CBCS study plan
CBCS · Give each week a clear focus.
8 weeks · About 8 hours per week
Coding (Diagnosis and Procedure)
Map the ICD-10-CM tabular structure and index conventions (includes/excludes, 'code first', 'use additional') by annotating a printed guideline summary
Apply ICD-10-CM official guidelines to sequence principal vs. secondary diagnoses across 20 practice vignettes
Demonstrate correct alphabetic index and tabular lookup for 30 assigned diagnoses, citing the pathway used for each
Detect and correct 10 deliberately mis-coded records by identifying the violated convention
Your checkpoint
A 30-entry diagnosis coding log with code, pathway, guideline cited, and a scored 25-question ICD-10-CM quiz at 80% or higher
Coding (Diagnosis and Procedure)
Differentiate CPT code sections and HCPCS Level II categories by sorting 40 codes into the correct section with rationale
Assign E/M codes to 15 documented encounters using level-of-service elements (history, exam, MDM) and record the deciding factor
Apply modifiers -25, -59, -51, and -LT/-RT to 15 operative and outpatient scenarios, justifying each in one sentence
Identify bundling and unbundling risks in 10 surgical scenarios using NCCI edit logic
Your checkpoint
A 40-question procedure coding worksheet (E/M plus modifiers) scored at 85% or higher with written justifications for every modifier used
Billing, Claims Submission, and Reimbursement
Reconstruct the CMS-1500 form field-by-field from memory and label which fields drive payer edits
Sequence 15 multi-payer claim scenarios, selecting correct payer order and coordination-of-benefits rules
Explain the clean-claim lifecycle from scrubber to payer adjudication in a written walkthrough
Compare fee-for-service, capitated, and value-based reimbursement models across 10 payer contract terms
Your checkpoint
A one-page CMS-1500 field map plus a 10-question payer-order/COB quiz scored at 90% or higher
Billing, Claims Submission, and Reimbursement & Insurance Eligibility and Prior Authorization
Calculate allowed amount, contractual adjustment, deductible, coinsurance, and patient responsibility for 12 reimbursement scenarios
Verify eligibility for 10 simulated patients, capturing copay, deductible remaining, and coverage limits in a tracking sheet
Determine prior authorization requirements for 10 services and document submission elements and timelines
Identify 8 reasons claims are denied at the front end (eligibility/auth failure) and state the preventive action for each
Your checkpoint
A 12-row reimbursement calculation worksheet and a 10-patient eligibility/authorization log, both scored at 85% or higher
Insurance Eligibility and Prior Authorization & Accounts Receivable, Collections, and Revenue Cycle
Build an A/R aging analysis from a 25-claim sample, classifying each claim into 0-30, 31-60, 61-90, and 90+ buckets
Categorize 15 denial scenarios by root cause (coding, eligibility, timely filing, medical necessity) and draft the corrective action for each
Draft a first-level appeal letter for 5 denials that cites policy, code, and supporting documentation
Sequence the patient collection workflow from statement to final notice while applying fair-collection and financial-hardship options
Your checkpoint
A denial-management log covering 15 claims with root cause, action taken, and appeal draft, plus an A/R aging summary showing correct bucketing
Accounts Receivable, Collections, and Revenue Cycle & Compliance, Privacy, and Regulatory Requirements
Compute 6 key revenue cycle metrics (days in A/R, clean claim rate, denial rate, net collection rate, first-pass resolution, cost to collect) from supplied data
Apply HIPAA Privacy and Security Rule requirements to 10 scenarios covering minimum necessary, TPO, and breach notification
Distinguish fraud, waste, and abuse across 10 vignettes and identify the applicable law (False Claims Act, Anti-Kickback Statute, Stark)
Outline the elements of a compliance program and map each element to a specific billing-office control
Your checkpoint
A two-page revenue cycle metrics scorecard with all six calculations shown, plus a 20-question compliance quiz scored at 85% or higher
Compliance, Privacy, and Regulatory Requirements & Coding (Diagnosis and Procedure) & Billing, Claims Submission, and Reimbursement
Audit 12 coding and billing records against a self-built checklist, flagging each deviation with the rule violated
Complete a 75-question mixed-domain timed practice set under exam conditions and log every missed question by domain
Remediate the two weakest domains by re-drilling 20 targeted questions in each until reaching 90%
Recite documentation-retention and record-release rules for 8 request scenarios
Your checkpoint
A completed 12-record audit with findings and a remediation log showing the two weakest domains raised to 90% accuracy
Insurance Eligibility and Prior Authorization & Coding (Diagnosis and Procedure) & Billing, Claims Submission, and Reimbursement & Accounts Receivable, Collections, and Revenue Cycle & Compliance, Privacy, and Regulatory Requirements
Complete two full-length timed mock exams and compare domain-level scores between attempts
Re-review every missed item from both mocks and convert each into a one-line takeaway rule
Rehearse fast recall of code conventions, claim fields, and compliance statutes using spaced-repetition cards
Finalize an exam-day plan covering timing per question, flagging strategy, and break scheduling
Your checkpoint
Two completed timed mock exams with the second scoring 85% or higher overall and at least 80% in every domain
Milestones
Week 2: Achieve 85% or higher on the procedure coding worksheet, confirming coding foundations before adding billing content
Week 4: Correctly complete at least 10 of 12 reimbursement calculations and 8 of 10 eligibility/authorization entries
Week 6: Score 85% or higher on the compliance quiz and produce all six revenue cycle metrics without reference
Week 8: Score 85% or higher overall and at least 80% in each of the five domains on the final timed mock exam