learners are introduced to the intricacies of the ICD-10 coding system in the “Medical Coding and Billing ICD 10” course. This segment delves deeper into the complexities of coding medical diagnoses and procedures, providing students with the tools to navigate the nuanced world of healthcare coding standards. The course is meticulously structured to ensure learners are well-versed in the latest coding practices, preparing them for real-world challenges in medical billing.

The training further advances with the “ICD 10 & 11 Medical Coding and Billing” course, which brings students up-to-date with the newest developments in the field, including the transition to ICD-11. This course is particularly valuable for those looking to stay ahead in the rapidly evolving landscape of medical billing and coding. It not only reinforces previous learning but also introduces forward-thinking concepts and practices that are becoming increasingly relevant in the healthcare industry.

In addition to the technical aspects of coding and billing, the series places a strong emphasis on legal and ethical considerations in the “HIPAA, Fraud, and Abuse” course. This crucial component of the training educates students on the importance of compliance with healthcare laws and regulations, particularly HIPAA, and the detection and prevention of fraud and abuse in medical billing. The course aims to instill a strong ethical framework in students, ensuring they are not only skilled in the technicalities of the job but also in upholding the highest standards of professional integrity.

Overall, the Medical Billing Specialist training series offers a detailed, practical, and ethically grounded educational experience, setting up aspiring medical billing professionals for a successful and fulfilling career in this vital sector of healthcare administration.

The Medical Billing Specialist training series is designed to cater to a diverse group of individuals who are either looking to enter or enhance their skills in the field of medical billing and coding. Here are some of the people who might benefit from this training:

  1. Career Starters: Individuals looking to begin a career in medical administration. This training provides the foundational knowledge and skills needed to start a career in medical billing and coding.
  2. Healthcare Professionals: Nurses, medical assistants, and other healthcare professionals who wish to expand their career opportunities or understand the billing side of healthcare to complement their clinical skills.
  3. Medical Office Administrators: Office managers and administrative staff in medical offices who need to understand billing and coding to effectively manage the administrative aspects of a healthcare facility.
  4. Health Information Technicians: Those already working in health information management who want to specialize in medical billing and coding, or update their skills in light of new coding standards like ICD-10 and ICD-11.
  5. Insurance Claims Processors: Professionals working with health insurance companies who need to understand medical billing and coding for accurate claims processing and reimbursement.
  6. Freelance Medical Billers and Coders: Individuals seeking to work as independent contractors or freelance medical billers and coders, offering their services to various healthcare providers.
  7. Career Changers: People looking to transition into a new field. Medical billing and coding can be an attractive option due to its critical role in healthcare and potential for remote work.
  8. Continuing Education Seekers: Current medical billers and coders seeking continuing education to stay current with the latest changes in codes, regulations, and technology in the field.
  9. Healthcare Consultants and Auditors: Professionals who advise healthcare facilities on billing practices, compliance, and efficiency improvements.
  10. Legal Professionals: Lawyers and legal consultants specializing in healthcare law who need a solid understanding of medical billing and coding for litigation, compliance, and advisory purposes.

The versatility of this training series makes it suitable for a wide range of professionals and individuals interested in the field of medical billing and coding, offering them the opportunity to develop or enhance skills that are highly valued in the healthcare industry.


What is Medical Coding and Billing, and What Does a Specialist in This Field Do?

Medical coding and billing involves translating healthcare services, procedures, diagnoses, and equipment into universal medical alphanumeric codes. A Medical Coding and Billing Specialist is responsible for accurately coding medical records and processing insurance claims, ensuring healthcare providers are reimbursed for their services.

What Kind of Training or Education is Required to Become a Medical Coding and Billing Specialist?

To become a Medical Coding and Billing Specialist, individuals typically need to complete a specialized training program or a certification course. These programs often cover medical terminology, anatomy, and various coding systems like ICD-9, ICD-10, and CPT. Some roles may require an associate degree or a professional certification.

Is Certification Necessary for a Medical Coding and Billing Specialist, and How Do I Obtain It?

While not always mandatory, certification can enhance job prospects and credibility in the field. Certifications like the Certified Professional Coder (CPC) and Certified Coding Specialist (CCS) are obtained through accredited organizations, such as the AAPC or AHIMA, often after passing a comprehensive exam.

Can Medical Coding and Billing Specialists Work Remotely?

Yes, many Medical Coding and Billing Specialists have the option to work remotely, thanks to digital health records and online coding systems. Remote work arrangements depend on the employer’s policy and the nature of the specific role within the organization.

What are the Career Advancement Opportunities for a Medical Coding and Billing Specialist?

Experienced specialists can advance to supervisory or managerial roles, become auditors, consultants, or educators in the field. Continuous education and additional certifications, such as specializing in a particular area of coding, can further enhance career prospects.

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