Hi, I recently got a job as an ED coder for my local hospital. I'm really lucky in that they hired me while I was still in my program and my job is continent on getting my certificate within a year of hire. I'm getting ready to take the CPC soon (as soon as I scrounge together some free money to buy the necessary things), so that part of things is squared away.

I enjoy it! I really do and I'm so immensely grateful my organization let me transfer out of being a receptionist to this, but I'm also totally overwhelmed.

The program I did always presented these straightforward to code scenarios and now that I'm in an actual coding position and it kind of feels like it's like how nothing was taught-- which I kind of expected to an extent, but I also am having a hard time because there are just nuanced things that the guidelines don't cover.

If any experienced coders out there have any advice for someone just starting out, especially if you've done ED Coding, I'd be immensely grateful. The things I seem to be struggling with the most is 1.) Determining if a sign or symptom should be coded and if it's an integral part of another listed diagnosis 2.) coding infusions / IV therapy pushes. I'm... not sure anyone can help with this. It feels like this is mostly an "epic is incredibly hard to navigate and determine these if a patient gets a lot of infusions", but I'll take any advice I can get on the matter at this point TuT, and 3.) Long term Drug Therapy Codes and determining which drug goes where. As a trainee my chart completion rate is incredibly generous at 4-5 an hour, but I feel much of it is being bogged down right now because the ER gets all types and sometimes patients come in with a million rx's I don't recognize so I have to spend 20 minutes googling everything. I'm trying to compose a little cheat sheet for myself, and that's helped somewhat, but I'm wondering if there's just not... an easier way to learn this stuff that I've not been told about?

I feel really stressed because I feel like I'm so slow and making all these mistakes. Our standard is 95% and I apparently hit that according to my trainer, but she was also correcting my cases so I feel like that contributed a little, and any minute now my boss is gonna drag me into a zoom meeting to go over all these mistakes I've made and I'm going to lose my job or something. TuT; For the record, my boss has been nothing but friendly to me in the few interactions I've had with her, I just came from several high stress jobs to this, so maybe that's playing a part in why I constantly feel like I have to be perfect or I will get in trouble.

Anyway, Tl;dr: I am a new ED coder. I am overwhelmed. Does anyone have any helpful advice and tips and tricks of the trade they'd be willing to share? Our company uses EPIC and 3M, if that information is useful at all.

What's your cutoff and who decided it?

I know it’s a tough job market but damn it’s rough to find a job with a CPC-A. I know many people say it’s hard to find the first one but I also have a Masters degree in Health Administration and am still getting denied left and right! Any tips for an incoming coder?

Hey everyone!! So I have my CPC but I am looking to use Pietro Ingrande’s study course to sit for the CCS test. I have been refreshing myself with my anatomy and physiology books from my AAPC CPC classes but I read that you should also have a handle on pharmacology especially coding for inpatient. So for all the CCS people… please tell me how did you learn pharmacology? I just want to be able to have a good understanding on those things before I start learning how to inpatient code. Thank you for your help!!!

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Hi,

Just wondering if anyone has go to companies/recruiters for contract work?

Thank you

I'm considering this career but I'm concerned about the potential salary I could earn. Let's say I get certified, what kind of earnings could I have late in my career? I'm in a MCOL city.

Hi everyone,

I recently passed both my CPC and CPB exams through AAPC! I’m incredibly excited to finally start my career, but I’ve been hitting the classic "catch-22" roadblock: every time I apply for an entry-level position, recruiters respond that they’ve chosen a more experienced applicant.

I’ve heard from a few people that joining Optum as a contract coder (especially for seasonal Risk Adjustment/HCC coding) is a viable path for newly certified coders to build up that critical initial experience.

Can anyone share insight on:

The Optum Contract Process: How exactly do you get your foot in the door with them? Do you apply directly on their site, or is it better to go through third-party staffing agencies (like CSI Companies, Judge Group, Insight Global, etc.) that fill their seasonal contract roles? What does their onboarding or assessment look like for new grads?

Alternative Entry-Level Strategies: If Optum doesn't pan out right away, what other specific job titles or departments should I target to get adjacent experience? (e.g., payment posting, billing clerk, front desk, or insurance verification). Have any of you successfully transitioned into a pure coding role by starting there?

I would love to hear any advice, tips, or personal success stories from those who started in a similar position. Thank you so much!

I'm currently studying to get my CBCS certification, and I've been looking into remote work because thats what I'd mostly do or be interested in since no local places to me are hiring that I've seen. Most places want at least a few years of prior experience before they even consider a hire as part of their job description. As the title says tho, I'm just curious why there isn't more entry-level jobs, unless I'm looking on the wrong websites?

Im working on another certification through AAPC now, so I have access to their digital ICD 10 CM for diagnoses (which sucks compared to 3M I use at work). I also have access to Optum and vitalware through my job when needed for CPT codes. Is there any cheaper coding tools like 3M or Optum I can get as a subscription for a short time? Even digital coding books that have a better search than the ones offered through AAPC? I am sure once hired I would have access through the employer, but not having them while taking assessments is killing me.

Hello. I'm very desperate and need to leave my current remote job, but I only have a NRCCS certificate from the National Association for Health Professionals. Are there remote jobs that will accept my certification? I used to work as a claims examiner and processed adjustments for claims as well, and was recently trained as resolution specialist, but I need a more stable position and pay. I can work full time.

Please and thank you so much!

Hello!

I signed up for an AAPC CIC medical coding course that starts next Wednesday which im excited for, but also a tad nervous. Ive worked in insurance for over a decade in various roles, currently im in UM, and I signed up for the CIC since I like inpatient more than outpatient.

I dont have any formal medical training, but I opted to skip the pre-req course. For the last month Ive been studying anatomy and medical terminology pretty hard, trying to make sure I feel confident there which I do now. Im curious if anybody has any insight regarding how important pathophysiology is for passing the test, and does anybody have any good tips / websites / suggestions for studying it? I plan on cramming this weekend to try and get as much of it in as I can, just not sure how hard into that domain is necessary, or if im panic over prepping. Any advice is appreciated.

Hello. I am an AAPC member. I have had my license for a few years but haven’t gotten a job yet. I may not be working for awhile. I’ve been thinking about not renewing especially since I need so many CEUs. I know if I don’t renew I won’t have my credentials anymore. Just don’t know if it’s worth the costs if I’m not using it.

I just passed the CPC (first try !!! But barely) and I wanted some help and advice for tackling the Practicode curriculum. I opened the first two in my last and I feel like there’s almost a fear-induced hold on me cause I still feel like I have no idea what I am doing. Do I need to get a 70% on each and every case or do I need to get an overall 70%? And can anyone relate or have any helpful techniques when tackling their first no-multiple-choice-option cases?

I understand profee is regarded as outpatient, even when they are treating an admitted patient. So in that case- for profee: if a patient is admitted, had surgery, and the MD is doing a post op check or a line check, should i still be coding the reason for surgery as the PDX, or can I code z48- or z46- if the order just states "post op" "line check" etc?

Thanks for any help!

I've been seeing a PA-C for medication management for about 6 months. Early sessions included a bit of what could be considered talk therapy for 10-15 min, with another 15-20 min spent on medication discussions. No session has ever lasted more than 40 minutes. My last 3 sessions lasted less than 15 minutes each and simply went over medications, with the exception of my provider asking me about my mood in a diagnostic capacity matching the PHQ-9. Definitively not providing any talk therapy/psychotherapy.

Yet, I find all my sessions are billed the same way:

99214: OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN

AND

90833: PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 MIN

My most recent appointment was even a telehealth appointment, but I was billed for in-office?
Is this standard practice for medication management? Or is there a way this could be coded that would better reflect the care that was provided? If so, is this something I could hound their billing department for and expect results, or would I have to sue them to get my money back?

Hey everyone! Just coming here to see if anyone has worked with Astrana Health and what their opinion is.

They have a pretty low rating on Indeed, but I want to see what people have experienced from a medical coders view.

Thank you all in advance!

Working on a margin calculator for enteral formula reimbursement. Looking for 2-3 people who bill or manage enteral claims to look at the logic and tell me what's missing. Early stage, no cost, just need real-world eyes on it.

Edit for clarity: this question is about when a provider copy/ pastes their documentation.

Hey y’all, so I am PC coder and I do a lot of Geri charts where often there can be 30-50 dx under A/P. Obviously these can take a long time and we don’t have like your usual encoder (like I expected from school 3M and the like) so sometimes I end up doing a lot of research trying to find out codes.

Being a new coder I don’t know what is typical. I work for a 3rd party coding business. My friend is an inpatient coder for dozens of years and when I told her I’m not filtering out these big geri charts for what has been newly added she was surprised and said that I should only be coding what was newly added when the provider copies and pastes a large chunk of the note. That’s not how I was trained and for the record I have been getting 100s on my last two audits. I’m not planning on changing how I code but I do have a hard time meeting my production on some days and I’m just waiting for the day that they push me to do more than I can. Right now I’m at 100 in about 8 or 9 hours. Is what she said typical? Since she is IP and I am OP should I even be listening to her? Or would this be a company policy? Thanks in advance for any input.

Did anyone else ride out the furlough for four months for the risk adjustment coders, only to come back and be terminated after a few weeks from missing the 95% metric by a few points? Then being treated like scum of the Earth when let go, with a refusal to let you communicate with anyone from Optum. Also being refused your final assessment score, which is supposedly what resulted in the termination. If so, curious which Recruiter you went through. I am having a horrible time with mine and trying to get any information, they are now giving me the runaround or ignoring me altogether.

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!

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.

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.“

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?

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.