BCHHC Certification Roadmap

Phase 1 — Foundation (Weeks 1–2)

•ICD-10-CM code structure and conventions

•NEC vs NOS, Excludes1 vs Excludes2

•Combination codes (HTN, DM)

•Placeholder X and 7th character rules

Phase 2 — Home Health Specific (Weeks 3–4)

•Medicare home health coverage criteria

•OASIS types, timing, who completes

•PDGM: 5 factors and 12 clinical groups

•Primary diagnosis selection rules

•Homebound documentation requirements

Phase 3 — Complex Coding (Weeks 5–6)

•Wound coding (L89, L97, T81) and 7th characters

•CVA sequela coding (I69.3xx series)

•HTN combination codes (I11, I12, I13)

•Diabetes complication codes and Z79.4

•Infection coding with A/B organism codes

Phase 4 — Exam Prep (Weeks 7–8)

•Timed practice case studies

•Mock BCHHC-style exam questions

•Review error patterns and weak areas

•Form 485 and plan of care compliance

Recommended Study Resources

•CMS ICD-10-CM Official Guidelines (free at CMS.gov)

•CMS PDGM Final Rule and PDGM fact sheets

•OASIS Data Specifications (current version)

•AAPC Home Health Coder study materials

•SynfraCore BCHHC mock exams and coding scenarios

8-Week Study Plan

Weeks 1-2: ICD-10-CM Foundation

•Code structure: 3-7 characters, decimal after 3rd

•NEC vs NOS distinction

•Excludes1 vs Excludes2

•Placeholder X and 7th character rules

•Combination codes: HTN (I11/I12/I13), DM complications

Weeks 3-4: OASIS and Home Health Coverage

•Four Medicare coverage criteria: homebound, skilled service, physician care, reasonable/necessary

•OASIS types: SOC, ROC, REC, SCIC, DC — timing for each

•Who can complete OASIS: SN, PT, SLP (not OT independently)

•Primary diagnosis selection rules for home health and PDGM

•Plan of Care (Form 485) requirements

Weeks 5-6: PDGM Deep Dive

•Five classification factors: timing, admission source, clinical group, functional level, comorbidity

•12 clinical groups — which primary diagnoses map to each

•LUPA thresholds per clinical group

•Homebound documentation: specific language that supports vs. generic that doesn't

Weeks 7-8: Complex Scenarios and Mock Exams

•CVA sequela: I69.3xx series, never acute stroke codes in home health

•Wound coding: L89 vs L97 vs T81, 7th character A/D/S selection

•Full complex patient coding (CHF + CKD + DM + anemia + insulin)

•Timed practice exams under exam conditions