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PBC-MBC-P · Professional

Medical Billing & Coding — Professional

Master the complex, high-stakes coding that commands premium remote pay — advanced sequencing, surgical and E/M coding, full modifier and NCCI mastery, appeals, audits, and risk adjustment. Aligned to the recognized CPC and CCS standard.

Duration

40h self-paced

Exam

65 Qs · 130min

Pass mark

75%

What you'll learn

This Professional track moves beyond standard encounters into the complex, error-sensitive coding that commands premium remote pay. It assumes you already code at the Associate level and takes you into advanced ICD-10-CM sequencing, surgical and E/M coding, full modifier mastery, payer rules and NCCI edits, denial management and appeals, coding audits, compliance, and risk-adjustment (HCC) coding. The curriculum is aligned to the professional standard set by the CPC and CCS credentials. PBridge's certificate is its own credential and prepares you toward that standard, proven with a peer-reviewed capstone. Self-paced. Worked examples, code-lookup drills, and interactive knowledge checks in every module.

Course modules

  1. 01

    From associate to professional: the complexity leap

    What changes at the professional level — specificity at scale, specialty breadth, financial stakes, and audit exposure — reading complex multi-problem documentation, the professional mindset, and why one miscoded surgical claim can trigger a six-figure clawback.

    ~240min
  2. 02

    Advanced ICD-10-CM: sequencing & combination coding

    Principal/first-listed selection in depth, etiology/manifestation and 'code first'/'use additional code', combination codes, complex 'with', multiple coding, and the neoplasm table — with several fully worked sequencing examples.

    ~360min
  3. 03

    Surgical coding & the global surgical package

    The CPT surgery section, the global surgical package concept and global periods (0/10/90 days), what's bundled vs separately billable, and the surgical modifiers (-58, -78, -79, -57, -24, -25) — with worked global-period scenarios.

    ~360min
  4. 04

    E/M mastery: MDM, time & the audit grid

    The MDM grid in depth (problems, data, risk), leveling by total time and prolonged services, new vs established and hospital/observation E/M, and the documentation failures auditors target — with worked leveling of complex visits.

    ~300min
  5. 05

    Modifiers & NCCI edits

    Modifier categories in depth, NCCI procedure-to-procedure (PTP) edits and the modifier indicator, Medically Unlikely Edits (MUEs), the -59 and X{EPSU} modifiers, and bundling/unbundling judgment — with worked edit-resolution examples.

    ~300min
  6. 06

    Denials, appeals & the professional revenue cycle

    Denial taxonomy and root-cause analysis, writing a formal multi-level appeal, underpayment and contractual recovery, AR aging and follow-up, and the revenue-cycle KPIs professionals manage — with a worked appeal and an aging-report read.

    ~300min
  7. 07

    Audits, compliance & fraud at the professional level

    The compliance program, audit types (prepayment/postpayment, internal/external, RAC), documentation and coding audits with extrapolation, the fraud-and-abuse laws at a high level, and how to respond to an audit — with worked findings and corrective action.

    ~300min
  8. 08

    HCC / risk adjustment & the professional career

    Risk-adjustment models and HCCs, the RAF score concept, MEAT-supported capture and annual recapture, specificity and compliance pitfalls (cloning, unsupported capture), and the professional credentials and job market — with worked capture scenarios, leading into the capstone.

    ~240min

What you walk away with

Not just a certificate. A career-grade credential built to open doors.

01

A credential employers verify in one click

Unique cert ID, QR code, and tamper-evident signature. No more wondering if your certificate is taken seriously.

02

A portfolio piece, not just a paper

Your capstone project lives on your public PBV portfolio. Recruiters click and see actual work — that beats a cert badge every time.

03

Lifetime access, no expiry

Once you earn it, it's yours. No renewals, no subscriptions, no surprises.

04

A profile that stands out

Verified PBV credentials show up on your PBridge freelancer profile, putting you ahead of unverified candidates in client searches.

Why PBC works

  • USD pricing, transparent and global. Pay in USD, accepted globally.
  • Built for the global context. Case studies and capstone briefs use real-world business scenarios.
  • Reviewed capstone project. A human reviews your final project.
  • Verifiable digital certificate. QR code and cryptographic hash for one-scan verification.
  • PBridge job board access. Featured in front of employers hiring on PBridge.

Medical Billing & Coding — Professional certification FAQs

How much does the Medical Billing & Coding — Professional certification cost?+

The PBridge Certified Medical Billing & Coding — Professional certification costs $199 for the exam-only path and $319 for the full path which includes the capstone project review. Both prices are in US Dollars. Payment via secure international checkout (Visa, Mastercard, Amex).

Is the PBridge Certified Medical Billing & Coding — Professional certification recognized internationally?+

Yes. PBridge Certified certifications are issued with verifiable digital credentials including a unique cert ID, QR code, and hash signature. Hiring managers anywhere in the world can verify any cert at https://www.pbridgeco.com/verify/{cert-id}.

How long does it take to complete the Medical Billing & Coding — Professional certification?+

The Medical Billing & Coding — Professional certification takes approximately 40 hours of self-paced study. The exam itself is 130 minutes with 65 questions. Most candidates complete the full path including the capstone project in 4-8 weeks studying part-time alongside work.

What makes PBridge Certified the right fit for learners and employers globally?+

PBridge Certified is built for the global market — USD pricing, capstone scenarios drawn from real-world business cases, international hiring manager recognition, and direct integration with the PBridge job board so certified holders get featured in front of employers actively hiring.

Can I get a job after the Medical Billing & Coding — Professional certification?+

PBridge Certified cert holders get priority access to the PBridge job board where global and remote employers post medical billing & coding — professional roles. Pair the certification with the capstone project as a portfolio piece — most certified holders see callbacks within 30 days.