Medical Coding By Jen Study Guide 2025
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