Medical Scribe Syllabus

The Final Exam – This test is necessary to receive a Certificate of Completion. Depending on your final score, certificate and/or letters are provided. The final will provide you the look and feel of a real employer exam. If you pass our final exam, you will pass almost any employer exam.

Final Exam for CD Version of the Courses The Final Exam is included in the cost of the online courses. If you choose to do a course via the CD option, it is $89.00 to take the final exam.

*** All coding courses, or courses that include coding require the purchase of two reference books from an outside source. You may also purchase a used inexpensive edition anywhere online instead of the new edition. *** – SELECT THE 89.95 EDITION and

TIME FOR COMPLETION: 500 hours (225 instruction, 275 laboratory/practicum


MODULE 1 – Medical Terminology

Chapter 1. Language Origins, Etymology

Chapter 2. English Grammar101

Chapter 3. Medical Words, Blueprints, Nuts and Bolts

Chapter 4. Dynamics of Medical Vocabulary & Word Structure

Chapter 5. Body Dynamics

Chapter 6. Medical Instruments and Equipment

Chapter 7. Medical Specialties and Specialists

Chapter 8. Diagnostic Medicine

Chapter 9. Abbreviations

Chapter 10. Anatomy and Physiology

Chapter 11. Pharmacology

Chapter 12. Just For Fun

MODULE 2 – Medical Records

Chapter 1 Medical Records

A. Electronic Medical Records

B. Electronic File Transfer

C. Confidentiality

D. Data Entry
Chapter 2 Medical Reports, Formats and Types

A. Medical Dictation

B. Report Types

C. Outpatient Reports

D. Correspondence

E. Inpatient Reports

F. Operative Report

G. Discharge Summaries

H. Consultations

I. Autopsies

J. Interpreting Medical Records & Dictation




Chapter 1 – Industry History and Codes

A. ICD Codes

B. CPT Codes

C. HCPCS Codes

D. Evolution of Coding

Chapter 2. The Coder

A. Private Practice

B. Hospital Services

C. Coder Responsibility

D. Ethical Standards

E. Understanding What is Coded

F. Documentation

G. Medical Necessity

Chapter 3. ICD-9 Coding

A. ICD-10 Coding

B. Using Reference Books

C. General Coding Guidelines

Chapter 4. CPT Coding

A. Types of Services

B. CPT Coding Book Guidelines

C. Modifiers

D. CPT Book Sections

E. Symbols

F. Unlisted Procedures

G. Evaluation and Management

Chapter 5. Software

Chapter 6. Legal Issues


Applied Coding Practicum

A. ICD-9 and ICD-10 Coding

B. CPT Coding

C. Reports 2 through 63

D. Evaluation and Management Reports

E. Supply Codes, APC, PCS

F. Appendix