Medical Coding By Jen Study Guide for 2025 1st Edition
 
This study guide takes the major concepts needed to know for any medical coding certification exam and turns it into a more bullet point condensed version. 
 
Midpoint in the study guide will show you some areas of the manuals color codes I use with examples. Then I will go over the key areas one more time in an even more condensed version.
 
Sprinkled in are practice questions with answers and rationales over key areas with information placed into word maps and charts in hopes that this will help all types of learners. 
 
I hope this 1st version helps and please let me know any suggestions for revisions you have for further versions. 
 
Table of Contents
Introduction
About This Guide
Disclaimer and Copyright Information
The Business of Medicine
Understanding the Hierarchy of Providers
Non-Physician Providers (NPPs)
Health Insurance in the U.S.
Commercial Insurance
Medicare Overview
Medicare Parts A, B, C, and D
Medicaid Overview
Medicare Payment Structure
Resource-Based Relative Value Scale (RBRVS)
Physician Fee Schedule (PFS) Overview
Medical Necessity and Coverage
Medical Necessity Standards
National and Local Coverage Determinations (NCDs and LCDs)
Advance Beneficiary Notice (ABN)
HIPAA and Patient Privacy
Covered Entities
The Minimum Necessary Requirement
HITECH Act and Data Security
Fraud, Abuse, and Compliance
Definitions and Legal Provisions
Compliance Plans
The Office of Inspector General (OIG) and Work Plans
AAPC Certification and Training
Overview of AAPC Credentials
Training and Certification Programs
Practice Questions and Case Studies
Medicare Scenarios
Coding Challenges and Solutions
Detailed Case Reviews
Appendices
CPT® Codes Overview
ICD-10-CM Coding Guidelines
Glossary of Terms
Evaluation and Management (E/M) Services
Selection of E/M Service Levels
Time and Medical Decision-Making (MDM)
Diagnosis Coding for E/M Services
Specialized Coding Guidelines
Surgery and Global Packages
Pathology and Laboratory
Radiology
Medicine Services and Their Subcategories
Chapter-Specific Coding (ICD-10-CM)
Infectious and Parasitic Diseases
Neoplasms
Diseases of the Nervous System
Circulatory System Diseases
Pregnancy, Childbirth, and Puerperium