What Is the BHAT® Method?

BHAT® (pronounced ‘bat’) stands for “Bubble, Highlight and Annotate Technique“. This is a proprietary system, which is used in connection with our educational services, created by Laureen Jandroep in 1999 that uses bubbling, highlighting and annotation techniques to help students quickly find key answers in their manuals during the open book CPC® exams.

Instead of flipping back and forth between pages where the guidelines are, the answers are right next to the codes when a student takes the board exam. Students have stated the BHAT® system gave them the confidence they needed to pass the exam. Another plus: the BHAT® system helps coders in their day to day coding work after the exam as well!

Until 2016, the technique was formerly referred to as “Bubble and Highlighting” or “Bubbling and Highlighting” by thousands of medical coders in the industry. Going forward, CCO will refer to this as the BHAT® system or BHAT® method.

I first heard about BHAT® July of 2019, from a friend who used it, when I was searching for extra material to study for the CPC® exam. I am SO grateful to say that it was the key to me passing the exam the first time just 2 months later with 88%!! I believe that the BHAT® method helped to select the accurate codes faster and give me confidence that I was in the right place.

– Althea Frimpong, CCO Student

YouTube video

The BHAT® Method FAQs

Where can I officially learn the BHAT® system?

The BHAT® system is explained inside the BHAT® Cave and since November 21, 2017 the BHAT® Cave is now included with all full Courses and Review Blitzes. It can also be found inside the CCO Club. Once access expires to Courses or Review Blitzes, continued access can be purchased by joining the CCO Club

Are there any free places to learn about BHAT®?

We have some videos that explain the logic behind the BHAT® method on YouTube. If you want the exact, step-by-step explanations for marking up your CPT Manual and ICD-10-CM Guidelines, you’ll need to purchase a full Course, Review Blitz or join the CCO Club.

Is the BHAT® system worth doing?

The BHAT® system is  absolutely worth doing! – just read the testimonials below.  It does take a good 20 hours plus per manual but it saves you so much time on certification exams and real world coding and it helps eliminate wrong code choices and puts guidelines in a very visual spot.

Do I need to use the BHAT® system in every section?

Regarding needing to do it to every section – Laureen uses the illustration of her complaining that flossing her teeth took too long and asked her dentist if she had to floss every tooth and he said “No – only the ones you want to keep”.  So if you’ll be taking a certification exam soon do you want to be one of the students that doesn’t pass because one question didn’t have the BHAT® system applied to it?

Can someone else mark up my manuals with the BHAT® system?

We have found that a lot of learning occurs in doing the bubbles, highlighting, and annotating.  It is great for light studying – you can do it while listening to music, the news or on one of the CCO webinars

Are BHAT® Videos Still Available?

From 2018 through 2023 we utilized embedded PDF documents that could be viewed on any computer, smartphone, tablet or device. We’re happy to announce starting that in 2024, we’ve moved back to our video format with instructor teaching included inside the BHAT® Cave.

Can I Save or Download the BHAT® Method Documents?

In order to protect our intellectual copyright and prevent unauthorized sharing and distribution, saving or printing the BHAT® documents is not allowed under any circumstances. However, please keep in mind the contents can be easily viewed on computers, smartphones and tablets that are connected to the internet.

Where Can I Learn More About CCO, the Creators of the BHAT® Method?

Since 1999, we’ve been proudly training thousands of students to help them pass their certification exams. If you feel the need to see examples of our teaching style, please visit our YouTube channel with hundreds of videos and over 2 million views. If you would like to read past student reviews on our products, you’re welcome to read through hundreds of testimonials.

The BHAT® Method’s History


The BHAT® System is Invented. In 1999, Laureen Jandroep created the Bubble and Highlighting Technique to help medical coders mark up their medical coding manuals.


. In 2012, Laureen posted a video to YouTube explaining the BHAT® System (formerly called the Bubble and Highlighting Technique). Click here to watch the original video.


The BHAT® Technique expands to ICD-10 Manuals. Chandra saw the potential in BHAT® and applied it to ICD-10 manuals to make medical coding easier.


In order to capture the full meaning of our proprietary system and protect our copyright, “Bubble and Highlighting” is now referred to as BHAT® which stands for “Bubble, Highlight and Annotate Technique” and a trademark is applied for.


In August of 2016, CCO interviewed Barbara Chiappini, CPC, CCS. She was one of Laureen’s first students and she proudly shows off her old 2000 CPT Manual complete with the BHAT® system inside. Watch the interview here.


In Febuary 2017, Chandra Stephenson utilized the BHAT® System to bubble, highlight and annotate the Errata for the 2017 CPT® and ICD-10-CM manuals. You can find digital copies inside the CCO Club’s Replay area.


On January 1st 2018, CCO replaces their video format with a new PDF format to help speed future updates and prevent copyright issues regarding the AMA’s CPT® Manual. The ICD-10 Manual is no longer supported since manuals arrive sufficiently annotated by the publisher.


On September 25, 2018, the United States Patent and Trademark Office officially registered our service mark for BHAT® which stands for “Bubble, Highlight and Annotate Technique”.


BHAT® is Celebrating it’s 20 Year Anniversary! Since 1999, Laureen Jandroep has been helping students learn the Bubble, Highlight, Annotate Technique (BHAT®).

The BHAT® Method’s Stories

Unsolicited Review from BHAT® Student
Unsolicited Facebook Review from BHAT® Student

I was in Laureen’s first coding class in Spring of 2000. We had classes at the Smithfield Inn Hotel and Resort in the evenings. It was a small class and we really had a great time.
It was here that Laureen taught us how to highlight, bubble and take notes in our CPT to make it easy to find codes. I was the student who had to make sure all my lines were ruler straight and highlighting was color coded. Notes had to be just right. We all had good laughs at my perfectionism.
The important thing was this bubbling and highlighting method Laureen developed was a rather ingenious process that not only made it more effective to pass our coding exam but made it easier to become an efficient coder in the real world.
Until my work took me out of the day to day coding, the bubbling and highlighting method I learned from Laureen was something I continued to reproduce every year when I received my new CPT manual.
On the job my CPT garnered a lot of attention with the coders who themselves found the lines, highlighting, markup and notes super helpful. Many asked me how to teach it to them and I was happy to do so.
Ironically, when Laureen’s company started growing and she needed more help, I became one of her first hired instructors teaching the very same class and same BHAT® method I learned from her.
Over the years Laureen has taught this same method to thousands of other students but I always smile fondly knowing I was one of the first to learn it.

– Tara Conklin

I tried BHAT® for the first time and I am proud to say that it helped me to pass the CPC exam after many unsuccessful tries! It is all about prepping, getting ready and preparing for the exam. BHAT® is a powerful weapon that helps you to save time and cut your test taking time from 90 minutes up to 2 hours. You will not regret it once you try it!

– Angie S, Learned about BHAT® in 2016 on Social Media

I do use the BHAT® method in my coding books. Every year I take the time to bubble, highlight and add notes next to the codes in my new books. Other coders have commented on all the notes and markings in my books. It is well worth the time, as it saves me time every day in my coding job and increases my productivity and accuracy. Thanks Laureen!

– Judy Green, Learned about BHAT® in 2013 on YouTube

I was looking for a way to pass the exam after not passing it twice. I found Lauren and decided to follow her method of BHAT®. I know with being ADD that I would never have passed without it.

– Lisa, Learned about BHAT® in 2013

I think the most important purchase I have ever decided to make was buying the Blitz videos and learning the BHAT® method. It will help me on my exam as well as every day coding at my current employers.

– Summer Hale, Learned about BHAT® in 2016 with CPC Review Blitz

I heard about this through a class taught by Laureen in Las Vegas at an AMBA Conference. I think I had heard about it earlier, but never got to hear the whole story before. I used this technique to pass the CPC exam in 2010. It took me about 3 months to do my book and it was very worth the time and effort. For me, I think it was THE factor that helped me pass the exam on the first try.

– Cyndee Weston, Learned about BHAT® in 2004 from Laureen’s Class

OMG!!!! It saves some much time taking the exam finding the information you need. If it were not from BHAT®. I would had never ever passed. Now when I look at my CPT book you can find information faster.

– Anna Burnham, Learned about BHAT® in 2011 on CCO Webinar

I took the Christiana Care Health sponsored CPC coding course in Newark, Delaware. It was such a comprehensive course and I was so confident when I sat to take my test. I worked very hard studying and using BHAT in the coding manuals but it paid off – I finished the test with plenty of time to spare and passed the first time. I know that Laureen’s method of teaching is the very best that I could have even taken and I still find the teaching methods of CCO to be very effective for me. I took Alicia’s ICD-10 Blitz and passed the ICD-10 exam the first time also. I highly recommend CCO courses for anyone that wants to begin in the coding field or to further their education in coding.

– Dawn Wilson, Learned about BHAT® in 2004 from Laureen’s Class

I first stared bubbling and highlighting in 2012. Immediately I knew this was the best path for me (and you)! The organization has only gotten better with time. The growth has produced many new coders. The business is growing but Laureen”s desire to share this incredible method with people is still the foundation…. same as in 2012.
For anyone who thinks the fees are high then check out other places like the AAPC. It is easy to know that the bottom line plays a lot into their business decisions….it certainly does not cater to students. Please do not get me wrong, the AAPC is a wonderful organization. However it does not work like the blitz!

– Tammy, Learned about BHAT® in 2012

I became disabled and quickly had to change my career. I’ve worked in various aspects of medicine for over 40 years. Coding seemed a logical application for my experience, especially with the big changes occurring in ICD. I studied and studied but still felt unprepared until I stumbled on Laureen’s BHAT® system on line. I immediately started applying her system to my CPT and ICD manuals and gained confidence.
I passed my certification on my first attempt with her assistance!!!

– Pamela Kornitsky, Learned about BHAT® in 2016

I first heard about the BHAT in 2013 when looking for study resources to help me study for the CPC exam. I had taken the CPC for the first time and didn’t pass. I was disappointed and looking for additional resources to help me study. I watched all the Blitz videos online and used the concept to mark my CPT book. After taking the exam again in 2014 I passed my CPC exam with less stress and time to spare.
I am currently taking one of the courses available at CCO and I love this technique for my coursework. Also, I work as a remote medical coder in a high production roll , and marking my books helps with my daily coding job. I plan to continue to use the BHAT® method every year it has truly made a difference in my coding career.

– Sandra Shong, Learned about BHAT® in 2013