About the Medical Coding Program
This intensive, fully online program will expose participants to seasoned experts in the field, new requirements and emerging tools and technologies for capturing patient information, and prospective careers in the field.
Coders are the critical link between clinicians (physicians and other clinical professionals) and the billers, capturing/coding each procedure and aspect of treatment to enable billing staff to bill completely and accurately for services provided. Appropriate reimbursement for services helps ensure the solvency of the medical enterprise. Coders review patients’ records and assign numeric codes for each diagnosis and procedure. To perform this task, they must possess expertise in the ICD-10-CM and ICD-10-PCS coding system and the surgery section within the CPT coding system. The Medical Coding certificate program provides comprehensive education to prepare qualified individuals to become an outpatient and/or an inpatient coding professional. It will also enhance the skills of individuals who are currently coding in a healthcare setting. Upon completion of the 27-credit hour program, students earn a professional certificate from UC San Diego Extended Studies.
Certificate Benefits
At the conclusion of the program students will be able to:
- Relate the applicable clinical descriptions (Medical Terminology, Anatomy & Physiology, Pathophysiology and Pharmacology) found in the clinical review material to the proper coding categories in CPT, ICD-10-CM, ICD-10-PCS and HCPCS Level II
- Accurately construct and assign diagnosis codes and procedure codes in both the Outpatient (CM) and Inpatient (PCS) setting
- Associate procedure and diagnosis codes to the nature of the presenting problem(s) or chief complaint of the patient
- Understand the relationship between the Procedural Service and the Diagnostic Description (the procedure outlines what the Physician did, and the Diagnosis explains why he/she did it) and additionally proves the medical necessity for the encounter
- Explain and identify various compliance strategies and the payment methodology systems and be able to describe the billing process and reporting
- Accurately translate the Physician Narrative(s) into the coding nomenclatures that accurately reflect the services rendered by the physician in a billable format for reimbursement
- Abstract all of the billable services from a medical record to assure reimbursement is commensurate with the work performed
- Perform self or internal audits to assure all coding and compliance theories and rules are being followed and appropriately applied in the workplace
- Understand the Legal & Ethical issues in coding and how they are applied in the Health Information environment.
Medical Coding
Required Prerequisites
Required Courses
Example Trajectory Below
Conditions for Admission
The certificate is intended for individuals who have met the following requirements:
- High-School graduation/GED
- Introduction to Medical Coding (MEDC-40024)
- Medical Terminology: An Anatomy and Physiology Approach (FPM-40632)
- Anatomy & Physiology for Allied Health (MEDC-40008)
Certificate Guidelines
This Certificate (prerequisites not included) is intended to be completed within a 12-month time frame. However, you are permitted to take up to 5 years to complete the certificate. Starting points are offered every quarter.
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FAQs
Medical coders work specifically with the financial and technical aspects of the medical world. They check medical records of patients, along with doctors’ notes, records of testing, and possible diagnoses to corroborate that work was carried out.
Medical codes tell a sort of story about the patient’s visit. Whether a patient was seen for a routine exam, or a doctor ordered an xray for a workplace injury, each procedure and service receive a specific code.
The coding specialist must translate this information into precise medical codes for each one of thousands of possible services, which need to be valued for reimbursement purposes.
If the coder is uncertain about a particular patient’s records, they then need to speak with medical staff or other staff members to receive more details.
You can find medical billers and coders in a variety of settings. Typically, they’re found behind the scenes at clinics, hospitals and nursing homes, but they may also find work in pharmacies. With such a wide range of possible employers, it’s a great opportunity to find a career close to home.
Because so much of the work is done with computer systems, many billers and coders are given permission to work from home one or two days a week. Medical billing or coding can be a great choice for those who seek a more flexible working environment.
At a small facility, there’s a good chance that billing and coding will be done by the same person or a close group of associates.
Advisory Board
Emmy Clancy, MHA, CMPE, CCS, CPC, CDEO, CPMA
Brian Clay, MD
Laura Dineen, MHA, CRCR
Linda Flink
Freddie Guzman, MBA, CHC, RHIA, CCS, CDIP, CPC, CRCR
Basak Kaya
Terri Meier, CHFP, CSMC, CSBI, CRCR
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