Coding Specialist — Certificate
Program closed to admission for the 2020-2021 academic year.
Tim Bristol, Chair
Pauline J. Calla
Debra L. Hamada
Terri L. Rouse
Medical coding professionals
Health-care facilities need coders who accurately select ICD-10-CM/PCS codes, CPT codes, and HCPCS codes; and identify appropriate DRG or APC assignments for diagnostic and surgical information filed in health records. In most instances, financial reimbursement is directly tied to these codes. The statistical information generated from these codes is used in research, quality improvement in patient care, education, and administrative decision making.
Coding specialists are in demand in acute care and ambulatory care facilities, physicians' office practices, and long-term care facilities. A variety of government agencies require coding expertise as well. The need for accurate, skilled coders is acute in California and throughout the nation. Available information about job opportunities is provided to alumni.
The Coding Specialist Program is seven quarters in length. Prior to beginning coding courses, the student is introduced to health-care records, confidentiality, ethics, and pharmacology. Classes meet one night a week until the final two quarters. The last two quarters of the program, practical experience courses are integrated into the course schedule. During these quarters, students will spend one night a week in class and one night a week in practicum.
Program learning outcomes
Upon completion of the program, the graduate should be able to:
- Adhere to the format, organization, and mechanical conventions of the ICD-10-CM/PCS, CPT, and HCPCS coding systems;
- Determine the appropriate medical codes for health-care encounters with accuracy and consistency;
- Analyze health record documentation to verify that it is accurate, timely, and complete; and that it supports the diagnosis and other clinical findings;
- Supervise health data collection and processing through coding, indexing, and maintaining disease and operation statistics;
- Develop policies and procedures for coding, including a plan for coding quality;
- Comply with federal, state, and professional association guidelines for coding in the health-care environment;
- Interpret the revenue management cycle in relation to the prospective payment system;
- Perform diagnostic-related group and ambulatory patient-classification assignments using decision trees and computerized patient-data groupers;
- Develop appropriate physician queries to resolve discrepancies in clinical documentation and coding.
Upon successful completion of the program, the student is eligible to take the national entry-level certification examinations of the American Health Information Management Association.
Special course work/credit
Credit for life experience may be offered through waiver or equivalency examination as allowed by University policy.
The Loma Linda University Coding Specialist Certificate Program is approved by AHIMA's Professional Certificate Approval Program (PCAP). This designation acknowledges the coding program as having been evaluated through a peer-review process and against a national minimum set of standards for entry-level coding professionals. This process allows academic institutions, health-care organizations, and private companies to be acknowledged as offering an approved coding certificate program.
In addition to Loma Linda University and School of Allied Health Professions admissions requirements, the applicant must also complete the following requirement:
- High School Diploma or GED
The following corequisites/courses must be completed at a regionally accredited college or university:
- Human anatomy and physiology (must be completed before Summer Quarter of first year)
- Medical terminology
- Introduction to computer applications (must be completed before HLCS 961 Coding Practicum I)
- Essentials of human diseases/pathophysiology (must be completed before Fall Quarter of second year)
|HLCS 239||Introduction to Health Records Science||3|
|HLCS 242||Coding I||4|
|HLCS 247||Computer Applications in Health Care||2|
|RELE 257||Health Care Ethics||2|
|HLCS 243||Coding II||4|
|HLCS 245||Coding III||4|
|HLCS 254||Evaluation and Management Coding for Billing and Reimbursement||2|
|HLCS 961||Coding Practicum I||2|
|HLCS 962||Coding Practicum II||2|
|HLCS 257||Coding Special Topics||3|
A minimum grade of C (2.0) is required for all courses in the program.
Normal time to complete the program
Two (2) years based on less than half-time enrollment, with no full-time option available.
HLCS 236. Pharmacology. 2 Units.
Introduces pharmacology, including a review of pharmaceuticals used in diagnosis, prevention, and treatment of disease as commonly encountered in medical records.
HLCS 238. Essentials of Human Diseases. 3 Units.
Surveys human diseases, including the etiology, pathogenesis, and clinical manifestations of commonly encountered diseases.
HLCS 239. Introduction to Health Records Science. 3 Units.
Introduces health-care facilities and the information systems involving health records. In-depth study of health record content, confidentiality of health-care information, and professional ethics.
HLCS 241. Medical Terminology. 2 Units.
Prefixes, suffixes, and root words used in the language of medicine. Terms pertaining to pathology and surgery. Terms studied by body system: gastroenterology, cardiology, neurology, musculoskeletal, dermatology, ophthalmology, otorhinolaryngology, and respiratory.
HLCS 242. Coding I. 4 Units.
Principles and conventions of ICD-10-CM and ICD-10-PCS coding in diseases and procedures pertaining to infectious diseases; diseases of blood, endocrine, respiratory, digestive, genitourinary, skin, and musculoskeletal systems; and mental disorders.
HLCS 243. Coding II. 4 Units.
Principles and conventions of ICD-10-CM and ICD-10-PCS coding in diseases and procedures pertaining to pregnancy, perinatal conditions, poisonings, injuries, complications of medical and surgical care, the circulatory system, and neoplasms.
Prerequisite: HLCS 242.
HLCS 245. Coding III. 4 Units.
Principles of current procedural coding terminology (CPT) at the intermediate level, including: surgical coding for all body systems; medical procedures; anesthesia coding; radiology, pathology, and laboratory coding for inpatient and outpatient health-care settings. Modifier assignment. Also includes laboratory practice on 3M software.
Prerequisite: HLCS 243.
HLCS 247. Computer Applications in Health Care. 2 Units.
Introduces health-care information systems concepts and applications. Focuses on software application in the health-care arena. Specific topics addressed include: general system theory; data management; interoperability; health record applications (e.g., encoder, ADT-R, ROI, etc); electronic health records; personal health records; mobile technology; telemedicine; bioinformatics; heath information exchange; patient informatics applications; and emerging trends in health information technology.
HLCS 254. Evaluation and Management Coding for Billing and Reimbursement. 2 Units.
Principles of billing and third-party reimbursement as they relate to physician professional coding and APC assignment for health-care institutions. Includes E&M coding conventions and modifiers. Covers principles of health service billing, including billing terminologies, the billing process, and universal billing forms for the various physician-practice settings. Includes laboratory practice using actual patient records and 3M encoding software to enhance student proficiency.
HLCS 257. Coding Special Topics. 3 Units.
Coding-system usage by reimbursement agencies, laws governing these processes, and federally supervised coding auditing to assure that the laws of coding are followed. Health-care delivery systems and internal billing and reimbursement in these settings. Requirements of state and federal coding regulatory agencies, ethics of coding, coding quality, and coding compliance. Content varies to accommodate the changing nature of health care reimbursement processes and laws.
Prerequisite: HLCS 245.
HLCS 292. Computer Applications in Health Care II. 1 Unit.
Introduces health-care information systems concepts and applications. Focuses on software application in the health-care arena. Specific topics addressed include: general system theory; interoperability; specific health record applications (encoder, ADT-R, ROI, etc); electronic health records; personal health records; and patient informatics applications. One hour required each week.
HLCS 961. Coding Practicum I. 2 Units.
Twelve-week (six hours per week) coding laboratory provides a capstone experience for students who have completed all academic course work in coding. Enables students to apply all state and national coding and reimbursement regulations to a variety of inpatient and outpatient records. Provides students the opportunity to improve speed and accuracy prior to entering the job force.
Prerequisite: HLCS 257.