Medical Coding

🔹 Module 1: Introduction to Medical Coding

• What is Medical Coding?

• Overview of Revenue Cycle Management (RCM)

• Coders’ role in healthcare

• Difference between Medical Coding, Billing, and Auditing

• Coding Certifications: CPC, CCA, CCS, CRC

🔹 Module 2: Anatomy & Physiology for Coders

• Introduction to body systems

• Medical Terminology basics

• Anatomical planes and directional terms

• Body systems: Digestive, Nervous, Musculoskeletal, etc.

• Root words, suffixes, prefixes used in coding

🔹 Module 3: Healthcare Reimbursement & Compliance

• Health Insurance Basics (Medicare, Medicaid, etc.)

• Billing process overview

• HIPAA and patient privacy

• Fraud and Abuse Laws (OIG, Stark Law, Anti-Kickback)

• Documentation guidelines (SOAP notes, Operative reports)

🔹 Module 4: ICD-10-CM (Diagnosis Coding)

• Introduction to ICD-10-CM format

• Structure and conventions of ICD-10

• Guidelines and coding process

• Practice coding scenarios

• Chapter-specific coding (e.g., Neoplasms, Pregnancy, Infectious Diseases)

🔹 Module 5: CPT (Current Procedural Terminology)

• Introduction to CPT Manual

• Category I, II, III codes

• Modifiers and their usage

• CPT coding for:

  • Surgery

  • Evaluation & Management (E/M)

  • Radiology

  • Pathology & Lab

  • Medicine

🔹 Module 6: HCPCS Level II Coding

• Introduction to HCPCS codes

• Durable Medical Equipment (DME)

• Drugs and supplies

• Commonly used codes in outpatient settings

🔹 Module 7: Coding Guidelines & Case Studies

• ICD-10, CPT, and HCPCS coding scenarios

• Coding from medical records

• Practice with real-world case studies

• Denials and corrections

🔹 Module 8: Software Training (Optional but Recommended)

• Introduction to Medical Coding Software (EncoderPro, 3M, Optum, etc.)

• Hands-on Practice

• Medical Billing and EHR basics (Practice Management Systems)

🔹 Module 9: CPC Exam Preparation (if applicable)

• Mock Tests

• Time Management Tips

• CPC Exam Strategy

• Common errors and pitfalls