Coding and Medical Necessity

This course provides a foundational understanding of medical coding systems and the essential role of medical necessity in healthcare documentation and reimbursement. Students will explore the basics of ICD-10-CM, CPT, and HCPCS Level II coding and learn to navigate code sets accurately. The course also addresses how medical necessity affects claim approvals, compliance, and revenue cycle performance. Through real-world examples and hands-on practice, students will develop the skills needed to assign accurate codes and apply payer-specific medical necessity policies to support successful claim submission

• Understand basics of ICD-10-CM and CPT coding
• Apply HCPCS Level II coding principles
• Navigate code sets accurately
• Apply payer-specific medical necessity policies
• Develop accurate code assignment skills through practice

• No prior work experience required
• Recommended knowledge of medical terminology, anatomy, and pathophysiology