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Medical Billing and Coding Certification Pathway

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This six-part Certification Pathway was created with the National Healthcareer Association (NHA), and includes learning material directly from NHA. These self-led Skills Pathways are designed to help you learn the topics on the Certified Billing and Coding Specialist (CBCS) exam from NHA. Build in-demand medical billing and coding job skills as fast as your schedule allows with these self-paced, noncredit Pathways that help prepare you for new opportunities in the healthcare field.

Help prepare yourself to take the Certified Billing and Coding Specialist (CBCS) exam:

  • If you buy the Medical Billing and Coding Certification Pathway, you’ll receive a code to take the CBCS exam as part of your sign-up fee

  • While completion of this Certification Pathway can help prepare you to take the CBCS exam, additional requirements that must be met to sit for the CBCS exam can be reviewed at the National Healthcareer Association (NHA) website

Certified Billing and Coding Specialist exam prep

Successfully completing this Certification Pathway can help you prepare for the Certified Billing and Coding Specialist exam.

Included Skills Pathways

Skills Pathways begin with exploring the fundamentals of health information management and how to help protect the privacy and integrity of patient records. Next, Pathways dig into how to assign diagnosis and procedure codes, accurately interpret medical benefits and prepare medical claim forms. Then, learn detailed knowledge of human anatomy and physiology to code for maximum reimbursement.

Skills Pathway 1: Electronic Medical Records

    • Differentiate the laws and regulations impacting the management of Electronic Medical Records
    • Identify common components of medical records and requirements needed to preserve electronic record integrity
    • Recognize the influence of government and third party payers on the policy and practices related to medical records for healthcare organizations
    • Communicate relevant ideas and concepts through selecting appropriate medical language to accomplish professional goals

Skills Pathway 2: Medical Billing & Processing Fundamentals

    • Accurately identify reimbursable services and treatments
    • Identify payer policies and the party responsible for payment
    • Appeal medical claim denials
    • Prepare medical claim forms and process electronic transactions

Skills Pathway 3: Medical Coding Fundamentals

    • Utilize the ICD-10(-CM) manual when given patient medical information to assign the correct codes for claims purposes
    • Utilize the CPT (Current Procedural Terminology) code books to correctly assign the code for the medical procedure or service as documented in the medical record
    • Apply codes from the two levels of HCPCS (Healthcare Common Procedure Coding System) codes and correctly identify medical procedures or services claims to government (Medicare/Medicaid) or other payers that take HCPCS codes
    • Identify how and when to add modifiers with HCPCS and CPT codes

Skills Pathway 4: Anatomy, Physiology and Coding: Cardiovascular, Respiratory, Lymphatic and Endocrine Systems

    • Locate relevant information from patient medical records
    • Resolve medical record discrepancies and collaborate with providers for clarification
    • Determine appropriate responses and actions to claim rejections
    • Ensure all medical care and procedures are properly captured and coded for optimal reimbursement

Skills Pathway 5: Anatomy, Physiology and Coding: Gastrointestinal, Integumentary, Reproductive and Urinary Systems

    • Locate relevant information from patient medical records
    • Resolve medical record discrepancies and collaborate with providers for clarification
    • Determine appropriate responses and actions to claim rejections
    • Ensure all medical care and procedures are properly captured and coded for optimal reimbursement

Skills Pathway 6: Anatomy, Physiology and Coding: Neurological, Muscular, Mental Health and Skeletal Systems

    • Locate relevant information from patient medical records
    • Resolve medical record discrepancies and collaborate with providers for clarification
    • Determine appropriate responses and actions to claim rejections
    • Ensure all medical care and procedures are properly captured and coded for optimal reimbursement

Required Materials

We recommend having the following required materials on hand before starting this Certification Pathway. You will not be able to gain the full benefit of this learning experience without these coding manuals, and you’ll need them if you plan to take NHA's Certified Billing & Coding Specialist, (CBCS), certification exam. The following materials are not included in the purchase price and must be obtained separately. For more information, visit the NHA website

  • ICD-10-CM 2023: The Complete Official Codebook (ICD-10-CM the Complete Official Codebook)
  • HCPCS 2023 Level II Professional Edition (HCPCS Level II (American Medical Assn))
  • CPT 2023 Professional Edition (CPT / Current Procedural Terminology (Professional Edition))
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Showcase your achievement

You will earn a Certificate of Completion and Skill Badge for each individual skill in this Certification Pathway when you've successfully completed each skill with a score of 85% or higher. Share your accomplishments by uploading them to your social media profiles, such as LinkedIn®¹.

¹ LinkedIn is a registered trademark of LinkedIn Corporation and its affiliates in the United States and/or other countries.

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Frequently asked questions

Employees can immediately access and begin learning after completing your purchase.

A Skills Pathway is a series of skills that can be learned over a period of time.

Prebuilt Pathway: A series of two or more existing skill modules that’s ready to launch today.

- Training Pathway: A series of two or more one-hour skill modules that does not prepare employees for a certification exam or help them earn recertification credits. - Certification Pathway: Completing this Prebuilt Pathway can help employees prepare for a third-party certification exam. - Recertification Pathway: Completing this Prebuilt Pathway can help employees earn recertification credits for a specific agency such as SHRM® and HRCI®.

Tailored Skills Pathway: Select multiple existing skill modules to create this Pathway. Skill modules and assessments can be modified slightly to accommodate the needs of your business.

Custom Skills Pathway: Our team will build completely new skill modules and assessments for your business and workforce.

A skill module teaches a single skill in four to eight hours.

  • A one-hour skill module teaches a single skill in about one hour.