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Welcome & Orientation: Welcome!, Welcome to AMBCI Advanced Medical Billing & Coding Training! |
• Navigate the AMBCI learning platform, resources, and support channels;
• Understand program structure, pacing options, and assessment formats;
• Review school policies, enrollment agreements, and certification requirements;
• Set learning goals and prepare for CPC® and CPB® certification paths. |
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AAPC CPB Certification (Required): AAPC CPB Course Overview, 1A. Introduction to Healthcare, 1B. Introduction to Healthcare Regulations and Their Impact on Medical Billing, 2A. Health Insurance Models, 2B. Health Insurance Models, 3A. Patient Registration Process/Data Capture, 3B. Patient Registration Process/Data Capture, 3C. Patient Registration Process/Data Capture Practical Application, 4A. How to Use Your ICD-10-CM Code Book, 4B. Introduction to ICD-10-CM Coding, 4C. ICD-10 CM Coding Basics, 4D. ICD-10 Practical Application, 4E. ICD-10-CM Official Guidelines for Coding and Reporting FY 2024, 4F. ICD-10 April 2025 Update, 5A. Intro to CPT Coding, 5B. Introduction to CPT® Coding, 5C. CPT Coding Practical Application, 6A. Introduction to HCPCS Level II Coding, 6B. Introduction to HCPCS Level II Coding, 6C. HCPCS Coding Practical Application, 7A. Medical Necessity, 7B. Medical Necessity, 7C. Medical Necessity Practical Application, 8A. CMS 1500, 8B. UB-04, 8C. CMS-1500 and UB-04 Claim Forms, 8D. Claim Forms Practical Application, 9A. Billing, 9B. Billing Lecture, 9C. Billing Lecture Practical Application, 10A. A/R and Collection Concepts, 10B. Accounts Receivable and Collections Management, 10C. A/R and Collection Concepts Practical Application, 11A. Government Carriers (Medicare, Medicaid, TRICARE), 11B. Government Carriers Review, 11C. Government Carriers Practical Application, 12A. Blue Cross/Blue Shield, 12B. BCBS, 12C. Blue Cross/Blue Shield Practical Application, 13A. Commercial Insurance Carriers, 13B. Commercial Insurance Carriers (Cigna, Aetna, UnitedHealthcare), 13C. Commercial Insurance Carriers Practical Application, 14A. Workers’ Compensation, 14B. Workers' Comp Lecture, 14C. Workers’ Compensation Practical Application, CPB Practical Workbook Reference, AAPC CPB Practice Exam Questions, Final Exam Answer Key, CPB Practice Exam 1 (135Q), CPB Practice Exam 2 (135Q), CPB Practice Exam 3 (4 Mini Exams), CPB Practice Exam 4 (135Q), CPB Practice Exam 5 (135Q), CPB Practice Exam 6 (135Q), AAPC CPB Final Exam |
• Master CPB®-specific coding guidelines, payer rules, and practice workflows;
• Apply ICD-10-CM, CPT®, HCPCS Level II, and medical-necessity principles in real-world scenarios;
• Accurately complete CMS-1500 and UB-04 claim forms and resolve denials;
• Navigate government, commercial, and workers’-compensation carrier requirements;
• Perform accounts-receivable management, appeals, and collections best practices;
• Prepare through workbook exercises, practice exams, and final CPB® certification exam.
Additional Objectives:
• Comprehensive Code-Set Fluency: Master the structure, chapters, and conventions of ICD-10-CM and CPT® across all sections—ensuring rapid, accurate code identification (< 15 s per lookup) and correct application of guidelines for each chapter.
• Biomedical Terminology Integration: Seamlessly correlate anatomical, pathophysiological, and procedural terminology with coding logic; translate complex clinical narratives into precise code sequences, including E/M level determination and time-based services.
• Modifier & Global Package Expertise: Analyze surgical, anesthesia, and radiology scenarios to apply modifiers, global-period rules, bundling/unbundling, and multiple-procedure conventions; reduce bundling errors by ≥ 30%.
• E/M Level-of-Service Mastery: Deep-dive into 1995/1997 E/M documentation guidelines; perform point-based audits on HPI, ROS, PFSH, exam, and MDM to justify CPT® levels 992XX with ≥ 90% accuracy.
• Specialty-Specific Precision: Demonstrate advanced coding proficiency for dermatology, orthopedics, pulmonary, cardiology, anesthesia, radiology, pathology, and other high-yield sections; complete sectional quizzes at ≥ 95% correct before progressing.
• Real-World Scenario Application: Solve integrated case studies requiring multi-chapter code sets; practice with mixed ICD-10/CPT® scenarios including telehealth, ancillary services, and clinical trials; refine critical thinking under timed conditions.
• Exam Strategy & Simulation: Engage in 10 full-length practice exams under strict time constraints; master question-dissection techniques, code-book navigation shortcuts, and elimination strategies; target a simulated score ≥ 85% before sitting the AAPC CPC® exam.
• Error-Proofing & Continuing Education: Utilize errata logs and workbook drills to identify common pitfalls; set up a post-certification maintenance plan to track quarterly CPT® and ICD-10-CM updates, ensuring lifelong coding accuracy.
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AAPC CPC Certification (Required): AAPC CPC Course Overview, 1A. The Business of Medicine Lecture, 1B. Business of Medicine Lecture, 2A. Anatomy & Medical Terminology, 2B. Anatomy and Medical Terminology Lecture, 3A. Intro to ICD-10, 3B. Introduction to ICD-10-CM, 4A. ICD-10-CM Ch 1–11: 4.1 Certain Infectious/Parasitic (A00-B99) Pt 1, 4.2 Infectious/Parasitic (A00-B99) Pt 2, 4.3 Neoplasms (C00-D49), 4.4 Neoplasms (C00-D49), 4.5 Blood/Immune Disorders (D50-D89), 4.6 Endocrine/Nutritional/Metabolic (E00-E89), 4.7 Mental/Behavioral/Neurodevelopmental (F01-F99), 4.8 Nervous System (G00-G99), 4.9 Eye and Adnexa (H00-H59), 4.10 Ear and Mastoid (H60-H95), 4.11 Circulatory System (I00-I99), 4.12 Respiratory System (J00-J99), 4.13 Digestive System (K00-K95), 4B. Practical Application, 5A. ICD-10-CM Ch 12–22: 5.1 Skin/Subcutaneous (L00-L99), 5.2 Musculoskeletal (M00-M99), 5.3 Genitourinary (N00-N99), 5.4 Pregnancy/Childbirth (O00-O9A), 5.5 Perinatal (P00-P96), 5.6 Congenital (Q00-Q99), 5.7 Signs, Symptoms, Abnormal Findings (R00-R99), 5.7 Injury/Poisoning (S00-T88), 5.8 External Causes (V00-Y99), 5.9 Factors Influencing Health (Z00-Z99), 5C. Practical Application, 6A. Intro to CPT/Surgery Guidelines/HCPCS/Modifiers: 6.1 Intro to CPT, 6.2 Intro to HCPCS II, 6.3 Intro to Global Surgical Package & Modifiers, 7A. Integumentary System: 7.1 Fine-Needle Aspiration, 7.2 Incision and Drainage, 7.3 Foreign Body Removal, 7.4 Abscess/Pilonidal/Hidradenitis, 7.5 Debridement, 7.6 Biopsy, 7.7 Removal of Lesions, 7.8 Destruction, 7.9 Excisions, 7.10 Nails, 7.11 Repair, 7.12 Adjacent Tissue Transfer, 7.13 Skin Replacement, 7.14 Flaps & Grafts, 7.15 Pressure Ulcers, 7.16 Burns, 7.17 Mohs, 7.18 Breast Incisions, 7.19 Breast Biopsy, 7.20 Mastectomy, 7.21 Special Derm Procedures, 7.22 Photodynamic Therapy, 7B. Practical Application, 8A. Musculoskeletal System: 8.1 Arthrocentesis/Injections, 8.2 Wound Exploration, 8.3 Fractures, 8.4 Head, 8.5 Neck, 8.6 Back & Flank, 8.7 Spine, 8.8 Abdomen, 8.9 Shoulder, 8.10 Wrist, 8.11 Humerus/Elbow, 8.12 Hands/Fingers, 8.13 Pelvis/Hip, 8.14 Legs, 8.15 Foot/Toes, 8.16 Arthroscopy – Knee, 8.17 Endoscopy/Arthroscopy, 9A. Respiratory/Hemic/Lymphatic/Mediastinum/Diaphragm: 9.1 Nose, 9.2 Foreign Body Removal – Nose, 9.3 Accessory Sinuses, 9.4 Larynx, 9.5 Airway, 9.6 Trachea & Bronch, 9.7 Lungs & Pleura, 9.8 Spleen, 9.9 Lymph Nodes/Channels, 9.10 Bone Marrow/Bone Cell, 9.11 Mediastinum, 9.12 Diaphragm, 9.13 Pulmonary, 10A. Cardiovascular System Overview: 10.1 Pacemaker/ICD, 11A. Digestive System Overview, 12A. Urinary & Male Genital Overview, 13A. Female Genital Overview, 14A. Endocrine & Nervous Overview, 15A. Eye/Ocular Adnexa & Auditory Overview, 16A. Anesthesia Overview: 16.1 Lecture, 16.2 Looking Up an Anesthesia Code, 16.3 Added Codes for Anesthesia, 16.4 Medicare Medical Direction, 17A. Radiology Overview, 18A. Pathology & Laboratory Overview, 19A. Evaluation & Management Overview: 19.1 E/M Overview, 19.2 Office/Outpatient, 19.3 Observation, 19.4 Inpatient, 19.5 ED Services, 19.6 Critical Care, 19.7 Nursing Facility, 19.8 Preventive Medicine, 19.9 Non-Face-to-Face, 19.10 Newborn Care, 19.11 Case/Transitional Care, 19.12 Practice Application, 20A. Coding in Medicine Overview: 20.1 Vaccines & Immunizations, 20.2 Biofeedback, 20.3 Dialysis, 20.4 Vascular Studies, 20.5 Allergy & Immunology, 20.6 Health Behavior Assessments, 20.7 Hydration & Chemotherapy, 20.8 Physical Therapy, 20.9 Medical Nutrition Therapy, 20.10 Acupuncture, 20.11 OMT, 20.12 Patient Self-Management, 20.13 Moderate Sedation, 20.14 Medication Therapy, 20.15 Endocrinology, 20.16 Psychiatry, 20.17 Chiropractic, 20.18 Telephone Services, CPC Practice Exam 1–10 (100Q each), AAPC CPC Midterm, CPC Midterm Answer Key, AAPC CPC Final Exam, CPC Final Exam Answer Key, CPC Errata, CPC Practice Application Workbook |
• Master CPC® coding conventions across all ICD-10-CM chapters and CPT® sections;
• Apply surgery, anesthesia, radiology, pathology, and E/M guidelines;
• Execute specialty-specific coding for integumentary, musculoskeletal, respiratory, cardiovascular, and beyond;
• Use modifiers, global packages, and HCPCS II codes appropriately;
• Navigate anesthesia, telehealth, and procedure documentation updates;
• Prepare through extensive practice exams, midterm, final, and errata review.
Additional Objectives: • Regulatory Mastery: Interpret HIPAA, CMS, and payer-specific rules; integrate new CPT® and ICD-10-CM guidelines (2024/2025) into daily workflows; maintain compliance across all claim types.
• Clinical Documentation Analysis: Critically evaluate provider notes for coding accuracy; identify documentation gaps; coach providers on charting improvements to substantiate medical necessity, level-of-service, and code selection.
• Claim Form Expertise: Build, audit, and correct CMS-1500 and UB-04 forms; ensure proper placement of codes, modifiers, and provider signatures; reduce rejections and denials by ≥ 20%.
• Payer Protocol Proficiency: Analyze government, BCBS, commercial, and WC reimbursement policies; execute payer-specific billing strategies; optimize reimbursement by navigating complex payer edits and bundling rules.
• Revenue Cycle Optimization: Design end-to-end AR workflows, from claim submission through aging and appeals; employ scrubber tools and root-cause analysis to streamline clean-claim rates; develop KPI dashboards for denial/conversion tracking.
• Technical & Analytical Skills: Leverage EHR integration, macros, and software automation to expedite data capture and coding; perform forensic-level claim audits to detect fraud, upcoding, and undercoding; implement corrective action plans.
• Exam Readiness & Confidence: Complete rigorous workbook exercises and timed practice exams under simulated conditions; apply test-taking strategies to master CPT® questions, code-book navigation, and scenario-based prompts; achieve a pass rate ≥ 95%.
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Chapter 1: Introduction to Medical Billing (Week 1): Overview of the Medical Billing Profession, The Importance of Accuracy in Billing, Advanced Overview of Healthcare Systems for Billers, Advanced Overview of Patient Care and Billing Cycle, Advanced Overview of Key Roles in Medical Billing and Coding, Advanced Overview of Medical Billing Terminologies |
• Understand the medical-billing career pathway and ecosystem;
• Map the billing cycle, stakeholder roles, and system components;
• Define critical billing terminology and accuracy standards;
• Prepare foundations for advanced billing tasks. |
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Chapter 2: Medical Billing Fundamentals (Week 1): Advanced Overview of the Anatomy of a Medical Bill, Advanced Overview of The Medical Billing Process Step-by-Step, Advanced Review of Fee Schedules and Payer Contracts, Advanced Review of Patient Registration and Data Collection, Advanced Review of Determining Eligibility and Insurance Coverage, Advanced Review of Managing Pre-Authorization Requirements |
• Break down each billing component: charges, adjustments, payments;
• Apply payer-contract interpretation, fee-schedule lookup, and credential verification;
• Execute eligibility checks, benefits determination, and pre-auth workflows;
• Maintain data integrity during registration and billing setup. |
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Chapter 3: Understanding and Mastering Medical Coding (Week 1): Advanced Overview of Medical Coding Systems, Advanced Overview of ICD-10-CM Structure and Usage, CPT Codes and Their Applications, Advanced Overview of HCPCS Level II Codes, Diagnosis Coding Guidelines 2024, Procedure Coding |
• Compare ICD-10-CM, CPT®, and HCPCS II code sets and guidelines;
• Apply chapter-specific ICD-10-CM conventions and subcategory logic;
• Assign CPT® codes for services, procedures, and global packages;
• Use HCPCS II for supplies, DME, and drugs; |
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Chapter 4: Insurance and Reimbursements (Week 1): Health Insurance Systems, Common Insurance Denials and Solutions, Advanced Revenue Cycle Management, Claim Scrubbing and Clean Claims Submission, Negotiating Payer Reimbursements, Medical Billing Software Systems, Handling Out-of-Network Billing Requests, EHR Integration, Automating Tasks to Improve Billing Efficiency, Data Protection and Security Measures in Software, Advanced Data Analytics for Medical Billing, Advanced Tools to Improve Billing Accuracy, Healthcare Compliance Laws, Securing Reimbursement for Uninsured Patients, Improving Claim Approval Rates, Out-of-Network Billing Challenges |
• Navigate diverse payer models and contract types;
• Identify denial reasons, implement corrections, appeal processes;
• Optimize RCM through scrubbing, software tools, and automation;
• Integrate billing with EHRs, ensure HIPAA/security compliance;
• Leverage analytics to reduce leakage, increase approvals, and serve uninsured populations. |
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Chapter 5: Coding Specific to Orthopedics and Neurology (Week 2): Orthopedics Coding and Billing Specifics, Neurology Medical Coding and Billing, Coding for Fracture Care and Bone Procedures, Parkinson's and Alzheimer's Billing |
• Apply anatomy and procedure codes for orthopedic and neurologic encounters;
• Document fracture repair, joint injections, and neurodegenerative-disease management;
• Resolve specialty-specific billing challenges. |
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Chapter 6: Maternal and Child Healthcare Coding (Week 2): Obstetrics and Gynecology Coding, Maternal and Child Healthcare Billing, Prenatal and Postpartum Care Billing, Newborn Screening Procedure Coding, Coding for Childhood Vaccinations |
• Assign correct CPT® and ICD-10-CM codes for prenatal, delivery, postpartum, and pediatric care;
• Code newborn screenings, immunizations, and well-child visits;
• Ensure compliance with AAPC OB/GYN and pediatric guidelines. |
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Chapter 7: Pulmonology, Emergency, and Urgent Care Coding (Week 2): Pulmonology Billing Practices, Coding for Asthma and Respiratory Disorders, Coding for Emergency Room Visits, Coding for Pediatric Emergency Room Cases, Urgent Care Billing and Codes, Critical Care Billing and Reimbursement |
• Apply respiratory CPT® codes for pulmonary function tests, nebulizer treatments, and ER procedures;
• Document pediatric and adult emergency-department encounters;
• Navigate critical-care units’ time-based coding and modifiers. |
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Chapter 8: Surgical Coding and Specialties (Week 2): Surgical Coding for General Surgeons, Advanced Neurosurgery Coding and Billing, Breast Reconstruction Surgery Billing, Organ Transplant Procedure Coding, Major Organ System Procedures Coding, Orthotic and Prosthetics Coding Guidelines |
• Assign surgical CPT® codes: general, neurologic, reconstructive, transplant;
• Use global-surgery and modifier conventions correctly;
• Code orthotics, prosthetics, and related supplies per HCPCS II. |
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Chapter 9: Radiology, Anesthesia, and Pain Management Coding (Week 2): Radiology Billing and Coding, Teleradiology Billing, Updates to Mammography Billing Standards, Anesthesia Coding Guidelines, Pain Management Billing and Coding |
• Code diagnostic imaging, interventional radiology, and tele-radiology services;
• Apply anesthesia time-based and medical-direction coding rules;
• Document pain-management injections and modalities. |
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Chapter 10: Billing for Specialized Medical Practices (Week 2): Podiatry Billing and Diagnosis Coding, Physical Therapy Coding and Documentation, Chiropractic Billing and Coding Practices, Ophthalmology Specialty Billing, Audiology Billing Processes, Coding for Speech-Language Pathology Services, Coding for Hearing Rehabilitation Services |
• Use specialty code sets for podiatry, PT/OT, chiropractic, ophthalmology, audiology, SLP, and hearing rehab;
• Document therapy modifiers, evaluation time, and device fittings. |
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Chapter 11: Coding for Laboratories and Pharmaceuticals (Week 2): Toxicology Coding and Laboratory Billing, Laboratory and Pathology Coding, Coding for COVID-19 Diagnoses and Treatments, Specialty Pharmacy Billing Guidelines, Updates to HCPCS Drug Codes |
• Assign CPT® and HCPCS® codes for lab tests, pathology services, and toxicology panels;
• Code COVID-19 testing and therapies;
• Navigate specialty-pharmacy and drug-code updates. |
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Chapter 12: Coding for Chronic and Complex Conditions (Week 2): Coding for Long-Term Conditions like Diabetes, Chronic Disease Management Codes, Coding for Rare and Complex Diseases, Coding for Rare Genetic Diseases |
• Apply chronic-disease and care-management coding per CMS guidelines;
• Code rare disorders and genetic-testing services accurately using ICD-10-CM standards. |
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Chapter 13: Behavioral and Community Healthcare Billing (Week 3): Behavioral Health Telemedicine Billing, Substance Abuse Billing Documentation, Substance Use Disorder (SUD) Program Billing, Community-Based Mental Healthcare Billing, Strategies to Lower Denial Rates in Behavioral Health |
• Code tele-mental-health and in-person BH services per webinar rules;
• Document SUD and community-based program encounters;
• Implement denial-reduction tactics in behavioral-health billing. |
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Chapter 14: Coding for Geriatrics, Hospice, and Palliative Care (Week 3): Geriatrics Coding and Billing Challenges, Coding for Hospice and Palliative Care, Transitional Care Management Billing Guidelines |
• Navigate geriatric assessment codes, hospice-care levels, and palliative interventions;
• Apply transitional-care management (TCM) CPT® rules and billing workflows. |
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Chapter 15: Preventive and Population Healthcare Billing (Week 4): Preventive Care Coding, Population Health Billing Management, Vaccination Administration Billing Introduction, Birth Control Coverage and Billing, Breast Cancer Screening and Treatment Billing |
• Assign codes for wellness exams, screenings, and immunizations;
• Manage population-health program billing and reporting;
• Document preventive services under ACA and payer policies. |
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Chapter 16: Medicare and Value-Based Billing (Week 4): Medicare Risk Adjustment Coding, MACRA and MIPS Reporting Requirements, Impact of Value-Based Care on Billing, Evolution of Value-Based Billing Models |
• Code hierarchical-condition categories (HCCs) for Medicare Advantage;
• Report MIPS/QPP metrics and quality measures;
• Adapt to shared-savings and value-based reimbursement frameworks. |
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Chapter 17: Coding for Cardiology and Vascular Procedures (Week 4): Advanced Cardiology Diagnostic Procedures, Coronary Angioplasty and Stenting Billing, Cardiac Catheterization Billing Tips, Cardiovascular Stress Test Billing Procedures, Vascular Surgery Specialty Billing |
• Assign interventional cardiology CPT® codes for caths, PTCA, and stents;
• Code stress-tests, echocardiography, and vascular interventions;
• Apply modifiers for angioplasty, atherectomy, and stenting. |
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Chapter 18: Gastrointestinal, Sleep Medicine, and Reproductive Health (Week 4):Gastrointestinal Endoscopy Billing Strategies, Coding for Sleep Medicine Diagnoses, Sleep Apnea Diagnosis and Treatment Coding, Male Reproductive Health Coding |
• Code GI endoscopic procedures and therapeutic interventions;
• Assign sleep-study and PAP therapy codes;
• Document male-reproductive and infertility procedures. |
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Chapter 19: Billing for Medical Devices and Durable Goods (Week 5): Coding for Durable Medical Goods (DMG) Rentals, Coding for Medications and Biologics, Billing Codes for Congenital Abnormalities, Categorizing “Incident to” Services |
• Apply HCPCS II codes for DME rentals, biologics, and supplies;
• Code congenital-anomaly surgeries and incident-to-physician services under Medicare rules. |
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Chapter 20: Administrative Processes and Auditing in Billing (Week 5): Billing and Payment Posting Procedures, Accounts Receivable (AR) Management in Healthcare, Appeals Process for Denied Claims, Return on Investment for Billing Outsourcing, Compliance Audits for Medical Billing, Advanced Auditing Techniques for Coders, Reducing Coding Discrepancies During Audits, Ethical Practices in Medical Coding, Fraud Detection through Coding Analysis, Navigating Claim Reprocesses and Resubmissions |
• Master patient-posting workflows, AR aging, and cash application;
• Conduct denial appeals, root-cause analyses, and ROI assessments for outsourcing;
• Perform compliance audits, error-rate reduction, and fraud-monitoring; |
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Chapter 21: Technology and Innovation in Billing (Week 6): EMR and EHR Systems Integration in Billing, AI and Automation in Medical Billing, Leveraging Technology for Simplified Claims Processing, Innovative Tools for Increasing Revenue Cycle Efficiency, Navigating Interoperability in Billing Systems |
• Integrate billing modules with EMR/EHR platforms;
• Deploy AI/automation tools for claim-scrubbing and payment posting;
• Ensure HL7/FHIR interoperability and data flow integrity. |
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Chapter 22: Specialty Billing Challenges (Week 6): Cosmetic and Plastic Surgery Billing, Pediatric Developmental Disorders Coding, Audiology Evaluation Billing Codes, Sexual Health Services and Billing Codes, Sports Medicine Billing and Coding Basics |
• Address niche payer policies for cosmetic, pediatric, audiology, sexual-health, and sports-medicine services;
• Code complex modalities with sensitivity to coverage criteria. |
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Chapter 23: Insurance and Regulatory Standards (Week 6): Private Insurance Billing Guidelines, Commercial Payer Updates and Coding, Workers’ Compensation Medical Billing, OSHA Requirements for Billing Offices, Understanding the Clean Claim Ratio |
• Stay current on private-payer rule changes, CPT®/ICD-10 CM updates, and WC coding;
• Comply with OSHA, CMS, and NCQA clean-claim standards. |
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Chapter 24: Global and Emerging Trends in Billing (Week 6): Global Medical Trends Impacting Billing, Social Determinants of Health (SDoH) Coding, Trends in Digital Health Billing, ICD-11 Transition and Updates, Quarterly Coding Updates and Education |
• Prepare for ICD-11 adoption and SDoH code sets;
• Track global digital-health billing innovations and quarterly regulatory changes;
• Educate billing teams on emerging trends. |
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Chapter 25: Oncology, Hematology, and Infectious Diseases (Week 6): Hematology and Oncology Chemotherapy Billing, Oncology Radiation Treatment Coding, HIV and Infectious Disease Billing |
• Code chemo-administration, OCM models, and radiation-therapy procedures;
• Apply ICD-10 CM codes for HIV, TB, and other ID treatments with CDC guidelines. |
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Chapter 26: Dermatology, Rheumatology, and Immunology Billing (Week 6): Dermatology Billing and Coding Standards, Rheumatology Coding Essentials, Allergy and Immunology Coding |
• Assign correct dermatologic procedure codes (e.g., excisions, biopsies);
• Code DMARD injections and RA assessments;
• Document allergy testing, immunotherapy, and vaccine administration. |
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Chapter 27: Home Health and Long-Term Care Settings (Week 6): Long-Term Care Facility Billing, Home Health Coding |
• Code home-health SOC/EOC visits, OASIS assessments, and LTC-facility per-diems;
• Navigate PDGM and RUGs reimbursement models. |
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Chapter 28: Outpatient and Ambulatory Services (Week 6): Coding for Outpatient Services, Ambulatory Care Coding Guidelines |
• Code office visits, minor procedures, and preventive services in outpatient settings;
• Apply global-surgery and modifier rules for ambulatory surgery centers. |
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Chapter 29: Telehealth and Remote Monitoring (Week 6): Telehealth Coding Essentials, Remote Patient Monitoring (RPM) Billing |
• Use COVID-era and long-term telehealth CPT® codes;
• Document RPM device setup, monitoring intervals, and care-management services. |
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Chapter 30: Business Processes and Revenue Management (Week 6): Business Office Procedures for Medical Billers, Insurance Contract Negotiation Tips, Authorization and Referrals in Billing, HEDIS Measures and Quality Reporting, Revenue Leakage Prevention in Billing |
• Optimize front- and back-office workflows and contract negotiations;
• Manage authorizations, referrals, and HEDIS-quality data collection;
• Detect and plug revenue leaks. |
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Chapter 31: Expert Skills (Week 6): Intermediate Cataract Surgery Coding, Health Information Exchange in Billing, Ultrasound Imaging Billing Tips, Utilizing Coding Edits for Error Control, ICD-10 Chapter-Specific Tutorials, Translating Global Codes to Local Payer Codes, Medical Team Collaboration in Coding, Coding for Immunocompromised Patient Care, Community Health Clinic Billing Strategies, Outpatient Surgery Center Coding Challenges, Trends in Comparative Billing Reports, STDs/STI Services Billing, Scoliosis Treatment Coding Essentials, Alternative Medicine Billing Codes, Keeping up with Coding Reimbursement Reductions, Rheumatic Disease Billing, E/M Coding Changes and Updates, Coding for Rehabilitation Centers, Diversity in Coverage Policies for Payers, Accessibility in Patient Financial Support Services, Diagnostic Coding for Auto Accidents, Principles of Code Sequencing, Ambulatory Payment Classification (APC) Coding, Internal Controls for Billing Services, Compliance in Contracted Network Billing, Coding for Dental and Maxillofacial Procedures, Differences Between Facility and Professional Billing, Internal Medicine Coding and Billing Pointers, Understanding Explanations of Benefits (EOBs), Patient Financial Assistance Billing, Coding for Advanced Practice Providers, Coding for Clinical Nurse Practitioners, Outsourcing Medical Billing Services, Correcting Coding Errors, Tracking Claim Submissions and Follow-Ups, Translating Physician Notes into Codes, Comorbidity Coding and Documentation, Bundled Payment Models in Billing, Billing for Substance Abuse Rehabilitation Centers, Genetic Testing Billing Processes, Coding and Billing for Bariatric Surgery, Understanding Relative Value Units (RVUs), Audits and Documentation Standards, Charge Capture in Hospitals, Coding Policy Updates and CMS Guidelines, Coding for Clinical Trials and Research Studies |
• Develop niche coding expertise for advanced procedures, multi-disciplinary care, and specialized settings;
• Implement edits, sequencing rules, and APC grouping;
• Collaborate with clinical teams and manage payer-specific code translations;
• Adapt to evolving RVU, bundled-payment, and clinical-trial coding requirements. |
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Chapter 32: 500 Practice Cases + AAPC Exam Prep (Week 7/8): Virtual Internship – Practicode Guide, AMBCI Exam Review Questions, AMBCI Final Exam |
• Apply comprehensive coding and billing knowledge across 500 real-world scenarios;
• Reinforce learning through targeted exam-review questions;
• Demonstrate readiness via the AMBCI final exam. |
