Frustrated by the Coding Practicum?

You just got through the coding modules. E/M coding almost killed you, but you survived. Now you’re looking back and wondering if you remember anything from the last four modules. At the same time, you are looking ahead at the giant pile of reports to code in the practicum; you may have even coded a few of them. You may feel frustrated, overwhelmed, and possibly astonished at the work it takes to learn medical coding. From someone who has been where you are now, allow me to offer a few words of advice…

Learning to use your books and apply guidelines has been the focus of the course thus far. Now you get to work on developing a new skill—abstraction. The practicum is composed of authentic medical charts, dictated by actual physicians in patient care situations. This means you will be reading physician-level writing and abstracting the pertinent info for code assignment. Abstraction is definitely a skill unto itself. A huge part of going through each of these charts is learning to identify key words and phrases and turn them into the right codes—this takes A LOT of practice. Don’t expect to be able to get all the codes right immediately!

Your scores on the practicum reports are not considered when we determine your eligibility to take the final exam. You need to attempt every report, but you do not need to get an 85% on them like you do on the Unit Tests and Module Exams. This gives you the opportunity to learn from each report by going through the documentation and coding what you can, submitting your codes, and working backward from the codes you missed. This is a valuable way to learn abstraction while simultaneously gaining indexing skills and learning which codes are appropriate for disparate report types.

The practicum component of online medical coding training takes a lot of discipline, but hopefully with these ideas in mind you can move through the reports with a little less stress and, instead, focus on learning from each report.

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48 thoughts on “Frustrated by the Coding Practicum?

  1. Jennifer says:

    I’m trying not to beat myself up when on cases I don’t even know where to begin. I know this is a skill that has to be learned with a lot of practice so I’m trying to keep that in mind and not get too discouraged.

    • Lana says:

      I’m right there with ya! I’m hoping it just will click!! I think I’m getting it then forget some codes from the beginning ???? I do feel better not to be the only one! Thanks for posting!

  2. Ashly Provorse says:

    I beat myself up when I can get two in a row right, and then the next one will take me six tries before I finally figure out what to code! Glad to know there is frustrating people with me!

  3. Anna B says:

    It is so frustrating cause I feel like I need to make 100 on all of them. It is taking me to much time getting through them this way I was glad to read that I don’t have to have perfect scores on them all ugh

  4. angela says:

    It is frustrating for sure. I read and reread and there are times I still miss something that needs to be coded. The explanations do help me learn from my mistakes though. I can then pinpoint those situations that tripped me up in other reports.

  5. Kimberly says:

    Seeing everyone’s post is reassuring to me. I thought that by this point I was supposed to be coding almost every question right one the 1st try and I felt like I was the only one struggling. This really helped. Thanks everyone good luck to all of you

  6. Liz says:

    Struggling hardcore as well guys…sometimes it’s a simple mistake like coding order, and others it’s just entirely the wrong code alltogether. Super frustrated, but I keep trudging along. Keep it up. We got this!!

  7. Stephanne says:

    I am on the first portion of the medical coding and billing. I have completed everything with an 85% or higher and it’s still telling me the course is incomplete. Can anyone help me understand?

  8. Lori says:

    This was such a blessing to read! I also thought that I should be getting these all correct. The coding order trips me up too! Feeling a little less overwhelmed reading this 🙂 I like the online course, but sometimes it would be nice to just be able to ask an actual person why something is coded a certain way!

  9. Suzanne says:

    I’ve never experienced so many highs and lows with something until I was introduced to coding;-) Comforting to see we are all having similar struggles! Really skeptical about the CPC exam! I am about to start the Neurology section in the practicum, if anyone else is close to that section and wants to work together let me know….without the help in the chat room, that has added another level of frustration as well!!

  10. Stacey says:

    I wish i had seen this when i started the practicum. Lol! Just started the neurology section as well and have been frustrated this whole time. I am glad I am not the only one. 🙂

  11. Briana Hill says:

    I’m so happy I’m not alone in being frustrated and completely terrified to finish and take the CPC exam! I’ve been doubting this idea wayyyy too much lately because of this practicum. I feel like I’ve forgotten wayyy too much stuff!

  12. jodie drouin says:

    oh thank gods I’m not the only one who feels like banging my head on the desk!!! now I feel less discouraged going into the practicum!!

  13. Barb says:

    I hear all of you! ????. Ever since I started the practicum, I’ve been asking myself man did I learn anything? Check, recheck and check again. I’m determined! I will pass this exam even if it kills me.

    • sheron budhram says:

      I am so happy I came to this blog. I’m in my practicum too at Cardiology. And I was asking my self the same question too. Sometimes I got it correct 100% and sometimes I have to try 3 or 4 times. I started to pray and I found this page. I will pass this exam too. Good luck everyone and thanks for all the information this really help.

  14. Teresa R. says:

    Thank goodness for all of you!!!! I’ve always considered myself an intelligent person. HA!!! Am currently on cardiology in the practicum and feel like I haven’t remembered a thing. So frustrating…..

  15. Ginger says:

    I’m so glad to know that I’m not alone in my frustrations with this course! Some of the things I code don’t necessarily make sense from what I’ve learned, and some appear contradicting. I’m hoping like the rest of you that it’ll just click with me eventually. I’m almost halfway through the practicum and still find myself struggling.

    Is there an active chat for our coding course so that we can pick at everyones brains and get more of an insight into the course?

    I’d love to pass the course and state exam the first time around instead of prolonging this pain lol

    • mbunderson says:

      Thanks for your feedback, Ginger. Keep your chin up! Be sure to reach out to your instructors at or 1-888-657-5752 if you feel you need any help or even just a little encouragement. That’s why we’re here! You can connect with other students and graduates in the Student and Graduate Community where you’ll find a medical coding forum. Just sign up with your Student ID (if you can’t find that, just shoot us a quick email at and we’d be happy to look it up for you) at You might be surprised at just how much it can help to have other students to connect with. 🙂 Best wishes.

  16. Ashly Provorse says:

    So I completed everything, and took the final exam! Wow got my results back and about lost it, if anyone is having same trouble, sure could use some help studying again, before I have a melt down!

    • Ginger says:

      About how long did it take for your post to be published? I still haven’t seen mine pop up yet and I’m not sure why not.

      How did the final exam go for you? I may not be the best study partner, but if theres a chat group in career step Id love to be apart of it and perhaps we can all pick each others brains for what they know and help us more

      • Angie says:

        I too am concerned. I am struggling with this practicum. I feel like they expect us to be able to code like we have done it for years after taking this program. I am scared to take the final. They say it should take 7-8 hours which for me means I will have to take the full 2 days. very discouraging.

  17. Jo Anne Chacon says:

    I’m so discouraged. I felt really good about things before I started the Practium. I have 99 pages left and I’m not sure of anything anymore. I’m close to quitting and throwing all material away. I hope I’m not the only one.

  18. dylan says:

    I am at Internal Medicine and skipped 2 records on cardiology because what the heck was that.. i know it wasn’t advised for us to skip any page but i just could not handle it and feeling really depressed i might have submitted the page more times than I can count.. still dont get it. Glad to know i am not the only one going thru this stress.

    • Kristi says:

      Cardiology was a nightmare for me as well. I put in a couple of them into the Instructor Chat and RichB noted that cardiology was difficult for everybody. 😛

  19. Ginger says:

    I now utilize my student chat room, and instructer chats and I can say with certainty that it’s made a tremendous difference since my last comments. I highly recommend utilizing them and asking any and all questions you have!

  20. Jacque says:

    Thanks for the post. I nearly had a STROKE, and almost had to purchase a new laptop. I was so frustrated it seemed that I could not get anywhere. I code everyday at me current job but these samples have me beat to a pulp!. I have calmed down not that I know someone out there feels the same. Plus I can afford another laptop.

  21. dawn petty says:

    i’m frustrated that i will have gotten the code correct other than i’m one number off at the end of a code, or i get them in the wrong order. last njite i FINALLY felt like i had the codes right, then 2nd guessed myself and changed the order only to learn i had them right to begin with

    • Kristi says:

      I can’t count the number of times I’ve done that!! I’m just relieved to know that the scores don’t count. I still want to know what the correct answers are, but I won’t go back and input the correct answers now!! ????

  22. Lisa says:

    I have been so frustrated by the practicum!! I will be honest and say I have walked away a few times just to clear my head. I use to do abstraction in my old job and what I am picking out and what they want is different sometimes ( I just want to scream).. Thanks for the insight in the article because it helped me to refocus and know there are others with me.

  23. Shelby says:

    Seeing this post helps, however; I am confused as to what needs to be an 85 or higher now. This course is nothing like I was told, it has been an uphill battle from the start. (It didn’t help that I had a rough pregnancy and now an infant in the middle of trying to take it.

    • mbunderson says:

      First, congratulations on your new baby! Second, I’m sorry this program has been a challenge for you. I’m glad this blog post could help. Please make sure you reach out to our Student and Graduate Community! (You can find this community at You’ll need to create an account to login; if you’re not sure what your Student ID is, just shoot us an email at and we’d be happy to look it up for you.) Many of our students find it helpful to connect with other students who are going through similar experiences.

      Best of luck to you!

  24. Angie says:

    This program is very thorough perhaps too thorough. It is a lot of information to take in and learn. I can appreciate that they want us to be prepared for the real world but it is a lot. It would’ve been helpful to know that the grades don’t matter in the practicum. It should bein the notes at the beginning of the practicum I shouldn’t have to come to a blog to find that important information out. I am trying to stay the course but am frustrated.

  25. Kari says:

    I am so glad to know it isn’t just me! I get so frustrated, I cry. I am so afraid I won’t pass the final or the CPC and I need this. I did coding years ago and medical billing but it seems so foreign to me now. Also, never got certified years ago. I have taken forever to get through this course too, going on two years now as I am a single parent and work fulltime. Half of the reports I get half wrong or I can’t for the life of me figure out how they got the codes they got. It is stressing me out. I feel like if I can’t get this, then how will I ever pass the final or CPC. 🙁 I am not giving up but sometimes I want to. I am almost to the Encoder part.

  26. Sam says:

    Can someone please explain to me why I can’t access my final exam? I am confused because I went back and checked I have 85% or higher on all modules and exams, but for the coding practice it is saying I need 85% on all of them. I’m confused because reading this it states you don’t have to have 85% on everyone.

    • mbunderson says:

      Hi Sam, I’m so sorry to hear that you’ve had some trouble getting in touch with your instructors! Are you calling our Student Support team directly at 1-888-657-5752? Even if you can’t get through when you call, be sure to leave a voicemail—we try very hard (and are usually quite successful) at returning all calls within a few hours during normal business hours. We also reply to emails ( within 1-2 business days. You can also use our Ask-an-Instructor chat option in our Student and Graduate Community ( This lets you chat with an instructor in real time. Hope that helps! Best wishes. 🙂

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