Frustrated by the Coding Practicum?

Coding and Billing103 Comments

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.

Leave a comment below »

  1. Amy September 30, 2014

    I just started the Practicum portion a week ago. Im soo frustrated that Im ready to quit!!! I can’t seem to get any problems correct on the first try & the E/M coding drives me crazy!! When will it ever get easier?? Also in a time crunch since my time is running out in 2 months. Not sure if I should extend or if I have enough time to figure this out. Any suggestions would be really appreciated.

  2. Instructor Craig Laursen September 30, 2014


    Very few students get all the codes correct the first time through. As an instructor, I have seen students make great progress going through the report and assigning what they find and then going back through a second time after they know the correct codes from the answer page.
    You already know how to code (the process) now its a different skill of learning how to apply the process. This takes time and practice.
    We are here to answer your questions! Please email .(JavaScript must be enabled to view this email address) with your questions!

  3. Hemvati Patil October 23, 2014

    hi guys, i am in same boat as u all are, really frustrated. when i can’t find codes for key words, i try finding synonym for keywords online and then look into coding book for code. Hope it helps.

  4. Craig Laursen October 23, 2014

    This is a really good tip, Hemvati, thank you!

    Finding just the right main term and sub-term can be a challenge. Sometimes the physician and the codebooks don’t use the exact same language. I remember having the hardest time with OB/GYN reports until I found “Pregnancy, complicated…” Indexing takes practice and gets easier with experience, which you will get a good chunk of in the practicum.

  5. Amber April 22, 2015

    Do most people go through the practicum more than once?

  6. Career Step April 23, 2015

    Hi Amber,

    No, most people do not go through the practicum more than once. You’re welcome to do each report as many times as you’d like, but you’re only required to attempt each one at least once. There is not even a required score or anything, we just encourage you to give each one a good honest try and use it as a learning experience as you move on.

    Hopefully that helps, and don’t forget that you can always contact your coding instructors for individualized help at 1-888-657-5752 or .(JavaScript must be enabled to view this email address).

    Best wishes!

  7. Annette April 07, 2016

    I am so appreciative for this blog!!  Especially seeing that others are feeling as I am. I feel as though I am failing miserably…just when I think I have the codes right….NO! I am 100 plus pages into the practicum and have a deadline of June 2 and things are still not clicking.  Again thank you for the blog post.

  8. Craig Laursen April 12, 2016

    Keep moving forward! Try not to worry about your scores. Don’t let things that are marked wrong for sequencing discourage you. If you are finding the codes and learning from each report you are doing exactly what you need to do.
    Keep up the good work!

  9. Rena Warmath April 19, 2016

    I’m so glad I found this blog…everyone here is voicing how I’m feeling!  I’m about 30% through the practicum and sometimes I’m ready to throw the books away. Thank you all for making me realize that I’m not as stupid as I feel! Now…back to the practicum…

    Hi Rena,
    We are so happy this post was helpful for you and made you feel not alone, and certainly not “stupid” smile

    Keep up the great work!

  10. coding support April 28, 2016

    Hi Barbara-

    Yes! the practicum is challenging.  Please keep in mind this is not a test, only an experience reading and coding real reports before you get into the real world.  We ask for an attempt on each report, but do not look at your specific scores. If you have made it thus far in the program, it is just a matter of pushing through to the end.  Please let student support if you need assistance on any specific report. 

    Best wishes!

  11. LG August 18, 2016

    OMG, thank you for writing this blog! It’s obvious you were echoing the feelings of all of us here in this coding practicum. I am having trouble in the practicum like everyone else and it feels like no matter what I do, I always get something wrong in some way. I am utilizing all the tools available to me but it still comes out wrong but I believe I’ll get it.

  12. Stephanie Adcock September 01, 2016

    I am so glad you sent me this blog. I have been working on this practicum and it has made me feel like maybe I made a mistake on choosing this program. Every time I start to do fairly well, the next several problems give me fits-when I think my codes are right, they are not!! I feel a whole lot better seeing that other people are in the same boat and makes me not want to quit!

  13. Sharon Glockzin September 12, 2016

    I also appreciate getting this blog. I thought I might be that one person in the entire course who is feeling totally inadequate! I am a burned out RN looking for something that I enjoy doing and can hopefully do from home. Somedays I wonder…! I will continue to get through this practicum because I’m just too stubborn to give up.

  14. Debbie September 12, 2016

    Thank you so much for the email with this blog. I have been feeling so frustrated and wondering if I had made a mistake choosing to pursue a career in medical coding. It is a relief to know that I am not alone. Does anyone know what format the final exam is in? The way I feel right now, I am worried about passing it. I felt like I was doing great with the program until the practicum part. Thank you again for the encouraging email and blog.

  15. Judy September 15, 2016

    I to appreciate this blog! I have really struggled with the practicum. I have cried, yelled and felt very alone. I have been in nursing for 30 years and wanted to get away from bedside care. I felt like I made a mistake by going into this, then I read this blog and found others that felt the same way. I have 100 pages left before my final exam. I just pray I can get it together enough to pass with a good score and remember guidelines going forward. Gone too far to look back now.

  16. Jennifer September 21, 2016

    I am working on the practicum also and it is definitely a relief to hear that I’m not alone in my frustrations or that everyone else is just breezing through this without a care or a question. And being a perfectionist, I want to get everything right every time…but that’s not happening and I had to reevaluate my approach to each practicum question and the medical coding profession, otherwise I’d end my study time in tears and questioning my sobriety. Instead of focusing on the fact that I “missed” the question, coded it in error or just plain didn’t code it at all…I’ve really tried to focus on why I coded something wrong (which I do a LOT) and add it to my monsterous pile of notes so that the next time I’m sitting around scratching my head about a problem, I’ll go, “Now we had this in an earlier question…how was it done before?”  I still feel frustration but I also feel encouraged because every day I’m learning a little more, things are starting to make sense a little more, and I’m getting closer to finishing the coarse.  Keep up the good work everyone and someday, we will all be experienced, professional coders!!!

  17. Career Step September 21, 2016

    Hi Jennifer,
    Thank you for sharing your experience and giving encouragement to other hard working students! We wish you the very best of luck as you continue through your course!

  18. Shirl September 21, 2016

    This was me last week! I was so frustrated that I was in tears and just had to walk away for the weekend. Now I’m refreshed, but I’m still not getting all of the answers right on the first try…Many times I have the right codes, just the wrong order and so the portion of that code is still wrong…frustrating!

  19. Alyssa September 22, 2016

    So thankful for this blog! I’m so happy to hear that I am not alone with these fears and frustrations with the practicum.. I was beginning to feel EXTREMELY stupid, because I miss so many questions!  It terrifies me because I’m beginning to think that there’s no way I will be able to pass the final exam with the scores I’m getting on this practicum. It also scares me because I only have 40 days left and I only have 37% done on this module. It feels like I am going so slowly… I know I can purchase an extension but I really want to get done WITHOUT having to buy one. Sometimes I want to cry and give up, but I won’t because I’m almost there! Just have to push through everybody! We can do this!

  20. Career Step September 28, 2016

    Hi Shirl,
    Thanks for your comment and reaching out to us. Please know you are not alone as you are working through the course. We have many resources to help you be successful—please take a look at this link to learn about the support that is available to you.

    Hope this helps and best wishes!

  21. Career Step September 28, 2016

    Hi Alyssa,
    We are so glad the blog has been a help to you. Keep your chin up and continue to work hard—you will be finished before you know it! Please let us know how we can help in anyway at all. Take a look at this link that provides information the student services available to help you be successful in your course.

    Best wishes!

  22. Anneliese September 28, 2016

    Thank you so much for the encouragement!!I was frustrated but plugging along as I felt I was getting all kinds of exposure to codes and ways to observe a case. I can’t wait to be done and working in this career!

    Thank you Career Step and all instructors!!


  23. Kathryn October 02, 2016

    This gave me hope, I feel like it’s all in a different language! And I’m overwhelmed. So, I’m finding myself frustrated and almost dreading each example. Was feeling like an idiot! Thank you for THIS! I needed that encouragement. Took a much needed breath and can get back to it

  24. Vicki Roberts October 03, 2016

    I am not doing well with the Practicum.  It is very discouraging.  I am emailing pages and I wish the answers they gave were a bit more detailed.  Sometimes it seems on one question they want one thing and then on a similar question they don’t want a particular element.  A lot of it seems random.  Hoping to get thru this and be done with the whole thing.

  25. Career Step October 03, 2016

    Hi Anneliese,
    You are doing great! Keep up your dedication and positive attitude and please let us know if we can help you in anyway at all! Take a look at this link that provides information the student services available to help you be successful in your course.

    Best wishes!

  26. Career Step October 03, 2016

    Hi Kathryn,
    Please know you are certainly not alone! Keep pushing through and let us know how we can help! There are resources available and other students you can chat with about the course. Take a look at this link to learn more:

    Hope this helps and best wishes!

  27. Parastou October 05, 2016

    Thank you for giving those hints. It gave me more strength to go forward. And I feel better finding I am not alone in this.

  28. Career Step October 05, 2016

    Hi Parastou,
    You are sure welcome, we are so glad this post help you feel encouraged to keep going strong in the course. You are certainly not alone, take a look at this blog post highlights the wealth of resources available to help you succeed:

    We wish you the very best of luck as you continue on the road to a new career!

  29. Amy October 06, 2016

    Soooo glad to hear I’m not alone!  After relatively doing ok on most of the curriculum so far, this coding practicum makes me feel sooo stupid!  It’s almost like I haven’t learned anything up to this point!  Just when I think I’ve figured out the codes and I check my scores, it’s very frustrating when you get them wrong and you wonder HOW did you use those codes and why not the ones I found?  It is very discouraging to say the least!  I feel a little better now knowing I’m not going to be perfect on all of them but it is still frustrating to think you might have finally figured things out and this coding practicum is like a kick in the gut!!

  30. Sue October 06, 2016

    Wow, so glad you shared this blog. I was getting so frustrated with assigning wrong codes. It’s really really good to hear it’s a normal process. At least I do feel that I am learning from most of my mistakes. Feeling better smile

  31. Kim October 07, 2016

    I see myself as a perfectionists and when I do not get a concept within a few tries, I start questioning my abilities in learning what is needed. I have had many days that I just want to scream, and other days that I find what I am learning “a gift”, no matter how many I get wrong, being able to go back and look at the scenario with the correct answers and navigating through the code books has helped in many ways. I do wish that there was some kind of song or poem to put to the steps of coding, so we do not miss steps, kind of like reading music notes. “EGBEF- Every good boy eats fudge or FACE, which we learn in music classes”. Overall, I think that talking to a coding instructor will be my next step in defining what I am missing and to possibly give me pointers in being successful.

  32. Career Step October 10, 2016

    Hi Amy,
    Thanks for sharing your experience! It is obvious you are working hard—keep going and don’t give up! Please let us know how we can help in anyway! You can reach us at .(JavaScript must be enabled to view this email address) or 1-888-657-5752.

    Best wishes!

  33. Career Step October 10, 2016

    Hi Sue,
    That’s wonderful news—you have a great attitude! That certainly is what the coding practicum is all about, learning from your mistakes and improving.

    Best wishes!

  34. Career Step October 10, 2016

    Hi Kim,
    Thanks for reaching out to us and sharing your experience! We are always available to help you with anything you need to be successful in the course.  Please contact us at .(JavaScript must be enabled to view this email address) or 1-888-657-5752.

    Best wishes!

  35. Jaci October 17, 2016

    Great article. Thank you! There are some great tips in the article and in the comments. One thing that frustrates me, though, is that you say to contact coding support in order to understand, but I feel like I would be emailing and/or calling on almost every scenario. I really wish there were better explanations on the answer pages instead of having to rely on guessing/inferring or bugging the coding instructors several times a day.

  36. Tarra October 22, 2016

    Am I the only one using the 2015 edition books? I started the coding course in the middle of Nov. 2015 but didn’t get to the point of using the coding books until 2016. Because the books have updated I am missing a few codes and getting some questions wrong. Should I buy new books or are there other tools for the updated codes.

  37. Career Step October 25, 2016

    That’s great feedback, Jaci. Thank you! We’ve passed that along to our support team. In the meantime, don’t ever feel bad about contacting your instructors—that’s why they’re there. You should also check out the Student and Graduate Community ( There’s an Ask An Instructor feature that lets you connect with an instructor over chat. This could be a an easier way to get in touch with someone. smile

    Hope this helps!

  38. Randy Johnson October 26, 2016

    Hi Tarra,
    There are other students that are using the 2015 code books. We recommend purchasing the new code books. The 2017 ICD-10-CM and ICD-10-PCS code books are available. The 2017 CPT and HCPCS code books will be available in December.

    Hope this helps,
    Randy Johnson
    Career Step Instructor

  39. Eileen October 26, 2016

    I just received this blog link as I am over 1/3 done with the Practicum and I see my emotional rollercoaster in everyone’s comments.  Glad to see that this appears to be ‘normal’ for this part of the course.  I feel empowered when I get the majority of codes correct though often they are not in the correct order.  I try to keep positive and not get discouraged and this blog sure has helped and will continue to do so.  Thanks again.

  40. Darci November 05, 2016

    I’m not quite at the halfway point in the coding practium and have been experiencing the same frustrations a everyone else.

    I have been going back and re-doing each case until I get 100% But I also write down all the answers so that I can use this a “study tool” for later.

    I wish everyone the best of luck in a successful finish of the coding practicum.

  41. LJ November 05, 2016

    I have 32 days left and I’m determined to finish the practicum and pass the final on time… Thanks for the blog.. Took some pressure off!

  42. Career Step November 08, 2016

    Hi Darci!
    Thanks so much for passing on how you have found success in the coding practicum and we wish you the best of luck as you continue on through the second half of the practicum!

  43. Jackie December 01, 2016

    After getting an extension I now have about 40 days left but promised myself to get it done by Christmas due to wasting far too much time on frivolous distractions. I’ve found the sequencing of the codes to be the most frustrating part of the practicum like many others here. I compromised between my want to be perfect and an imperfect answer system; I give myself three trys to get to 85% or better. After that its on to the the next one. Yes, some of the correct answers baffle me to no end when my pick seemed to make more sense and a more thorough explanation would be much appreciated then (Checking O2 levels via the ear? What kind of crazy is this?! The other code made perfect sense! Ugh!). Knowing now the practicum scores don’t matter is a relief, but in the field every code matters so I’m keeping my system, no matter that it takes so much extra time. I hope others feel free to adopt my method if they feel stuck and overwhelmed. I wish I had from question #1 instead of #90. Best of luck to everyone and Happy Holidays too!

  44. Tanya McIntosh December 03, 2016

    I am almost on Introduction to Coding and cant wait

  45. Ghia December 06, 2016

    I thought I am the only one who is struggling in the practicum part of the course. I got a very few right answers, the easy ones but the long progress notes, it is frustrating. And sometimes the secondary codes, I will get a wrong answer if is submitted in the wrong order. Sometimes I am in the right category but my answer is still wrong because you have to be specific. I do get online help and use resources they offer and it helps me get the answers right (sometimes). So, I guess we just have to keep moving on and learn from our mistakes. Good luck everyone.

  46. Career Step December 08, 2016

    Hi Jackie,
    Thanks for sharing your ideas on studying! We wish the best of luck and a very happy holiday season!

  47. Career Step December 08, 2016

    Hi Ghia,
    Thanks for your comment—you certainly are not alone. You do have a great attitude, keep up the great work and continue to use the available resources.

    Best wishes!

  48. Georgette Laliberte December 11, 2016

    It is such a relief to see all of these comments. I have been so frustrated. I did grrat on the modukes and now no matter what i do i get half the codes wrong..or they are in the wrong order or i get a super short report and have to find 8diagnosis codes in it when there isnt one clear diagnosis qt all. Ive been pulling my hair out. I just went back to the practicum today after stepping away from the laptop for a couple days to recharge my brain. I am enrolled through i need to email someone to find out what my requirement is for each page of this practicum. Because if i can do a problem once grad eit and move to the next and not have ro go back and do esch one over until i get above an 85 and research my notes and books to see how i meeaed up every single problem i will breeze through the rest of my practucum. Ive got about 40 some odd days left and im only at problem 104 of the practicum. Thank you for this blog!

  49. Career Step December 14, 2016

    Hi Georgette,
    Thanks for sharing your story with us. As you can tell from the previous comments,many others share your frustration. Keep your chin up and working hard, remember to reach out to us if we can help in anyway!

    Best wishes!

  50. Terri R. December 19, 2016

    Thank God I’m not the only one with all the frustration with the practicum. I just wish all the other modules would have had the explanation of the correct answer like this does so you knew why you got it wrong. I am almost halfway through and just hope when it comes time for the exam I can pass it with no problem but I am worried because I rarely get the codes in the right order. Ugh !!  Merry Christmas Everyone and Good Luck to All of You with the Practicum and the Exam. smile

  51. Shanna December 29, 2016

    Thank you so much for this! I too have been feeling very frustrated with the practicum. I did so well on everything up this point and now I’m feeling like I have may have wasted my time with this course because Im getting so many answers wrong (mostly sequencing). I only have 39 days before I have to get an extension, so I have been stressing hard over time and trying to get through this practicum!

  52. Dottie SIMMONS January 07, 2017

    Thank you for the blog connection. It really helped to boost my confidence and to give me that much needed push to keep going. Knowing that I am not alone in my frustrations doesn’t completely eliminate the frustrating feelings, but I handle them better! I can really relate to blogger who said it seems as if my codes are so close but there is always one code more specific. Such a learning experience…and I have no intentions of giving up..thanks everyone for your comments

  53. Melissa January 16, 2017

    Frustrated is an understatement.  I really don’t feel like I can pass the exam. Do they give partial credit?

  54. BH January 17, 2017

    Thank you so much for sending me the link to this blog today. I was working on the Practicum Part the whole last weekend (incl.the Holiday on Monday) and I was so frustrated. I was ready to quit and to “burn all my books”. I work full-time and I just can’t concentrate after work so studying on the weekends is my only option. After doing some “math” yesterday I realized that I need to study at least 10 hours each weekend to finish my class on time. It added even more to my frustration. Today after reading your blog I feel encouraged and I hope that I can finish it on time since I don’t have to “pass” all the practice questions. It will help me to move a lot of faster. Sometimes I was spending almost an hour on one question and I still didn’t have it right (50% or higher).
    Here is my question: Is there any time limit to take the final exam? How many days before the program expires? Thank you again for this awesome and encouraging blog.

  55. CodingSupport January 17, 2017

    Correct, only an attempt at each page is required for your program. An attempt is achieving a score higher than 0%. 
    To take the final you do have to be a current student.  Two days (48 hours)are given to take the final, so you can’t start the final on your last day in the program.  Please give us a 2 business day notice to schedule the final.

  56. CodingSupport January 19, 2017

    Hi Melissa,
    If you need assistance, please contact student support at 1-800-411-7073 or .(JavaScript must be enabled to view this email address). We are here to give you one-on-one help.  There are three attempts given to pass the final.  Let’s talk so we can get you the information you need to be successful.

    Best wishes!

  57. Tamra January 27, 2017

    Oh thank GOD I saw this post!  I am in the middle of my practicum and I’m dying!  I feel more lost than I have ever been.  I thought I knew what I was doing but had to get help from one of the instructors. It was a tremendous help, but it is always reassuring that I am not the only one struggling.

  58. Career Step January 30, 2017

    Hi Tamra-
    Thank you for your comment—it helps to know you are not alone in your frustration! Remember we are here to support you as you go through your course. You can contact us at .(JavaScript must be enabled to view this email address) or 1-800-411-7073 and you may want to check out the forums and chats as well for additional help!

    Good luck with your studies and remember: You’ve got this!!!

  59. Shiloh Sheree January 31, 2017

    Before I started the practicum, I felt much more confident in my coding abilities…now I’m questioning whether I should even be doing this.
    I’m going to just work through it, and hope for the best…

  60. Dottie SIMMONS January 31, 2017

    Hey doing okay in practicum practice. However just can’t get what order or how to categorize diagnosis, when you are listing several. Any tips. I remember reading “the how to” but can’t seem to get it. Thanks

  61. Bonnie February 01, 2017

    I too am REALLY struggling. Feeling stupid and burned out. Hopefully things will get better as I just feel like crying right now.

  62. Susie February 01, 2017

    I was also at my wits end. I was getting so frustrated that I think I was going to have to take something for my nerves. I do feel better knowing I am not alone does kind of put my mind at ease, but I have to finish everything in about 50 days. I feel that I can do it now that I know that this is somewhat normal. My brain is fried and smoking. Thanks for the help.

  63. CodingSupport February 01, 2017

    Hi Dottie,
    That’s an excellent question! Guidelines can assist when sequencing diagnosis codes. If there are not any rules that apply, in the real world you can list those secondary diagnosis codes however you like!  In the practicum the secondary diagnosis codes are sequenced in ascending alphanumerical order (unless a guideline specifies it should be listed in another arrangement).  Check out page 5 in the practicum for some examples of sequencing codes.

    Hope this helps and best wishes!

  64. Osler Rivas February 13, 2017

    The support team of medical coding are perfect. They don’t seem to be irritated with my questions. You are always there to help us when we don’t know the answers regardless of how much we tried in one scenario. But in real life, when I am already working for a doctor or a clinic, whom can I call when I am alone in the coding team? It is a scary thought especially if you consider that the income of the doctor or the clinic solely depends on your ability to code accurately.

  65. Career Step February 15, 2017

    Hi Osler,

    That is an excellent question. Career Step graduates have 12 months of graduate support. This support does not include extensive certification exam preparation or coding advice for provider specific medical records, but grads can call and ask general questions of the coding team. Career Step grads also retain access to the student forum that allows them to reach out to other coders and grads.

    Employers will have resources or a process to follow for coders with questions. These resources may include mentoring by more experienced coders, corporate coding hotlines or coding advisors that work for an encoder vendor such as 3M. Coders can also access resources available from AAPC and AHIMA, such as coding forums and local chapter/state associate meetings.

    Ultimately, there are lots of options for help and lots of support for new coders.

    I hope that helps!

  66. Maryalice Russo February 15, 2017

    I glad I got the email re this. This was encouraging, as I was frustrated with my progress. I have also figured out it is time to pull out all the books again and review different section of the handbook,  to go back and read guidelines.
    What I find most frustrating is I may get the codes correct but the sequence wrong, to maybe missed one secondary code.  I will just keep plugging along!

  67. Priscilla February 15, 2017

    It seems like I have been working on this practicum FOREVER. I’m frustrated because it seems as though the rules keep changing. I pray that I will get through this and actually pass and be able to get a job.  I have invested a lot of time and money (as I’m sure many have) and I am very concerned. I thought I was doing well until I got to the practicum. I wish there were more online interaction for students.

  68. Beata February 15, 2017

    I am a little bit confused with the coding practicum. You said we just have to attempt each scenario. What if our score is 0%? Is it still ok or should we go for more than that? Thank you.

  69. CodingSupport February 16, 2017

    CareerStep requires an attempt (a score higher than 0%) on each practicum report.  Some schools have their own requirements. If you enrolled through a college or university, please check there for specific requirements.

  70. Marie February 16, 2017

    I’m working so hard it’s seems endless I feel frustrated want to give up but I feel if I give up I’m giving up on my mother in law who is fighting cancer she has been encouraging but sometimes I figure the codes out it nothing close. I need to be finished before Feb 23 so I can take the finals. It seems so hopeless. My job is already stressful working with special needs seizure babies. Getting home after to code is a nightmare. I’ll try my best to hang in there but it seems

  71. Michele February 16, 2017

    I agree with the sequencing issue and feel the same way about the time spent. Will it amount to something?  I keep plugging away as well.  Sometimes I find myself trying to code too much b/c it seems in some reports there are history codes and others that seem very similar the history is not coded.

  72. Jackie February 17, 2017

    Thanks for this email!!  I feel like I might survive this. I too was getting the right codes but getting wrong because they were in the wrong order. Now that I know to sequence alphanumerical unless a guideline. Very refreshing to know I’m not the only one very frustrated and I can stop asking myself am I really this dumb.

  73. Marie February 17, 2017

    So frustrated I need to complete by Feb 23, it seems hopeless and they emailed me to say I’m doing a nice job. I’m no where close.

  74. CodingSupport February 17, 2017

    Hi Michele,
    Time spent can used to develop your skills further.  History codes are typically only coded when the condition impacts or influences the current management/treatment of the patient. see section III in the guidelines for more information.

  75. CodingSupport February 17, 2017

    Hi Marie, you are welcome to contact student support for assistance with finishing your training program.  Sounds like you have a lot going on right now and are tight on time. We do have extensions available if you find more time is needed to complete. Best of luck!

  76. CodingSupport February 20, 2017

    Hi Jackie,
    You can do it! There are many details, rules and guidelines to coding. It usually takes quite a bit of practice to master, feel free to ask questions when needed smile

  77. Brenda February 20, 2017

    Working on the practicum Is very frustrating to say the least. With 70 something pages to go and time running out. I don’t feel I will be able to complete this. It would be one thing if I was an experienced coder and was trying to complete these overwhelming scenarios. When I’ve searched and searched the code books and think I’ve come up with a solution and it is wrong again. Very frustrated coder want to be.

  78. EllenLake February 21, 2017

    I am very glad to have received this email this week.  I like others who have posted have been feeling frustrated at how slow I am going.  I know I am close yet so far away from being done.  Thank you for the encouraging words they are helpful.

  79. CodingSupport February 22, 2017

    Hi Ellen,
    Sounds like you agree with this article, the practicum can be frustrating.  Hopefully these tips help.  Good luck to you smile

  80. Scarlett March 02, 2017

    Thanks so much for sharing this with us…I was honestly ready to give up yesterday because I felt like I couldn’t get anything right. If I got the codes right they were in the wrong order…at least I know now that this is normal…it gives me hope!

  81. Jole March 03, 2017

    I have never felt so stupid as I have these last 2 week in the Practicum Module.  Sometimes I read too much into the Med Record, then the next one I do not enough.  ARRRGH!  I feel like I’m never going to get this right.

  82. CodingSupport March 06, 2017

    Hi Scarlet,
    Yes, the practicum is challenging! As you work through each report keep in mind each report is unique.  It is east to take what you learned from one report and try to apply the same concepts to another report, However, as each report is unique this rationale often does not work.  As you practice your skills are being developed and you will become better at identifying what to code. 

    Best wishes!

  83. Career Step March 07, 2017

    Hi Scarlett,
    Thank you for your comment! Keep up the good work. If you run into problems, don’t hesitate to contact your coding instructors at 1-888-657-5752 or .(JavaScript must be enabled to view this email address).

    Best wishes

  84. Career Step March 07, 2017

    Hi Brenda,
    We are so sorry to hear about your frustration. Please don’t hesitate to contact your coding instructors for support and help at 1-888-657-5752 or .(JavaScript must be enabled to view this email address).

    Best wishes

  85. Career Step March 07, 2017

    Hi Jole,
    Please don’t feel that way, many students really struggle with this portion of the course. As you read through the comments on this blog post you will see that it is difficult for many people. Remember, there are options for support. Please don’t hesitate to contact your coding instructors for help at 1-888-657-5752 or .(JavaScript must be enabled to view this email address).

    Best wishes!

  86. Analyn Santiago March 14, 2017

    Thank you CS for sending me this blog after reading all the comments i feel relieved a little bit.. felt like going crazy in this practicum still not getting all the codes right or not in order…  but im hoping i can push it through before its expired…

  87. Mari Ellen Brown March 15, 2017

    Today I got an email from Careerstep simply acknowledging my progress (almost to midpoint in practicum) and letting me know frustration is normal, with a link to this blog.                  It made my day! Everyone - we can DO this!!
    Just knowing I am “normal” is a comfort.The Practicum is certainly a ...“challenge”
    Thank you Careerstep! Makes a big difference.

  88. Career Step March 15, 2017

    Hi Analyn,
    We are so glad this post has helped you find a little relief. Remember we are here to give you the support you need to be successful.Please don’t hesitate to contact your coding instructors at 1-888-657-5752 or .(JavaScript must be enabled to view this email address).

    Best of luck!

  89. Career Step March 15, 2017

    Hi Mari Ellen,
    Thank you so much for your kind words and feedback! You are absolutely right, you (and all of our other amazing students) can do this! Thank you for your encouragement and positive attitude.

    Best of luck!

  90. Faith Muchirahondo March 17, 2017

    Thanks for the email. Coding practicum is killing me, l feel like l haven’t learned anything from the time l started. These scenarios are frustrating me and l can’t concentrate. I feel drained and lost.

  91. Career Step March 20, 2017

    Hi Faith,
    Keep your chin up! Be sure to reach out to your instructors at .(JavaScript must be enabled to view this email address) or 1-888-657-5752 if you feel you any help or even just a little encouragement. That’s why we’re here! You may also want to connect with other students and graduates in the Student and Graduate Community. You can sign up with your Student ID (if you can’t find that, just shoot us a quick email at .(JavaScript must be enabled to view this email address) 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. smile

    We wish you the very best of luck!

  92. Becky March 20, 2017

    What grade do you need to get on the final exam, so that you can complete the course and schedule the CPC exam?

  93. Instructor March 21, 2017


    For your final exam through Career Step, you will need to score 75% or higher. For the national certification, you will need to score 70% or higher.

    Good luck with your studies!

  94. Josephine March 21, 2017

    Thanks for the Email leading me here. now I know I am not the only one frustrated with the practicum. I feel like I have not learnt anything. still pushing on

  95. becca March 22, 2017

    can anyone help. im stuck on pg 232 and i feel im not getting anywhere:(

  96. CodingSupport March 22, 2017

    Hi Becca,
    Page 232 is a guided exercise. The instructions are provided on the page. You are welcome to contact coding support for assistance. The encoder is a very detailed process, it is hard to provide step by step instructions in this small blog post Feel free to reach out to us with your specific questions at 1-888-657-5752 option1, then option 2.  We are open Monday through Friday 9-7 eastern time. Our e-mail is .(JavaScript must be enabled to view this email address) Thank you.

  97. Career Step March 23, 2017

    Hi Josephine,
    So sorry to hear about your frustration. Feel free to Contact your instructors at .(JavaScript must be enabled to view this email address) or 1-888-657-5752 if you feel you any help or even just a little encouragement. They are here to help. In addition it can be very helpful to connect with other students and graduates in the Student and Graduate Community. You can sign up with your Student ID (if you can’t find that, just shoot us a quick email at .(JavaScript must be enabled to view this email address) and we’d be happy to look it up for you) at

    Hope this helps and best of luck with your studies!

  98. Margaret March 25, 2017

    I think frustrated is an understatement. I am very much relieved to see that what I am feeling is normal.  Is the final test a one-time test or can it be taken as many times as necessary?  Thank you for sending me this link at this time. It definitely brought my blood pressure down.

  99. CodingSupport March 27, 2017

    Hi Magaret,
    Glad you found this blog article!  Three attempts are given to pass the final and a 75% or higher is needed to pass the final. Keep in mind it is an open book test smile

    Best of luck!

  100. Carol March 29, 2017

    Oh my gosh! Thank you, thank you, thank you!
    These comments are exactly how I feel! I just told my husband it’s like I have forgotten everything I’ve learned! To know I am not alone and that so many have encountered the same thoughts and feelings makes me feel so much better! Thank you all for stating your frustrations and for your honesty. We got this! We are almost there!
    I will save this email and re read it when I need to remember I am not alone! smile



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