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Medical Billing & Coding: Curriculum Detail
The comprehensive Blackstone Medical Billing & Coding course curriculum covers a broad range of topics. Please click on a volume for more detail, or scroll downward to view all.

Unit I: Blackstone Skills for Success
Unit II: Introduction to Computers, Keyboarding and Office Technology
Unit III: Medical Terminology 1: An Introduction
Unit IV: Medical Terminology 2
Unit V: English and Written Communication
Unit VI: Medical Terminology 3
Unit VII: Medical Terminology 4
Unit VIII: Introduction to Pharmacology
Unit IX: Professional Development and Medicolegal Ethics
Unit X: Introduction to Insurance Billing and Coding 1
Unit XI: Introduction to Insurance Billing and Coding 2
Unit XII: Introduction to Insurance Billing and Coding 3
Unit XIII: Medical Office Practice 1
Unit XIV: Medical Office Practice 2
Unit XV: Medical Office Practice 3
Unit XVI: Practical Applications of Coding 1
Unit XVII: Practical Applications of Coding 2
Unit XVIII: How to Find a Job as a Healthcare Professional


Unit I: Blackstone Skills for Success
Discover How You Learn Find a Place to Study Learn How to Study
  • DetermineYour Learning Style
  • Intrinsic versus Extrinsic Motivation
  • Learning Defined
  • Self-Efficacy & Self-Determination
  • Learning Styles
  • Visual, Auditory, & Kinesthetic Learners
  • Field Dependence & Independence
  • Know How You Learn Best
  • Choose a Perfect Place
  • Work When You're at Your Best
  • Schedule Time to Study
  • Set Realistic Goals
  • Avoid Distractions
  • Monitor Your Study Sessions
  • Take Care of Yourself
  • Avoid Procrastination
  • Learning Strategies
  • The SQ3R Learning Strategy
  • Note-Taking
  • Memory Tricks
  • References
  • Multiple Choice Tests

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Unit II: Introduction to Computers, Keyboarding and Office Technology
Chapter I Chapter 2 Chapter 3

Covers how computers are used in the office today, the different types of computers, and the parts of a computer system.

Covers basic keyboarding skills using the Mavis Beacon Teaches Typing CD.

Covers the Internet, the World Wide Web (WWW), URLs, the different types of Internet connections, search engines, e-mail, and other uses for the Internet.

Chapter 4
Covers other types of office technology including office telephones, the different types of telephone calls, fax machines, photocopiers, multipurpose machines, transcribers, digital cameras, and wireless communication.

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Unit III: Medical Terminology 1: An Introduction
Chapter I Chapter 2 Chapter 3

Explains how medical terms are constructed and analyzed to determine meaning; discusses types of medical terms including terms with no prefix and no root; explains the function of combining vowels and how terms are pluralized.

Covers the roots of each body system; explains the difference between anatomy and physiology; covers organ systems and common anatomical roots.

Covers general and adjectival suffixes and suffixes used to indicate pathologic conditions and diagnostic and surgical procedures.

Chapter 4
Covers prefixes referring to direction and position; discusses negative prefixes, prefixes referring to numbers, and those with the same or opposite meaning.

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Unit IV: Medical Terminology 2
Chapter 5 Chapter 6 Chapter 7

Discusses how the body is organized into cavities; covers directional terminology.

Covers the anatomy and physiology of the integumentary system; lists relevant word elements, terms, and abbreviations.

Covers the anatomy and physiology of the skeletal system; describes the skeleton and joints; lists relevant word elements, terms, and abbreviations.

Chapter 8
Covers the muscular system; discusses the skeletal attachments and major skeletal muscles; lists relevant word elements, terms, and abbreviations.

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Unit V: English and Written Communication
Chapter 1 Chapter 3 Chapter 4

Covers the parts of speech including nouns, verbs, pronouns, adjectives, adverbs, prepositions, conjunctions, and interjections

Covers pronoun/antecedent agreement and pronoun usage; explains how pronouns are used in sentences; covers subject/verb agreement.

Covers sentence types and sentence punctuation.

Chapter 2 Chapter 5
Covers the parts of a sentence including the subject, predicate, direct and indirect objects, subject complements, phrases, and clauses. Covers fundamentals of written communication including using active versus passive voice, writing unified and coherent paragraphs, and writing topic sentences for paragraphs. Discusses common types of business communication including business letters and memorandums.

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Unit VI: Medical Terminology 3
Chapter 9 Chapter 10 Chapter 11

Covers the divisions and functions of the nervous system; discusses nerve cells and synapses; discusses the central nervous system (CNS) and the peripheral nervous system (PNS); lists relevant word elements, terms, and abbreviations

Covers the eyes and the ears (sensory system); lists relevant word elements, terms, and abbreviations.

Covers the endocrine system; lists and discusses the central endocrine glands and the peripheral endocrine glands; lists relevant word elements, terms, and abbreviations.

Chapter 12
Covers the cardiovascular system; discusses the structure of the heart, the conduction system, blood pressure, heart sounds, blood vessels, and circulation; lists relevant word elements, terms, and abbreviations.

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Unit VII: Medical Terminology 4
Chapter 13 Chapter 15 Chapter 16

Covers the blood, immune and lymphatic systems; lists relevant word elements, terms, and abbreviations.

Covers the digestive system; discusses the oral cavity, pharynx, esophagus, stomach, small intestine, large intestine, accessory organs, and peritoneum; lists relevant word elements, terms, and abbreviations.

Covers the urinary and male reproductive system; lists relevant word elements, terms, and abbreviations.

Chapter 14 Chapter 17
Covers the respiratory system; discusses the nose, nasal cavities, paranasal sinuses, pharynx, larynx, trachea, bronchi, and lungs; lists relevant word elements, terms, and abbreviations. Covers the female reproductive system and obstetrics; discusses the structures of the female reproductive system, the menstrual cycle, and menopause; lists relevant word elements, terms, and abbreviations.

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Unit VIII: Introduction to Pharmacology
Chapter 1 Chapter 3 Chapter 4

Covers consumer safety and drug regulations; discusses drug laws, the FDA, DEA, and laws affecting healthcare workers.

Covers sources and bodily effects of drugs; discusses how drugs are processed by the body; explains absorption, distribution, metabolism, excretion, and other variables, and unexpected responses to drugs.

Covers medication preparation and supplies; discusses standard drug forms and supplies.

Chapter 2 Chapter 5
Covers drug names and references; discusses classifications, drug names, legal terms relating to drugs, and terms indicating drug actions, drug references, and drug cards. Lists and discusses abbreviations and systems of measurement.

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Unit IX: Professional Development and Medicolegal Ethics
Chapter 1 Chapter 2

Discusses concepts of professional development including attitude, self-esteem, professional attire, business etiquette, verbal and nonverbal communication, introductions, time and stress management, and continuing education.

Discusses medicolegal ethics in healthcare; covers the code of ethics; discusses aspects pertaining to the healthcare record including the purpose of ownership, how to correct mistakes, the difference between privileged and nonprivileged information, and the importance of timeliness.


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Unit X: Introduction to Insurance Billing and Coding 1
Chapter 1 Chapter 3 Chapter 5

Covers the roles and responsibilities of the health insurance specialist; discusses employment opportunities, basic skill requirements, and professional certification.

Discusses managed health care and its history; presents six managed care models; discusses the accreditation of managed care organizations, government managed care ventures, and the effects of managed care on administrative procedures in a physician's practice.

Covers the legal and regulatory considerations; explains confidentiality of patient information; discusses the retention of patient information and health insurance records, the Federal False Claims Act, and the Health Insurance Portability and Accountability Act of 1996.

Chapter 2 Chapter 5 Chapter 6
Gives an introduction to health insurance; defines health insurance; discusses disability and liability insurance and the major developments in health insurance, health insurance coverage statistics, and third-party reimbursement methods. Explains the life cycle of an insurance claim including the development of the claim, the new patient interview and check-in procedure, an established patient return visit, and post clinical check-out procedures; explains how insurance companies process claims and how insurance claim files are maintained. Covers ICD-9-CM coding, including HCFA ICD-9CM coding guidelines, primary and principal diagnosis coding, principal versus secondary procedures, and coding qualifying diagnoses; explains the basic steps for using the index and the organization of the tabular list; discusses considerations to ensure accurate ICD-9-CM coding.
Chapter 7
Covers CPT coding; discusses the CPT coding system, format, symbols, conventions, and index; explains the basic steps for coding procedures and services.

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Unit XI: Introduction to Insurance Billing and Coding 2
Chapter 8 Chapter 11 Chapter 12

Covers the HCPCS Coding System; explains how this system is organized; gives HCPCS national (Level II) codes and how these codes are assigned; explains how HCPCS national (Level 11) modifiers are assigned.

Gives essential HCFA-1500 claim form instructions, general billing guidelines, and optical scanning guidelines; discusses the reporting guidelines and restrictions covering the following claim form items: diagnoses, date entry, procedures, modifiers, charges, diagnostic reference numbers, and units; explains why the billing entity's employer tax identification number (EIN) should appear on the claim; explains the four processing steps that must occur before a completed form can be mailed to the insurance company; discusses how to set up a tickler filing system for completed claim forms.

Discusses how commercial claims are filed; explains how to determine the status of primary and secondary commercial claims; explains how to complete commercial primary and secondary fee-for-service claims and commercial primary supplemental fee-for-service claims accurately; explains how to create a comparison chart as an aid to mastering the details of completing claim forms.

Chapter 9
Discusses HCFA reimbursement issues; explains the Medicare fee schedule, and HCFA regulations that impact reimbursement.
Chapter 10
Covers coding from source documents; explains how to apply ICD-9-CM coding guidelines; discusses CPT/HCPCS billing considerations; gives coding clinical scenarios; discusses how medical and operative reports are coded.

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Unit XII: Introduction to Insurance Billing and Coding 3
Chapter 13 Chapter 14 Chapter 16

Covers Blue Cross and Blue Shield plans; explains the function of the national Blue Cross and Blue Shield (BCBS) Association; lists four distinctive features that make the BCBS plans different from other commercial medical insurance programs; compares and contrasts the advantages of being a BCBS participating provider versus being a non-participating provider; describes the features of BCBS basic benefits; lists typical services found in Major Medical coverage; explains the benefits of special accidental injury riders/clauses.

Covers Medicare; discusses medical eligibility, enrollment, Part A and Part B coverage, participating providers and nonparticipating provider restrictions; gives step-by-step claim form instructions; discusses situations where Medicare is the secondary player.

Covers TRICARE; presents TRICARE administration, options, programs and demonstration projects and service centers; discusses preauthorization, limited charges, supplemental plans, and billing information; gives primary claim instructions and secondary payer claim instructions.

Chapter 15 Chapter 17
Covers Medicaid; presents the legislative background of Medicaid and Federal eligibility requirements; discusses Medicaid services and the relationship between Medicaid and Medicare; discusses situations where Medicaid is the secondary payer. Covers workers' compensation; discusses Federal compensation programs and state-sponsored coverage, eligibility, and classification of on-the-job injuries; explains the OSHA Act of 1970 and the special handling of workers' compensation cases, first report of injury, progress reports; gives claim instructions.

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Unit XIII: Medical Office Practice 1
  • Job 1: Records Management - Organizing Work Files
  • Job 2: Written Communication - Revising Patient Information Sheet
  • Job 3: Records Management - Preparing New Patient Files
  • Job 4: Computerized Scheduling - Blocking and Scheduling Patient Appointments
  • Job 5: Appointments - Scheduling Telephone Appointments
  • Job 6: Completion of Encounter Form
  • Job 7: Transcription - SOAP Notes
  • Job 8: Transcription - SOAP Notes and EEG
  • Job 9: Appointments - Creating Appointment Patient List
  • Job 10: Appointments - Preparing New Patient Appointments Schedule, Drafting Letter to Patients to Inform of New Doctors' Hours
  • Job 11: Transcription - History and Physical Examination Record, Continuation Sheet
  • Job 12: Research and Written Communication Skills - Researching Drug Information

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Unit XIV: Medical Office Practice 2
  • Job 13: Computerized Medical Insurance Billing - Preparing CMS-1500 Insurance Reimbursement Form
  • Job 14: Insurance Claims - Preparing CMS-1500 Forms: Medical and Blue
  • Job 15: Research and Written Communication Skills - Creating a Travel Itinerary
  • Job 16: Transcription - Preparing Preoperative History and Physical Examination Report and Operative Report
  • Job 17: Written Communication - Completing Finished Copy from Rough Draft
  • Job 18: Communication Skills - Making a Referral to a Specialist
  • Job 19: Administrative Procedures - Faxing a Referral
  • Job 20: Transcription - Two History and Physical Examination Records
  • Job 21: Transcription -Two Operative Reports
  • Job 22: Scheduling - Appointment Requests

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Unit XV: Medical Office Practice 3
  • Job 23: Computerized Medical Records Management - Input New Patient Records, Edit Patient Records, Prepare Reports
  • Job 24: Records Management - Transcribing Emergency Patient Office Visit, Creating New Patient File, Completing Encounter Form
  • Job 25: Employee Payroll - Completing Work Record, Preparing and Proving Totals on Payroll Register
  • Job 26: Transcription - History and Physical Examination Record, Progress Notes, Letter
  • Job 27: Transcription - Operative Reports
  • Job 28: Transcription - Telephone Messages
  • Job 29: Research - Researching Electronic Medical Records
  • Job 30: Computerized Procedure Entry
  • Job 31: Insurance Claims and Managed Care - Preparing CMS-1500 Forms: Medicare and Blue
  • Job 32: Standard Precautions: Preparing Occupational Exposure Incident Report
  • Job 33: Communications: Proofreading and Preparing Final Copies from Draft Copies: Discharge Summary and History and Physical Examination Record
  • Job 34: Office Administration - Ordering Office Supplies and Preparing a Purchase Order
  • Job 35: Coding - Diagnostic and Procedural Coding

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Unit XVI: Practical Applications of Coding 1
Module 1: ICD-9-CM Module 3: Primary Care Module 6: Orthopedics

Explains how to use ICD-9-CM; discusses V codes and M codes, categories, and subcategories; reviews the basic steps in coding; explains how to use coding for infections, HIV infections, the circulatory system, diabetes mellitus, obstetrics, neoplasms, injuries, fractures, and burns.

Explains the meaning of primary care and the difference between a primary care physician and a specialist; explains how Evaluation and Management Codes are relevant to primary care; explains how to assign Evaluation and Management and Medicine codes to services provided by primary physicians; lists the criteria for a consultation and a referral.

Covers ICD-9-CM coding, including HCFA ICD-9CM coding guidelines, primary and principal diagnosis coding, principal versus secondary procedures, and coding qualifying diagnoses; explains the basic steps for using the index and the organization of the tabular list; discusses considerations to ensure accurate ICD-9-CM coding.

Module 2: CPT Coding: Evaluation and Management Module 4: Anesthesia/General Surgery Module 7: Cardiology
Lists and explains the components of an Evaluation and Management code assignment; distinguishes between levels of services included in Evaluation and Management codes; explains how to relate the appropriate code to documented patient encounters; identifies the specific categories and subcategories of Evaluation and Management services; explains how to apply modifiers to Evaluation and Management codes. Explains how and when anesthesia codes are used; defines physical status modifiers and discusses when they apply; describes the organs upon which general surgery is performed; identifies the major procedures performed within general surgery. Covers cardiology, anatomy, physiology, and terminology; identifies common cardiac diagnostic services; explains the difference between a cardiac therapeutic service and an interventional service; explains nuclear cardiology procedures.
Module 5: Integumentary System
Explains how to assign ICD-9-CM diagnosis codes and CPT Procedure codes to diseases involving the integumentary system; defines common terms related to the integumentary system.

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Unit XVII: Practical Applications of Coding 2
Module 8: OB/GYN Module 10: Billing and Collections Module 12: Reimbursement and Auditing/Appeals

Discusses female reproductive anatomy and physiology; defines and explains proper usage of terms; explains how to assign and sequence codes pertaining to OB/GYN; discusses the significance of global service; explains the difference between obstetric and gynecologic services.

Discusses the importance of billing and collection in the outpatient setting; discusses the patient registration process; discusses cycle and monthly billing; lists advantages of a computerized billing system; explains the accounts receivable process, account aging, and the purpose of an age analysis.

Covers HCPCS Level I, II, and III, and CPT and ICD-9-CM coding systems; discusses multiple mechanisms of reimbursement; explains components for payment calculation and reimbursement strategy; explains how to pinpoint discrepancies in billing and documentation; discusses guidelines for documentation, including audit flags, compliance concepts, documentation deficit, and E&M.

Module 9: Radiology, Pathology, & Laboratory Module 11: Filing the Claim Form
Covers subsections of radiological section; explains how to code various types of radiological procedures; explains the difference between qualitative and quantitative. Explains how to complete HCFA-1500 claim forms, including abstracting information from patient medical records and common guidelines; explains functions of Health Maintenance Organizations (HMO) and defines CHAMPUS/ TRICARE/CHAMPVA.

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Unit XVIII: How to Find a Job as a Healthcare Professional
Chapter 1 Chapter 2 Chapter 3

Covers job-search correspondence including resumes and cover letters.

Discusses job-search techniques such as networking and using online employment search engines.

Discusses job interviews; explains how to dress for an interview, what to bring to an interview, what to expect during an interview; discusses common questions asked during an interview and how to follow up after an interview.

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BCI provides an excellent foundation for anyone interested in earning a career diploma from home. With more than a century of expertise, Blackstone offers a committed, responsive faculty and a quality education, all at an affordable rate.
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