BU-918: Medical Coding and Billing II

Course Information

Course, prefix, number, & title: BU-918 Medical Coding and Billing II

Hours (Class, recitation, Laboratory, studio): 2 class hours, 2 lab hours

Credits: 3

Pre-requisites (if any): BU-916

Course Description in college catalog:

This class builds on the coding and billing procedures learned in Billing and Coding I, focusing on teaching the student how to enhance reimbursement in today’s healthcare environment. Using current ICD and CPT coding system resources, students will learn in-depth coding systems for medical procedures and diagnoses. Lab work will include working directly with complex medical records, using steps to assure third party approval for recommended treatments/ procedures and responding to and appealing insurance denials.

Academic programs for which this course serves as a requirement or an elective:

A.A.S. Office Administration and Technology

A.A.S. Medical Assistant

Certificate Program - Healthcare Administration

Certificate Program - Medical Office Assistant

Certificate Program - Office Administration Assistant

General Education Outcomes: Below is a listing of General Education Outcome(s) that this course supports.

  1. Communicate effectively in various forms

  2. Use analytical reasoning to identify issues or problems and evaluate evidence in order to make informed decisions

  3. Apply information management and digital technology skills useful for academic research and lifelong learning

Course-specific student learning outcomes:

Upon completing this course, students should be able to:

  1. Explain the structure and use of the CPT Manual, accurately extract patient procedures from patient health record case studies, and select correct procedure codes from the CPT Manual

  2. Determine when modifiers are necessary to report health care services

  3. Describe the structure of the category II and III codes and the use of those codes

  4. Describe the structure of the HCPCS Manual and the use of those codes

  5. Explain how the ICD-PCS procedure coding system is used for inpatient facilities to submit claims for reimbursement

  6. Demonstrate how the diagnosis (ICD) codes and services/treatment codes (CPT) are used on insurance billing forms, such as CMS-1500, CM-1450, UB-04, and superbills to demonstrate medical necessity and achieve reimbursement

  7. Explain the current AHIMA requirements for CCA candidate, Define the domains, format, and types of proficiencies included in the CCA Exam, and Analyze the preparation process recommended to be successful in passing the CCA Exam

Methods by which student learning will be assessed and evaluated; describe the types of methods to be employed; note whether certain methods are required for all sections:

  1. Participation

  2. Assignments

  3. Exams

Academic Integrity policy (department or College):
Academic honesty is expected of all students. Any violation of academic integrity is taken extremely seriously. All assignments and projects must be the original work of the student or teammates. Plagiarism will not be tolerated. Any questions regarding academic integrity should be brought to the attention of the instructor. The following is the Queensborough Community College Policy on Academic Integrity: "It is the official policy of the College that all acts or attempted acts that are violations of Academic Integrity be reported to the Office of Student Affairs. At the faculty member's discretion and with the concurrence of the student or students involved, some cases though reported to the Office of Student Affairs may be resolved within the confines of the course and department. The instructor has the authority to adjust the offender's grade as deemed appropriate, including assigning an F to the assignment or exercise or, in more serious cases, an F to the student for the entire course." Read the University's policy on Academic Integrity opens in a new window(PDF).

Disabilities
Any student who feels that he or she may need an accommodation based upon the impact of a disability should contact the office of Services for Students with Disabilities in Science Building, Room S-132, 718-631-6257, to coordinate reasonable accommodations for students with documented disabilities. You can visit the Services for Students with Disabilities website.

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