MDAS 205 — Medical Insurance, Coding and Billing
3 cr. This course focus is on the cycle of activit ies that are embedded in medical services to ensure accurate and complete healthcare provider reimbursement. These include national coding and billing policies, and procedures inherent in the medical billing workflow process. Predetermination, precertifica tion, and preauthorization for physician rendered services and supplies by commercial, state, federal, and third party liability insurance companies are key topics. Legal, regulatory, and Health Insurance Portability and Accountability Act (HIPAA) complian ce issues are explored. The student is introduced to the principles, guidelines, and conventions for assigning current International Classification of Diseases/Clinic Modification ( ICD/CM) and Current Procedural Terminology (CPT) / Health Common Procedure Coding System (HCPS) procedural coding to patient encounters for physician services. Prerequisite(s): MDAS-105, MDAS-150 Corequisite(s): HLTH-155