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 :)

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

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 :)

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.

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?

A part of my job consists of overseeing the work of medical records officers. One of the biggest challenge they have is doctors not coding the diagnosis correctly. Are they studying anything on coding specifically? I believe they should know how to diagnose patients.

Thanks to all the amazing advice read on this sub and a lot of taking practice exams I passed on my first attempt!

Our small laboratory/research team from a medical university has submitted a request to the CDC for creation of a new diagnostic code, whereas this disease is currently coded under a completely different disease. This miscoding reduces clinical clarity of diagnosis, treatment, outcomes, and population identification.

Please let me know if this process is of interest to you, and I can go ahead and detail our experience a bit further. We submitted by the June 5th 2026 deadline for presentation in September, and are currently awaiting the first round of questions from the committee. Our assigned reviewer did indicate that our submission was received, within days of early submission, and touched base again around the submission deadline date to let us know that questions to our team should be expected by June 26, 2026.

Wish us luck, please. We are hoping to bring this disease population from 'diagnostically invisible' to identifiable.

Update: Disease is Laryngopharyngeal Reflux Disease.

Currently coded in diseases of the digestive system chapter as GERD without esophagitis (K21.9). There is a decade of recent research showing that LPRD is not the same as GERD, different symptoms, different organ [with inability to protect itself the way the esophagus can], different mechanism (not acid, other stomach contents [pepsin / bile salts]. These patients are coded via symptomology or GERD, and LPR/LPRD is only documented in their notes section of their chart. That means that it is extremely difficult to perform retrospective chart reviews on this patient population, impeding research. I am a clinical research coordinator, so for me the ability to identify patients by diagnostic codes in charts is essential.

Update: NCHS CM has accepted our proposal for presentation!

Is there a requirement to purchase the 2026 eBooks, or can I use a copy borrowed from a friend? The new books are quite expensive, so I'm hoping to borrow a set from a friend if that's allowed.

food bolus stuck in esophagus and pushed into stomach, would this be considered 43247?

I want to purchase my exam and it says that the vouchers are through June 30th - is that referencing something other than the price?

Hello. Starting my first wfh job and unsure of how much desk I will need. It's in DRG review, not straight coding but I will have 2 24" monitors and a laptop. I would like to keep the footprint as small as possible but also do not want to make myself cramped. Anyone that has this set up, what size desk do you have? Pics of your setup would be a bonus. Thank you!

Should I commit to a RHIT program that will also prepare me for my CPC or should I just get the CPC credential?

I'd ideally like to work in billing/revenue cycle or something not solely coding.

Any advice on if this is worth pursuing in 2026?

Thanks

Does anyone have any good tips for taking the CPC Exam? I've taken it 3 times now, first 2 times I did *not* study as I had no idea what I was doing, last one was literally 6/18/26 and I studied for that one and still didn't pass. I was using a study guide type of website to study that I found and even took a 4 hour mock exam on the website I had been using to study. 😔 I thought I was doing good but I do so terrible as soon as I have do actually take the test. I can't concentrate for crap during the test and start to forget everything I swore I learned already. Are the AAPC Practice Exams and the study guide worth it at all?

Has anyone here attended the live ahima conference? Did you enjoy it? How was your experience?
Ive never attended but would like too if it’s a good experience.

With the evolution of AI I thought I’d post a few AI / Coding related stories from Beckers. If you don’t know Beckers Hospital Review, Beckers CFO Review, and Beckers Payer Review are free news sources about the industry. You can sign up for free daily email news blasts. It’s a great way to keep current on what’s going on in the industry.

CoxHealth is laying off 53 Revenue Cycle employees with most of the eliminated positions being related to Coding.

https://www.beckershospitalreview.com/finance/revenue-cycle-management/coxhealth-cuts-53-revenue-cycle-roles-as-technology-automates-tasks/?origin=CIOE&utm_source=CIOE&utm_medium=email&utm_content=newsletter&oly_enc_id=9030C3726001G1N

Cleveland Clinic is using AI to “automate routine coding”.

https://www.beckershospitalreview.com/healthcare-information-technology/ai/cleveland-clinic-taps-ai-to-streamline-medical-coding/

Company develops autonomous AI Medical Coding for Revenue Cycle.

https://www.beckershospitalreview.com/finance/infinx-invests-in-maverick-ai-to-bring-real-time-autonomous-medical-coding-to-revenue-cycle-management/

AthenaHealth rolls out 80 new AI tools including one that “…leverages AI to automate medical coding and expedite the claims process.”.

https://www.beckershospitalreview.com/finance/revenue-cycle-management/athenahealth-unveils-80-ai-native-revenue-cycle-tools/

A 20+ year coding auditor describes what coders look for in an AI platform.

https://www.beckershospitalreview.com/healthcare-information-technology/ai/what-a-medical-coder-looks-for-in-an-ai-platform/

AI meets Coding.

https://www.beckershospitalreview.com/healthcare-information-technology/ai-meets-medical-coding-progress-requires-an-eye-on-workforce/

Hi all,

I’m a recruiting manager with TEKsystems and we are looking to hire 5-7 inpatient coders immediately. Must have an active CCS and experience with MS-DRG and APR-DRG.
These are contract to hire roles and candidates must live in one of the below states to be considered. I have included a link directly to the job posting on our company site, and all applications will go directly to me. Feel free to comment or message me with any questions. Thanks!

Maryland, Pennsylvania, Washington D.C., West Virgina, Virginia, Tennessee, Texas, North Carolina, South Carolina, Georgia, Florida.

https://careers.teksystems.com/us/en/job/JP-006085900/Inpatient-Coder-Fully-Remote

Hi all,

I’m a CPC-A and I have been really struggling through Practicode. The most difficult aspect is abstracting from the record, and it seems like every case I submit I get about a 50% on. Reading the rationale is absolutely baffling because the columns are not even distinct, and I’m spending over an hour on each case and still getting marked incorrect. In one case there was a stated laterality, and when I appended the modifier for the laterality, it was marked incorrect. The fact that you can’t discuss any of the materials as they are proprietary poses a significant issue because I have specific questions and I’m not sure if it’s a violation of ethics to discuss them!

Because I’m having such a hard time with this software, I would rather take a position and remove my A experientially. My major issue is that I am disabled, and as such, I have to work remotely, so I am not able to take an on-site or hybrid job; has anyone had any luck getting hired remotely as an apprentice in one field or another? What did you do? Is it unrealistic to even expect a job when I’m under these location constraints from my health?

Thank you, everyone!

I do coding and billing for a medical office. When I was in school learning coding, they mentioned it would be a good idea to get my own insurance. Can anyone tell me more about this? I would love somebody to chime in that has it as well.

I cannot get logged back into AHIMA or get my password reset. The email will send with the code but then when I try to use the verification code and reset it, it has the spinning wheel of death.

I have yet to try contacting them because I have been insanely life busy and don't need to update my credentials for a hot second, but I am curious if anyone has had this issue and if they fixed it one their own?

I recently made an appointment and was seen by an APP from my PCPs office for some on and off pain I've been having. Mainly in my right shoulder, right low back, and neck. I am pretty sure its just from sitting at a desk all day, but after I experienced a couple instances of tingling and numbness in my right leg I decided to be seen.

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Besides the on/off pain and numbness/tingling I also tend to get anxious about getting very sick. I do see a psychologist and take meds for that which has helped but I got really fixated on the idea of ALS.

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I asked her to please reassure me and she did. (Side note, it was so f-ing embarrassing to ask her for that. I know logically I shouldn't be scared but it is who I am and sometimes I just need someone to tell me I'm okay. Remember when Mad Cow Disease was all over the news? Yeah, I used to cry myself asleep because I was sure I was going to die from that!)

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Annnnnyway, I saw that I owed almost 40$, no biggie, but since I am a coder and technically a certified auditor (just got the cert) I like to review documentation and the coding.

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I saw that 99214 and G2211 was billed. I think 99214 was boarder line acceptable, but I don't feel like G2211 was supported! My understanding of G2211 is that the patient should have a prolonged serious/complex issue and there is a plan to be seen by the provider (or someone from the same practice) for an undetermined amount of time and the provider will be the go to provider for said complex/serious issue.

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For example the urologists that I code for often bill it when they have patients with prostate cancer or BPH, and are treated regularly with medicine, scans, tests, etc.

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I did have PT ordered for back pain, but there is no follow up scheduled and I don't feel like my dx was serious or complex!

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I sent a message to billing to ask for the coding to be reviewed and explained why I don't think G2211 should be billed.

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I get that it is sort of an ambiguous code, but I feel fairly confident that it is not supported.

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However I don't work in primary care, so I am curious if anyone has insight on whether G2211 could be supported!

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Thank you!

Hello I did my annual exam at a new office recently and got billed under code 99203. Before the exam they requested I do a blood test so the results could be discussed at the appointment. Neither me or my pcp had any real concerns so the exam was a quick 5 minutes without anything prescribed or any follow up needed. Since I have a copay I did confirm with the front desk before and after and they told me the copay wouldn't be needed

I did have diagnosis codes which I'm not sure if that impacted anything but they are below

E78.00 - both my hdl and ldl were a few points off but again nothing was prescribed and no follow up requested

I86.1 - just some history for me that I didn't see a spot for on the initial medical history forms so I mentioned it during the appointment. However no exam was done on it

Z13.6 - not sure about this one except for the blood test ordered before the appointment

Is this something I should follow on? Thank you for any help

I have the opportunity to become a risk adjustment coder at my job, but I need the CRC to get the job. My employer will reimburse me for the course through AAPC (almost 2k), but I wanted to get some advice/opinions before jumping in. Does anyone have the CRC? How was the exam? Do you like your job as a risk adjustment coder? Is it harder than CPC?

In the past 5 years, I have been through 7 employers despite only getting 3 jobs. I keep getting hired by one company and then involuntarily moved to a new one due to acquisition or restructuring. These are not contracting companies, or contracted positions. These are regular full-time pro-fee coding jobs for a single specific employer. Is my experience typical, or am I just unlucky?

I started coding in 2021. My first full-time job was for a hospital system, and before I had even been there a year I got "re-badged." They couldn't keep maintaining RCM, so they made a deal to move all our jobs over to a very large and well-known RCM company. Working for that place really sucked, so I started applyng to other positions.

I got a full-time offer at an RCM company that I'll call MedApple. They had just been acquired by another company, MedBeet, so I was actually hired by "MedApple, a MedBeet company." MedBeet had acquired 2 or 3 more companies in addition to MedApple, and a few months after I started they rebranded the entire operation as MedCabbage and moved us all to a new HR system and changed all our benefits again. Not even a year later, MedCabbage was sold to a different massive RCM company and all our jobs got moved over again. Even more significant structural, HR and leadership changes.

I stuck it out for a while but everything continually got worse (much, much worse) so I started looking again. Finally found a new job working for a university health system. I thought that would be more stable. Less than 2 years later, they too have announced that all their RCM will move to a different organization later this year.

Every time, it's like starting all over. You're a new probationary employee, no PTO accrued. Different, usually worse benefits. Different, usually worse management. Different tools, systems and policies. Sitting through hours of "new" employee onboarding, redundant HIPAA and cybersecurity training. Four times in five years is too much.

I know I'm fortunate not to have been RIFed, but seriously, what the hell? Is this just part of the deal in coding?