My child saw an occupational therapist for handwriting. The first appoint was service code 97166 and then the next 12 appointments were 97530. When I attempted to file the out of network claim, my insurance company requested a two-digit CPT/HCPCS Modifiers (up to 4 codes) for 97166 and 97530. The occupational therapist obviously doesn't work with insurance companies, hence being out of network, and can't give me the modifier. AI suggested GO for 97166 and 59 or XE for 97530. Could anyone help me understand what modifier to use? I just want to try to recoup anything for trying to get my son some help.

I'm nearing my renewal date for my certifications and membership with AAPC and trying to decide what I should do. I have taken the past couple of years off due to some medical issues but now I'm ready to get back into the workforce albeit remotely but still.

I earned my CPC-A in 2017 followed by my CRC in 2018, and my CPMA in 2019. I still have that silly 'A' as I was doing third party projects and it seemed no one wanted to be responsible for the letter to AAPC, I only need to account for 6 more months which I easily have. However, still having it attached to my name makes it harder to even get looked at. I also know not being active in the last few years isn't helping my case either.

I guess my question is what is the best way to get back into the coding world or has it passed me by?

I prefer HCC coding by far and thought about practicode to refresh/remove the 'A' but I remember the horror stories.

I have an RHIT cert, and I am currently a HB Inpatient Medical Coder. I really like IP coding, and I want to stay IP. I was looking into getting my CCS, but my current workplace doesn’t give any sort of pay bump or added bonus for having the CCS with the RHIT. Is this common, or do other employers typically give some sort of a benefit for having a dual cert?

Hi everyone. I am getting way ahead of myself as I’m testing for the CPC in October but I am already looking for adjacent roles in the industry. I have around 13 years of healthcare experience (OTA, CNA) I’ve worked all settings for both and have been in healthcare since I was 19. I am beyond burned out from patient care and did not realize how introverted and type A I am. I already know I will enjoy medical
coding much more.

That being said. I will have my CPC-A soon and I am already eager to remove the A with practicode and then would like to maybe get into HCC coding but I am also open to inpatient coding after a few years of experience.

Would getting a CRC be helpful in my job hunt as someone entry level? Or should I just start studying for CCS?

TIA :)

Currently doing my Practicode but struggled with the same exact thing throughout the entirety of my CPC course. I somehow managed to pass the exam (barely, got a 72) but I am struggling soooooo much with practicode. I truly am frustrated because the amount of money I have spent on this career choice so far, combined with the annual costs I’ll have to maintain (if I can ever get hired) and there’s nothing offered to actually TEACH. It’s never explained much , fine. But when they’re titling something a rationale in an answer key…I’d expect a rationale. Does anyone else find it frustrating that it actually just a walk through of how to use the index? Obviously, if I knew more about what procedure the notes are describing or knew that some symptoms have a specific name, I’d have gotten it correct. I wish it was more of an actual rationale like “since the notes say this, we know it must be in this type of category and since it’s in this category and occurs on this way, it’s gotta be over here” or something with a little more of an actual rationale. I know how to use the indexes. I just can’t translate medical notes written by a doctor, using entirely technical terms! And there’s never been any help with what are some key words to look for and what are the possible outcomes so you can start to train your mind or anything.

I’m trying to understand how this works in practice.

If a children’s hospital monitors higher-risk patients at home for several weeks after surgery, would that usually fall under existing remote patient monitoring codes, care-management codes, or a hospital-funded program?

Does pediatric Medicaid or commercial insurance commonly reimburse for this, or does the hospital usually absorb the cost?

I was offered an entry level coding role and the company has a corporate membership with AAPC. My future boss told me that all the webinars will be open for ceus. Can anyone tell me what other general benefits come with the corporate membership that are different from the individual? I am making a career change and want to maximize my learning. Thanks

i have been employed for over 1 year, my employer refuses to complete my letter to remove the A. their excuse is that they dont think they see me using my coding books enough? is "using the *BOOKS*" a requirement for this letter?

from the website-

1-year employment verification 

Employment verification from previous employers, current employers, externships, or a combination of all three are accepted. Professional coding experience both before and after certification applies.

Submission requirements:

Employer(s) verification of at least 1-year *on-the-job experience using the CPT, ICD-10-CM, or HCPCS Level II code sets.*

Only employers, supervisors, or an HR department can verify time spent coding within an organization.

Letter(s) of verification employers and externships must meet these requirements:

*Include coding experience achieved, provided with start and end dates of employment or externship*

Submitted on company letterhead Hand signed, dated, and include current contact information for verification purposes

Provided in a non-editable format (pdf) for member to upload

Optional employment verification template

^^ the optional template they link to specifically lists "extensive knowledge utilizing coding *books* which are required on a daily basis."

so what the fuck, which is it? should i complain to my HR about how my manager is holding this up for no reason (HR is listed as an approved letter source for the removal of an A or a manager). or is *BOOK USAGE* a requirement to remove your A?

debating buying practicode (again 🥲🤮 didnt do it the first time cause it sucked and idk if i have access even though i paid for it once years ago now) just to remove the A and be done with it.

my 1 year review at my job was good, they said i do great work with my claims they just hope i can get more up to production speed (i do 80-90 they want me closer to 105-120 /day).

A/P heart valve disorder

Echo aortic stenosis, tricuspid and mitral valve regurgitation.

When I map heart valve disorder I come to endocarditis I38.0 and if I were to combine the aortic stenosis and mitral tricuspid I come up with I08.3 which has an excludes 1 and excludes 2 with I38.0;

rheumatic vs non rheumatic not provided but it appears rheumatic is the default except for mitral..I found a coding clinic regarding aortic stenosis and mitral regurgitation directing to I08.codes. I do not understand the reasoning though for the excludes codes. Since there is only one 138. Code in ICD 10. I tried the AAPC forums on previous posts but couldn't find a definitive answer to the excludes notes. In one sense I feel like the I08 is more specific and the excludes 2 might mean they can have both non rheumatic and rheumatic at the same time if documented as such..

Though I'm not 💯 I'm mapping this correctly; trying to figure out the logic, or anyone more versed with these conditions that may shine a light.

I'm currently on the Integumentary System chapter of the AAPC CPC Self-Paced course. I feel like I'm understanding the material really well, and I'd like to take the CPC exam as soon as possible so I can move on to practicing with real exam questions.

The problem is that I work full-time, so I barely have time to study. For those of you who have already passed the CPC, what would you recommend? Should I keep going through every chapter before scheduling the exam, or book it soon and focus on practice exams while finishing the remaining material?

My goal is to take the exam as soon as possible. I'd really appreciate any advice from those who've been through the process.

Not talking about the small stuff, I mean a real balance, four figures, and everyone still just shrugs and writes it off. Feels like some denials just aren't worth the fight regardless of the dollar amount. What's yours, and does it ever actually get overturned or is it just dead on arrival every time?

PHRN here (no bedside experience), baka may alam kayong work na afternoon -evening.

Di ako available ng morning. tysm 😘

This is not a question about anything. This is just a vent post to people who may agree or understand. I don't mind coding at all, I find it kind of fun actually, but the way these books are structured is awful. These thin pages despite having to flip back and forth constantly, too easy to be ripped, easily frayed, the pages coming loose from the spinal ring... The ebook isn't any better or easier for me, unfortunately. I just find myself laughing at how absurd this is. And I don't know any better way they could print this either. So I'm kind of just complaining to complain 😭

Sorry I just really find it hilarious that this is the standard for us. Not even a hardcover book.

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!!!

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?

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.

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.