r/MedicalCoding

I’m so happy I passed on my first attempt! I used the e-books at a testing center. I bought all the practice exams and passed 5 out of 6. I was so nervous because I was averaging 70-78% on the practice exams. I was so surprise to get 84%! In my opinion, the questions in the practice exams are slightly harder but they are pretty identical. I’m so relieved and I can finally sleep well tonight lol! Good luck to anyone who’ll be taking the exam!

hi guys! i graduated from my medical coding program last month and i've been studying for the ccs with ahima's 16th edition prep book. just wanted to know if it was a good tool to use/if the questions on the exam are similar as i'm extremelyyy nervous about taking this test and overthinking EVERYTHING lol. thanks in advance!!

Been reading about autonomous medical coding lately and wanted some real opinions from people who deal with it.

Quick bit of context on how it got here. Coding used to be fully manual, someone reading physician notes and assigning the codes by hand. Then came computer-assisted coding, where the software suggests codes and a human signs off. Autonomous is the next step, where the AI reads the documentation, assigns the codes, and processes the straightforward encounters on its own. Anything complex or low-confidence still gets routed to a human.

It works well for high-volume, low-complexity stuff. Faster turnaround, better consistency, less admin load. Where it still struggles is messy inpatient cases, ambiguous notes, and compliance-sensitive calls that need actual clinical judgment.

So honestly it doesn't feel like replacement to me. Most places seem to be going hybrid, letting AI handle the routine encounters while humans focus on audits, compliance, and the hard cases. The job just shifts more toward oversight.

The part I think people underestimate (I build healthcare software, so that's my bias) is the audit side. Auto-assigning a code is the easy bit. Proving why it was assigned, and logging it in a way that holds up in an audit, is where it gets hard.

Anyone seeing this in production, is the hybrid model actually holding up, or is autonomous creeping into more complex cases than you expected?

Long story short, I believe I have been over billed for a surgery. Requested the operative notes and they are totally barebones and don’t seem to support the code billed, in my layman’s and biased opinion.

That said, I’m slightly concerned they may find a way to up charge me further if I request a formal review.

Are there any resources out there to request an independent coding review for a professional opinion before I ask the surgery center to formally review?

Thanks, and apologies in advance if this is the wrong forum.

ETA:

Didn’t think this would get so much traction - appreciate the input. Pasting the full op note below; I thought 26115 meant they were going down under the skin vs cutting at skin level.

Also - just with the provider, no insurance involvement.

“Patient… with signs and symptoms of a left index finger mass which appeared to be a large pyogenic granuloma. Today under sterile conditions, left upper extremity was prepped and draped in usual sterile

fashion. At that point an incision made at the base of the mass and the stalk and the mass was excised. It appeared to be a pyogenic granuloma. The small 3mm origin was then treated with multiple silver nitrate sticks until it was well cauterized. The mass was sent to pathology and a dry sterile dressing was applied.“

The provider I work for is wanting to use B20 for a new patient who has HIV and came about a new rash that appeared. The provider sent out a referral and did lab work and prescribed a cream. No other prior illness or conditions were discussed. She told me she "thinks" that the rash is due to his condition. I am wanting to use Z21 since it is still not confirmed and she said she "thinks" . Please any more information would help. Online resources are basically saying the same thing over and over again. Also if Z21 should be used can someone please help me out on how I should respond to her to change it ? She is one of those providers that fights tooth and nail about changing a code. Thank you in advance everyone.

I've been a medical coder for nearly 4 years, and I have an extensive medical background + bachelors in public health, so I didn't have a whole lot of issues with the diagnoses/medical terminology.

My wife is sick of her job and wants to do something where she can work from home, have flexible hours, and have weekends off - so basically my current job. She's seriously thinking about getting a coding certification, which is great, except she doesn't really have any medical background at all. She's been a retail manager for about 15 years and has a bachelors in history.

For anyone who got their coding certification WITHOUT a prior medical background, was it incredibly difficult to understand the material? I know AAPC does offer medical terminology/anatomy courses, which I didn't take because of my background, but I'm wondering if she should try those first.

See I will be completing my CPC certification exam from India and can I get a job in Germany and how tough it will be to be placed as a medical coder ?

Well, job security for today anyway. I'm in a chart with computer aided coding. Statement says chest pain with radiation to the shoulder. CAC coded admit for antineoplastic radiation. Same chart, op note says cardiac cath indicated appropriate for treatment but patient declined, so of course CAC coded a cardiac cath. You would think after all these years CAC would be better.

I've debated making this post for a good while now, I just now have worked up the anxious courage to do so. I was assaulted by a coworker back in February of this year. I already had qualms with this job prior and was already trying to find a way out before that happened. While I'm out on work comp, I'm doing the Preppy course on Medical Billing and Coding and picking up books here and there when I can afford them that Contempo Coding recommends in her video. I have severe anxiety and depression behind this situation along with some other trauma as one may imagine. Some days, it latches on and I have trouble focusing when I try to study. Others, I can't manage to get out of bed to study at all. Or do much of anything for that matter. But I'm trying to at least get this certification before I potentially have to return to that place.

Between bills and my checks getting paused due to poor communication on the adjuster's end, I'm concerned I may not be able to continue paying for Preppy. Or even getting other self-study books. And also, I'm notoriously a bit of a perfectionist when it comes to learning new things, as illogical as I know it may be. I can't help it, I'm just wired that way. It's a strength and a weakness. This field I'm trying to move out of isn't of medical origin either, so I started from basics. But the issue is I've been studying for a few months now as I can and I'm still stuck in early foundational stuff about Anatomy and Physiology. It isn't that I'm not grasping it per se, but I don't have that perfectionist's 90 or above grasp on it and I'm concerned I perhaps may be struggling to retain vital information about A&P that would aid me in future study and my career. I don't want to unnecessarily struggle or handicap myself in this field; I want to do well. I have to do well because right now it's the best hope I have.

Can anyone tell me tips on how to study and retain while fighting anxiety and depression? How long should I be spending on various sections of this educational process to ensure I'm adequately prepared for the CPC Exam? I don't have money to just keep tossing at the exam, so my aim is to get it right the first time. Overall, I'm here for advice and tips. I read a post or three here everyday, but anxiety will take everything you learn or think you're learning, every detail whether its important or not and make it all a massive deal. Then depression will come in and auto-delete everything whie you're too tired to even think about it.

I'm not asking for a miracle, and I'm not coming at this expecting it to change my life over night. This is something I'm aware takes some time, patience, and a considerable amount of effort and competence to do. I just need some support and advice from people who are seasoned or are in similar boats as I am. Any good advice is appreciated more than you know.

New job? Pass your exam? Want to talk about work or just chat with another coder? Post it here!

I’m in the Phoenix az area. I am currently half way through my cpc course. Of course I am looking at jobs everyday. I am seeing SO MANY AI training jobs pop up and it is honestly freaking me out. These companies are seeking skilled coders to help train their AI.

What are your thoughts? I am hoping coders in the area aren’t doing it. I’m very nervous that all the entry level jobs will be completely gone soon and then it will get smarter and smarter to the point medical coders will not be needed or only a few will be needed. Which isn’t good.

It’s hard to not worry as someone getting into the field. Any insight from experienced coders would be helpful.

I'm 27F and I work for a major health group based in NY. I currently make 26/hr as an AR specialist. Prior to the merger, I was in medical billing and worked with Workers Comp and No Fault. I loved it! Since the Merge, I was dumped into AR with Insurances and HATE IT. I can't understand the denial or the unnecessary appeals that are pushed from the managers knowing that certain codes will not be paid, especially when it's explicitly written in these insurance guidelines. Anyway, the point of my post is, for any medical billers/coders, have you found being certified actually worth it? Or was the majority of what you learned and taught on your own in training?

The plus side to my company is that if I go to a vocational school that offers the program, the company will reimburse 80% of it once completed and passed. Recently I was speaking to an assistant director from a different company who also works in medical billing and stated that the program is useless because guidelines are changing every year. (Totally aware of that too). I personally think that I make okay money for someone who doesn't have their associates... a work in progress after all these years to say the least... Lives on their own on Long Island and work remote. I want to learn more and earn more of course. It took. me 5 years to get to this position and I think i've done a good job so far moving my way up the ladder.

I can't look at too much of the option of changing companies because maybe in many eyes, my pay is mid, but I work from home, have good health insurance, pretty good PTO and weekends off. I feel like that's an even trade off if I may say so myself.

Any feedback is GREATLY appreciated! Thanks :)

Look, I'm not in the business, just a patient at the end of his rope. I have looked everywhere to find the meaning of the code after getting a letter from my insurance telling me it was approved.

I wouldn't even be here, except after calling my insurance, they told me my name had changed and that if I couldn't provide them with the new one, they couldn't give me any information whatsoever.

That whole situation evolved into what is now a month-long mission spanning three organizations, and potential identity theft, and I'm no closer to figuring it out.

So back to the code:

T250 FINANCIAL MGMT SELF- DIR WAIVER; PD

I know it might be benign? But as a layman, seeing those words in that letter getting approved for a health care agency I don't recognize sent up some red flags, and I was hoping someone could explain what this means, or could mean?

I'm sorry if this not the right place, but I really don't know who else to go to at this point.

My Purdue medical billing course starts July 1st! I’m nervous as I am disabled and just really want to do well. I was hoping I could eventually get a work from home job as I’m struggling with my health. Is that realistic or not very common in this field?

I’ve been noticing a lot of orthopedic surgeons sending bills for rotator cuff repair with a synovectomy.

Usually how they start is they perform synovectomy (sometimes with a partial SLAP repair) & then jump right into the start of rotator cuff repair.

As far as I understand if the synovectomy clears the way for the rotator cuff repair, it’s included with 29827.

I reviewed a bill (I work for insurance) and I went back and forth with myself a lot whether or not the synovectomy should be included. I ultimately didn’t allow it, but I think I may be wrong…

So in this particular instance, the surgeon cleared the synovitis in the glenohumeral joint, debrided the anterior labrum and then begin the rotator cuff repair at the subscapularis tendon. The surgeon then moved to subacromoal decompression & finished up the rotator cuff repair at the supraspinatus tendon. The surgeon very specifically stated that the muscle was detached from the humeral head. And performed a repair.

Anyway, today I waffled a lot on the first day. Figured I’d come back the second day & decided it was included. And now today I’m thinking I should have allowed the synovectomy.

I should probably stop worrying about it, because they will certainly send an appeal, so I will have an opportunity to correct my wrong, if in fact, I am wrong.

I’m new to my company, with no real experience with surgical coding before this & I asked my senior coder & she said “up to you” (they’re very big on our personal integrity & won’t ask us to put our name on something we don’t agree with, but I keep disagreeing with myself!)

Arg….what are your thoughts??

Posting here because I’m afraid to ask my coworkers :,)
I work for lexicode right now and I kid you not—2 managers, 3 coders, and 3 educators have left so far.
Why are they leaving 😭 it’s genuinely so confusing as they have been w/ the company for years
Just need to vent to fellow coders thanks :)

Hi all, I was wondering if there are any active discord servers for medical coders?

The end date for my course is the end of the month and I finished everything except the exam. I just got approval for accommodations, but I have to schedule my exam for 4 weeks out (wtf is up with that?!). Is there any benefit to paying for the course extension or should I just renew my membership and schedule the exam? I don’t really want to give them any more money than necessary at this point.

I'm a new CPC with billing experience, no full-time coding experience. I'm confident enough in my own written resume. I've seen good things about them but mostly from 2-3 years ago. This has been my first job search up against AI filtering of resumes.

Has anyone got any recent success with them?

My facility has two providers that have most of their encounters at 48 minutes. I will see encounters with a cough, cold, etc and high time documented and it makes me raise an eyebrow.

I escalated my concerns to the supervisor and auditor. I was told we cannot question the time spent by a provider as coders but that it would be on insurance to catch on to a provider having all high mdms and investigating that way. Is that how it actually works? How frequently does that happen?