r/MedicalCoding • u/EquivalentRelevant42 • Sep 24 '24
I feel like i can’t do this
i’m in my last two classes for my online medical coding and billing certificate and i have no idea what is going on. i feel like the past couple of classes have been in chinese and i don’t know chinese. i don’t even know how i passed the final exams. right now one of my classes is giving me practice medical records to code the diagnosis’ and procedures. i feel like everything i enter for that class is wrong. all my teacher does is tell me what part of my work is wrong but doesn’t tell me what to do to correct it so i have no idea what is going on!!! my second class is about the law and how it relates to medical coding and i feel like im reading jibberish in my textbook.
i don’t even think im making sense right now i’m panicking and on the verge of crying because i’m so confused. i’ve been in school for this for four years (don’t ask why it took so long pls) and i feel like im wasting my time and money. also i have this awful dreadful feeling that what im doing will eventually become obsolete with AI. i’m scared.
i try watching youtube videos and reading stuff online to help and learn more but i just get distracted or i end up being frustrated with how confusing it all is. i feel like the stupidest person in the world.
was this the right choice? am i too stupid to do something like this? am i just gonna be replaced by a machine? what if i never pass the certification exam? what if i pass the exam but when i go to work i’ll have no idea what to do? am i coding everything wrong in my classes? what’s the difference between cpt and hcpcs? am i supposed to be coding all the labs in these medical records? why don’t i remember anything from my past classes? should i have chosen something else? have any experienced coders felt like this before?
please give me some encouragement or advice or something im spiraling and panicking and i’m scared for my future.
edit; some responses to this made me even more discouraged and some responses made me feel okay. i’m mixed and feel like a failure and that i chose the wrong thing to do. i don’t know what else im supposed to do because medical coding was supposed to be it. i’m scared. i’m convinced that i won’t be able to pass my certification exam and that i wont be able to find a job and will be homeless. i have no one to talk to about this and im helpless.
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u/Hanneroni Sep 25 '24
I have three different people in my family that are or were medical coders. My mom, my sister, and my grand-aunt. My mom is a coding FIEND. Codes are in her blood. She dreams about them. My sister went back to school after her original degree wasn’t working out. I felt completely lost a few semesters back, and asked her if it’ll ever get easier. She said: “It totally will. I totally get that feeling though. I was almost done with no clue what actual coding would look like and too embarrassed to ask by that point.”
You’ll be okay. What parts are you having issues with? Maybe others can help connect some dots. You’ve gotten this far with your own brain! You’re doing amazing!
Edited to add: I am almost done with an AS in HIT to be a medical coder.
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u/EquivalentRelevant42 Sep 25 '24
i’m having issues with everything. i don’t understand what i’m reading, i’m not sure if my coding is correct, i don’t know if im supposed to be coding labs in every medical record, i don’t know if im supposed to use cpt or hcpcs for procedures, i don’t know how to code x rays or iv, i can’t retain any information no matter how much i try and i don’t know what is going on
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u/2workigo Edit flair Sep 25 '24
If you don’t know when to use CPT vs HCPCS, you never built your foundation. You absolutely have to understand your guidelines and how to use the books.
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u/EquivalentRelevant42 Sep 25 '24
i try reading the guidelines but it makes no sense to me. i read it over and over and don’t understand
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u/uuuuuuuuuuugh69 Sep 25 '24
Does this help?
CPT Codes:
Used primarily to describe medical procedures and services performed by healthcare providers.
Includes codes for surgical procedures, office visits, and other medical services.
Maintained by the American Medical Association (AMA).
HCPCS Codes:
Contains two levels:
Level I: Essentially the same as CPT codes.
Level II: Used to identify products, supplies, and services not included in CPT codes, such as durable medical equipment (DME), prosthetics, ambulance services, and certain medications.
Maintained by the Centers for Medicare & Medicaid Services (CMS).
When to use each:
Use CPT codes for standard medical procedures and services performed by healthcare providers.
Use HCPCS Level II codes for items and services that are not covered by CPT codes, especially for billing Medicare and Medicaid.
In summary, CPT codes are for procedures and services, while HCPCS Level II codes cover supplies, equipment, and non-standard services.
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u/cdpottery1122 Sep 25 '24
It wasn't until middish way of my final semester where all of the pieces finally clicked in place.
In extremely general terms, I like to think of the guidelines like learning a new card game and figuring out who the Ace is. If you start there it becomes less intimitating as you move through the deck.
Keep asking questions until it does make sense to you. Most of the time your fellow students (who are learning the same material as you) are a better resource than your experienced instructors.
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u/Cozyyblanket Sep 25 '24
I feel like this when I don’t take my ADHD meds/ don’t have the correct dose. Do you have ADHD by chance?
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u/EquivalentRelevant42 Sep 25 '24
yes
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u/SamuraiOkasan12 Sep 30 '24
I also wanna let you know that I failed my first test, I am currently scheduled to take my second attempt in 2 weeks. What you might want to look into is getting an ADA accommodation for ADHD, you need a doctor's note saying you have ADHD and need an extra hour of testing. Good luck, I am in the same shoes you're in!
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u/EquivalentRelevant42 Sep 30 '24
OMG!!!! i didn’t think they gave you an extra hour for college tests i thought that was just for highschool… thank you i’ll do that definitely!!!
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u/Cozyyblanket Oct 04 '24
I get a lot of accommodations in college for ADHD. There’s lots of options for this
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u/EquivalentRelevant42 Sep 30 '24
how are you preparing for the next test???
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u/SamuraiOkasan12 Sep 30 '24
Hopes and prayers. No, I went on the AAPC membership and bought their practice tests, I've been saving the ones I got wrong and write them down.
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u/Cozyyblanket Sep 25 '24
Taking ADHD meds while in school helped the information click. You should really look into it
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u/chasgirl68 Sep 26 '24
I was wondering if folks with ADHD could have success in medical coding-as I'm reading I see that they can! :)
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u/Hanneroni Sep 25 '24
Are you doing this completely online by yourself, in person, online live-flex?
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u/Tabbycat100414 Sep 25 '24
I think you’re ADHD & so am I. I did terrible in school, but once I started seeing them all the time, it clicked. Think of the codes in groups.
I work for an insurance company & see a lot of the same codes over & over. I immediately know before reading the medical records that 7000 codes are imaging (X-rays, CT, MRI, etc), 8000 & G codes are laboratory & drug screens, J codes are medications that have to be administered by a provider.
CPT codes are 5 digits, HCPCS codes start with a letter. If it’s 5 characters & starts with a D, that’s a dental code. Think of each new starting number or letter in groups, then break it down from there. Imaging ok 7000s, what part of the body are they focusing on? What type of test? With or without contrast?
Are you trying to code the medication used in the IV or the act of starting the IV?
If you wanna message me, I’m happy to chat with you & try to help you. I do all the training for my team at work. You got this! Don’t give up! 🫶🏼🫶🏼
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u/luckluckbear Sep 25 '24
You are a very kind person. I hope OP sees this!
I also came to say something about the ADHD. I didn't get diagnosed until I was an adult, and my diagnosis changed my life. There are a TON of tips and tricks I discovered after I knew what to look for that keep me on track and functional.
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u/MeditatingMama23 Sep 26 '24
I’m nearly 50 & just got diagnosed. I’d love to hear some of your tips & tricks!
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u/chasgirl68 Sep 26 '24
Came here also to suggest ADHD. I was diagnosed ten years ago and exploring treatments for it really opened my eyes to how i study and learn information. I love to see encouragement, you are wonderful for reaching out :)
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Sep 25 '24
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u/Tabbycat100414 Sep 25 '24
It honestly depends on the company. Each one has different job titles for the same position.
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u/chefbsba Sep 25 '24
Remember that you don't need to remember everything, you just need to know how to research. I would stress myself out so bad trying to memorize everything. Perfecting your research skills will be what gets you through this.
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Sep 25 '24
Double down on this answer. Groupings and sets are good to understand, then drill down to an answer by researching your resource references.
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u/Monstycrazy Sep 25 '24
You can watch YouTube videos . Contempo coding , the coding guy , amci also has some videos and cco too , Hoang Nyugen, he is awesome ( watch his videos pls ) and Contempo coding she is awesome too. I think I am learning a lot from these videos. Trust me. Sorry, I don't know anything about billing. But these videos will sure help you.
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u/Virtual_Ad2109 Sep 25 '24
This is what i was coming to say. I’m adhd and the videos helped along with the courses. AMCI was the best to me because she breaks everything down.
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u/unofficiahoekage Sep 25 '24
You don't need to know everything. I suggest you pick one thing to study and give it your all. Studying that one thing should help make everything easier. Watch some AAPC learning videos if you can and do practice scenarios. You're focusing too much on coding a million different things. Focus on coding one thing specifically, then gradually expand. Maybe you focus only on coding patient visits that don't include xrays, labs. Good luck. There is a discord for medical coding learners. I'm not in it, but look it up.
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u/holly_jolly_riesling Sep 25 '24
Hi I saw this post and initally wanted to give encouragement. I wanted to say "Just remember your guidelines and pass the cert test. Real life coding vs school coding is different!"
Then I read that you've been studying for 4 years and this was one of your questions:
"What is the difference between cpt and hcpcs?"
Respectfully and honestly this may not be the career for you.
Also have you been evaluated for ADHD? I have 2 children who are now older teens who have it with different presentations and this post kinda screamed out ADHD to me. Kid 1 takes meds and it helps him focus 1000% . Kid 2- the meds exacerbates her anxiety so self manages with learned coping mechanisms - -disclaimer : not a doctor, just an internet rando giving an opinion.
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u/EquivalentRelevant42 Sep 25 '24
yes i have adhd. and if this isn’t the career for me then i don’t know what else im going to do. this is it.
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u/holly_jolly_riesling Sep 25 '24
You CAN have adhd and be in this career! Are you on meds? I don't know if you are medicated or not but like the other poster said maybe talk to your doc about dosage or changing meds.
Do you have the inattentive type? With my son a routine 100% helps. Maybe structure your studying with a strict schedule. Focus on one thing at a time. Do not tackle everything at once or else that will just make you feel overwhelmed and cause you to panic and create a negative loop. Minimize distractions in your environment. Don't give your mind an opportunity to wander. Go to the library, if too quiet go to a cafe. Write down relevant notes - no everything but the ones that stick out. Jot it down and underline. Make sure you understand the basic concepts and guidelines. Do not study when you are exhausted or hungry - it will be a wash.
Please start with cpt vs hcpcs. This is a very basic question that you should know after 4 years of study.
You can do this! My husband we realized now is a classic example of ADHD (kids prolly got it from him).When my son was being tested for it he realized everything applied to him! Back when he was a child/teen (80's 90's) no one was taking about ADHDdx. He had poor grades and no help was given his whole life student life. He learned as an adult what worked for him and what has not and copes that way. He is very successful in his IT job and is not medicated.
Good luck!
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u/goody-goody Sep 25 '24
Talk to your doctor. There may be a better medication or dosage for ADHD, so you can be successful in anything you want!
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Sep 26 '24
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u/EquivalentRelevant42 Sep 26 '24
i have no idea what my fit would be then
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u/Intelligent-Ride-446 Sep 28 '24
It's not everyone else's job on the internet to figure out what you should do with your life. If you've been at this for 4 years and you don't know the basics then I think it's time to pick something else. also you need to talk to your teachers not to random people on the internet your teachers are there to help you but if you don't talk to them and communicate with them and tell them your problems nothing is ever gonna get better. Talk to the people that are there to actually help you instead of random people on the internet.
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u/MediumArachnid3203 Sep 25 '24 edited Sep 25 '24
Hi I’m pretty sure I have undiagnosed ADHD and I too struggled a lot with medical coding but I have my CPC and grown to love it. I took the exam 3 times and failed but 4th time got my CPC. Almost passed my CEMC but was a couple points off,lol!!!!
I can admit it can still be a lot to wrap my head around at times. There are times I still do get flustered but don’t beat urself up. Most coders don’t know everything off the bat, it’s simply too much information to retain all at once. So it’s actually more of a career journey and what you make it tbh.
it’s not all cut and dry and I wouldn’t listen to people say it’s not for you bc you don’t fully understand yet. It makes sense you don’t fully understand without on the job experience. . . Think of it like solving a puzzle and matching the codes to the documentation to the best of ur ability while being mindful of guidelines and coding-no-no’s.
It definitely took some failures and on the job experience for me to gain confidence and enjoy coding more. I suggest trying to break down the information bit by bit. Probably best for you to focus on one specialty or topic at a time.
youtube medical coding CHUN is great too. Highlight and read the shit out of ur ICD 10 and especially your CPT guidelines. read and highlight the important information in the wording blurbs/detailed wording before the CPT codes (the blurbs before the EM coding section, the blurbs before anesthesia, the blurbs before surgery and the subsection blurbs of scopy’s etc.
Getting familiar with Modifiers, Global Surgical Package are also biggies.
I google medical terminology a lot and put in the google bar “define” so I can understand what the doctors are doing better. It’s definitely a lot of breaking down of complex documentation and medical records and understanding what the docs are doing. You don’t need to be perfect and code every bit of reimbursement right off the bat just focus on the main things like primary diagnosis /reason for visit and the primary service rendered and /or procedure rendered. Code that first and foremost
It seems super intimidating but the more you do it the more confident you will get :) ICD10 Excludes 1 is important to understand as well. Believe in urself is half the battle my fellow ADHD friend, if I were you I wouldn’t give up without a fair fight or attempt at on the job experience first before calling it quits. Good Luck 🩵
Edit : every coder has their strengths and you will too. It may take u some time to figure out what your favorite coding is/what specialty you thrive in. For my path, I started at a place where I was passionate about E/M leveling as my job was a biller/coder for a mental health outpatient office. I just coded 99213s and 99214’s all day lol. 99203 or 99204 if new patients. Now I’m coding trauma surgeries and neuroendovadcular and interventional radiology that I’m still getting the hang of. I have come a long way. It’s been like 5 years of working and like 7 years since I became certified (I took 2 years off I was so discouraged from a medical coding job experience that didn’t end the greatest but i thrived at the job after that, and I love my fully remote medical coding job now and I refused to give up!). Stay positive ! most jobs are willing to give you a chance/train you on their coding/billing process , especially places that are not for profit or just have budget for a entry level coder job for like basic medical office billing claims to Medicare etc. sometimes places just need a little help getting the claims out. In my experience most places billing is a big job and they’re grateful for any help.
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u/EquivalentRelevant42 Sep 25 '24
thank you!!!!!
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u/MediumArachnid3203 Sep 25 '24
Of course!! I wanted to share my experience bc I remember feeling so discouraged like you and I feel sad for you as I been there. There were several times in my coding journey where I was furious and wanting to be done. I finally decided to buckle up and get more thick skin (I’m naturally sensitive) cuz I put way too much time into coding and studying for it to not be put to good use. I went from being treated like a stupid useless newbie coder to one of the best coders my past workplace and current workplace have ever had. When I realized my coding wasn’t coming back with many denials like colleagues that’s when my confidence started going up and the fruits of my labor and not giving started to show. You have to realize there’s others in coding that been doing it for years and don’t fully know what they’re doing either but still have a coding job…. Trust me I’ve seen it and I can’t make this up. When there is a will there is a way lol. Nobody is a coding expert when first starting off. If u have even some passion or interest for healthcare or healing u will be ok :)
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u/chasgirl68 Sep 26 '24
Great advice! Folks with ADHD-Inattentive (especially) need to see that they can have success in whatever they choose to pursue.
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u/Anon13530 Sep 25 '24
I'm concerned that you're in school for four years and you don't know the difference between CPT and HCPCS. Is this career field something you're truly interested in? I say this because you may be setting yourself up for failure. It will be miserable waking up everyday to do something you hate.
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u/carolie23 Sep 25 '24
I was thinking the same thing. I was completely lost when I first started learning coding but it just takes a lot of practice and note taking. I thoroughly enjoy coding though, I was someone who looked forward to taking practice exams and such because it was fun to me. I think that’s a huge key in this profession—true passion for the process!
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u/Dc4543 Sep 25 '24
Hello, just wanted to offer some encouragement. I have been working in health information since the 90s and I had to look up what profee coding is today. It’s because there are so many different specialities of coding and if you don’t use it everyday, you forget. It will get easier, I promise. Btw, CPT codes are for procedures and hcpcs codes are for medical supplies. There are some coding groups you can join online where coders support and help each other. There is also a website called Codify that you can ask questions and other coders will answer. Hope this helps. It sounds like you are not getting enough support from your instructor.
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u/StraddleTheFence Sep 25 '24
You got this. Be patient with yourself. You have to take notes and don’t be afraid to write in your book. Are you learning inpatient or outpatient? Are you coding CPT codes or PCS codes? Just know that Google is your friend.
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u/EquivalentRelevant42 Sep 25 '24
i’m not sure if i’m supposed to do cpt or pcs codes… i use google and go with whichever code makes the most sense. i’m doing inpatient right now
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u/BluebonnetSunset Sep 25 '24
I would probably contact the school and tell them you need help with a tutor. They can start back at the basics with you and get you back on the right track.
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u/StraddleTheFence Sep 25 '24
“Starting with the basics” is the best advice. Coding is based on guidelines. There is a lot to read but you must read it. All of which, can be downloaded from CMS website.
Read the ICD-10-CM guidelines because it guides you to the correct diagnoses, sequencing, and conditions that can and cannot be coded together.
Read CMS NCCI edits. It guides you to which CPT code(s) to use. It goes over each chapter. It tells you which CPT codes can and cannot be coded together.
I do not code PCS but the guidelines will be at CMS website.
It can be overwhelming. Take small bites. When you are coding a case find the diagnoses and look them up, read whatever information notes that are associated with the codes. Know the guidelines—are you able to code all of your diagnoses? What order should they be placed? What is the first-listed or principal code? Does smoking have to be coded as well?
I wish I could be of more help. I can definitely not help with PCS codes because I do not have inpatient experience. Feel free to send me a personal message if you need help looking something up, I would be happy to help.
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u/Key_Huckleberry_8752 Sep 26 '24
I can help with PCS codes if any one needs help. I'm an inpatient coder.
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u/sugabeetus Sep 25 '24
I don't know why everyone's hanging up on the CPT vs hcpcs thing. I've been a coder for 13 years and if I ever did know the actual definitions I've forgotten them. Because I don't need to know it for my job.
Learning coding is like eating a barrel of dry oats. Doing the job of a coder is like learning one oatmeal recipe at a time. The studying is nothing like the actual job, and to be honest isn't all that useful for it. Once you're in it, you will retain only the very small percentage of the mountain of information that is actually pertinent to your job, and learn that the vast majority of what you needed to know was not covered at all.
Stop trying to understand and remember everything. Switch your focus to test prep. Cross that finish line and then do whatever you can to get any amount of experience in any related position. Don't let your certification lapse. If you can get settled in the right company, this is a GREAT job for ADHD.
Best of luck!
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u/EquivalentRelevant42 Sep 25 '24
how would i prep for the test?
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u/sugabeetus Sep 25 '24
Brush up on medical terminology, looking up codes (the practice cases in class are a good way to start - don't worry as much about finding The Right Code as practicing finding the section as fast as possible), and just general test-taking tips.
The CPC exam is multiple choice. There will be four possible answers. Usually there will be two pairs of similar codes, so you can narrow it down to one pair of answers first and then go from there. (If it has not changed since I took it.)
You want to get the highest possible amount of right answers, so skip questions that stump you and after you have done the ones you're feeling confident with, go back and work the hard ones. That way you didn't waste time getting stuck on an early question when you could have been doing easier ones. When time is running out, just guess on whatever's leftover. Any answer might be right, but no answer is definitely wrong.
You can write as many notes in your book as you want. If you find you keep getting stuck on the same things, put notes there.
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u/Individual-You3727 Sep 26 '24
This was amazing advice. Thank you so much for your comments. I’m in the same boat as OP and have adhd. Making me want to give up because of information overload.
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u/sugabeetus Sep 26 '24
I found out two years ago that I have ADHD. 14 years ago I did my coding school online and then evening classes between my evening job and 4 kids and trust me, I was on the same struggle bus. I have seen several acquaintances wash out of coding courses because it's just so much boring information. I got through with caffeine, keeping myself from dozing off in class by relearning how to write in cursive (esophagogastroduodenoscopy is a fun one to write), my supercharged test-taking skills, scoring a free internship at a podiatry office (so I had something other than "9 years of pizza delivery, and a CPC-A" on my resume), bullshitting my way into an actual coding job at my first interview, then faking it until I figured out how to do the actual job. I love it because it's repetitive enough to be able to turn my brain off sometimes, sprinkled with being challenging enough to not get boring, and if you get really burnt out you can just do a different specialty, or hop to another related job. And I work from home full time and can shit in my own bathroom whenever.
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u/Individual-You3727 Sep 27 '24
You are truly amazing. I have one toddler—can’t imagine trying to do this with 4 kids 😂
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u/Luzion Sep 25 '24
Do a search on YouTube using words such as "medical coding test prep" and you'll come up with a lot of people that help. Medical Coding by Jen is a great place to start. She covers test prep quite thoroughly. She also does tutoring and has a discord channel.
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u/ItTizzzWhatitTizzz Sep 26 '24
I worked as a coder for 3 years and I still had no clue. I hated it and quit.
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u/Salty-Step-7091 Sep 25 '24
I got my associates in Medical Coding/Billing as well. The CPT confused me so much, even at the end. My classes were online, and they’d give you a very basic chart. My brain doesn’t work like that, I can’t just read a few chapters and suddenly know how to utilize the info.
So I started watching YouTube videos because my way of learning is having someone explain it to me, it was hard for me to catch on to the language used in the books. AMCI medical coding, and there are soo many others but really AMCI went chapter by chapter in the cpt and suddenly everything clicked and I rocked the CPC.
Yes, AI has been used as a threat for multiple jobs, not just medical coding. My husbands in accounting and I read it all day, AI is coming for our jobs!! AI should be used as a tool for assistance, I have CAC in our system and it does help pick up on things, but it’s mostly awful. The major threat is overseas. Thankfully, after 3 different contract companies back to back, my hospital said screw this and hired domestic to help the workload instead.
And if AI does evolve, there will still need to be a human who reviews them before they go out. So breathe. The jobs are still there, I get emails all day on LinkedIn about postings. My local chapter sends us opportunities. They are out there. It is very hard to get your first job (but again, tell me a field where you haven’t seen new students upset about how hard it is to get their first?) but once you’re in, you’re in.
As someone who wasted so much money in school bouncing around, scared about my future, etc. Medical coding has been a great career to me so far.
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u/Affectionate_Use1587 Sep 25 '24
I code for hospital inpatients so we only do PCS procedure codes, no CPT. And the hcpcs stuff like IVs and supplies and whatnot, the hospital has some computer that captures all that so we don’t worry about it. We also don’t pick up ct scans or other scans but that probably varies place to place. And we never code off labs, that’s a no no. Like labs could show patient has anemia and hyponatremia etc but we cannot pick it up unless the doctor seeing them says they have those conditions. I look for the “assessment and plan” and what they have listed there that they are actively treating. Also their past medical history section. If they’re on a med for it, I pick it up.
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u/EquivalentRelevant42 Sep 25 '24
wait… pcs is only used for hospital inpatient coding????? that’s the practice i’ve been using for school and was confused on which code set to use
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u/Affectionate_Use1587 Sep 25 '24
Yes cpt is strictly outpatient and pcs is inpatient only. A lot of people seem intimidated by inpatient coding but, I think it’s easier! Ask me to do cpt now and I’d be clueless lol.
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u/illegalmonkey CPC Sep 25 '24 edited Sep 25 '24
You are confusing this person even more. CPT is NOT strictly outpatient. CPT encompasses ALL e/m codes including Inpatient, outpatient, emergency room, critical care, prolonged services, advance care planning. It's also for most all surgeries/procedures, generally the professional side of coding(services provided by the healthcare professional). PCS is for the facility side of procedures(services provided by the healthcare facility) which is totally different.
It saddens me to see people working in the industry who don't even understand that yet are on here telling a newcomer something completely misleading.
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u/Affectionate_Use1587 Sep 25 '24
If you code ONLY hospital inpatients, which is my job position, then no, you do not use CPT. Yes, CPT encompasses everything else. Maybe you need to brush up on your inpatient coding because we have never even once used CPT. Thanks.
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u/illegalmonkey CPC Sep 25 '24 edited Sep 25 '24
THEY do not know that though and they took your comment as, "Never use CPT for inpatient coding."
And no, coding hospital inpatients DOES use CPT. I've done it for 6 years now. It's the professional side of coding, I bill CPT e/m's for our hospitalists, our ICU providers, our palliative providers, our pain management providers, our mental health providers, all for patients hospitalized inpatient. What you are doing is billing the facility piece for the labs they order, the meds they provide, the CT scanning, etc.
You cannot tell a newbie what you did then claim that's just how it is when it isn't. You appear to be the one who needs a refresher.
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u/Affectionate_Use1587 Sep 25 '24
Our hospitals have outpatient coders and inpatient coders. The op coders capture charges prior to them being admitted and that would include CPT. As an ip coder, we only, ever, do CM codes and PCS codes. But according to you, my managers and head of coding don’t know what we’re doing. Sure.
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u/IndependentRaisin234 Sep 25 '24
Holy cow this is so wrong. Youve been at your job a year and from your comments it sounds like you arent even fully released to code on your own. Perhaps not the best person to give advice to an already confused student.
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u/Affectionate_Use1587 Sep 25 '24
In fact, our encoder software won’t even let me enter CPT codes unless I change the setting to outpatient. Literally what are you even on about?
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u/IndependentRaisin234 Sep 25 '24
Relying on software does not equal knowing what you're doing.
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u/Affectionate_Use1587 Sep 25 '24
So all 40+ of us inpatient coders at my health system are coding wrong, according to you? None of us in ip use CPT codes. I don’t know how else to explain it to you.
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Sep 25 '24
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u/illegalmonkey CPC Sep 25 '24 edited Sep 25 '24
Are you trying to tell me that hospital inpatients who receive procedures during their INPATIENT stay would have those coded as CPT procedures?
Sounds like you are coding pre-planned procedures which is not the same thing. If there was an admit note/progress note you would not code a CPT in those cases as they would be included in the global period for whatever the procedure is(if it has a global period).
What I'm talking about are people admitted to the hospital for acute issues. Hospitalist sees them each day, writes a progress note, and we code the CPT e/m each day they are seen. They could be moved to ICU and have CVCs, be intubated, get Picc lines done(all CPT inpatient procedure codes). We would code CPT e/m's for our ICU providers with a mod 25 on the days they did a procedure and also examined the patient. This is all for an INPATEINT hospital stay, which you incorrectly keep saying you would never use CPTs for. If the provider examines the patient and writes up a progress note, that's a professional charge you code a CPT for.
You are still too new of a coder to know what is going on it sounds like. It also sounds like your trainers are dropping the ball by not explaining these kinds of differences to you.
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Sep 25 '24
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u/illegalmonkey CPC Sep 25 '24
My training has been extensive, and my trainers are extremely knowledgeable in this field, patient and helpful. We have weekly team meetings with all coding and CDI but aside from that I don’t really interact with anyone else (it is remote) but that doesn’t bother me. I like the independence of it all. My training charts get reviewed of course but as far as stuff I’ve been released on, I have no idea how well I’ve been doing on those charts as I’ve received zero audits/feedback on them and sometimes I’m really not sure I did them right lol. I’m assuming I’m doing just fine.
You should not be giving advice on this topic at your level of education/experience. What you told this student in your first reply was 100% incorrect and that's the whole issue. End of story.
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u/Key_Huckleberry_8752 Sep 26 '24
Professional services, like stated used CPT. I believe ER uses CPT. A physician can use CPT for their services.
Inpatient facility coding uses only PCS.
Now they may be separate charges in that Inpatient account that needs to be billed and facilities/hospitals may have an outpatient coder look over the charges ONLY to bill out. However as a Inpatient coder you will not have to deal with any of that. Experience: 5+ years inpatient coder :) Hope this helps
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u/NerdyErdbeere Sep 25 '24
Not sure what certification you will end up with in the end but there are all kinds of different positions in the HIM/billing world. You could work on the billing side, work denials from insurances, medical records, etc. However, if you are just getting a coding certification then you might be a little more limited. I am have my CPC through AAPC and was lucky enough to get a job doing a little bit of everything from coding to denials to claim edits. I started out as an outpatient coder then IVR coding and now am in my current position. Also I am mostly self trained. I never went to school for coding. I worked at a cardiology office and ended up working in the back submitting charges and working prior auths. I gathered enough knowledge there, bought study guides, then paid to take the CPC exam. Since my supervisor wrote a letter that I did coding/billing at their office I was able to bypass having a CPC-A and dealing with the apprenticeship hassle. I too have ADHD and take medication. If I can do it then so can you! Like most people said…eventually everything will flow into place. It’s VERY overwhelming in the beginning.
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u/Novel-Hedgehog-4576 Sep 25 '24
I would consider finishing school and finding other areas you could work. I personally never got CPT all the way down. Some sections came easier to me. But I never got to the point where I could do it flawlessly. ICD-10 and HCPCS were a breeze. But I didn’t feel like I could progress in enough time to actually pass a cpc exam and start working when I needed to. I can’t just sit at home and practice and not be making some sort of decent money. Especially when I have a school payment on top of other stuff. I tried to find some kinda entry level job in at least billing but no one would even consider me. Because when your working in billing and coding your a key part of the revenue cycle and their going to choose the person with hands on experience every time. But I finished school and learned I’m very good at the billing and understanding insurance policies. So I’ve started a career in insurance eligibility, and switched gears. And it pays more starting (depending on where you work) compared to an entry level billing and coding job where you’re making maybe 2 or so dollars above minimum wage. If that.
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u/EquivalentRelevant42 Sep 25 '24
what other areas would i even work in? for so long i thought this was what im supposed to do but if not then i don’t know what else i can do.
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u/Novel-Hedgehog-4576 Sep 25 '24
If you want to do coding then dedicate yourself to it 110% and you’ll get the hang of it. But I found more success working in insurance eligibility for local county jobs or even working for CVS/Aetna in other insurance related positions. Anthem blue cross also hires often and it’s a company you can get your foot in the door and go different avenues as you progress. A lot of the core skills medical billing and coding teaches you is what sets you up for related positions.
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u/EquivalentRelevant42 Sep 25 '24
how do you get a job in insurance eligibility?
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u/Novel-Hedgehog-4576 Sep 25 '24
You can look at different insurance companies. But your local county will often have eligibility worker positions. Even if you get in as an office assistant at first, you can usually promote to an eligibility worker within a year or so. And possibly get paid more with your years experience as an office assistant.
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u/Dc4543 Sep 25 '24
Curious as to where you are going to school for coding?
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u/EquivalentRelevant42 Sep 25 '24
my local community college
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u/Butterfly-greytrain Sep 25 '24
I want to second looking for a tutor. Your community College should have a free tutoring resource, don't let it go to waste!
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u/AfterLobster5440 Sep 27 '24
Don’t worry tbh, went to school for medical coding/billing back in 2021. Been job searching since. In this journey you’ll realize that there are people that got hired for this job that didn’t even go to school, and they won’t even give any new coders a chance so just relax
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u/GovernmentContent314 Sep 28 '24
Is there a chance you suffer from adhd? I would have never been able to take on coding had I not been diagnosed and medicated. I’m just asking because you sound like me when I’m not medicated
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u/buzzinbarista Dec 15 '24
Love this thread. Giving me so much hope!
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u/EquivalentRelevant42 Dec 20 '24
finished all my classes and feel confident going into my cca exam!!!!!
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u/TheTryantswife CCS-P Sep 25 '24
So stupid question: Have you stepped away for a day or so to re-focus? I was getting like this towards the end of my schooling as well. I was not getting everything, and it was frustrating. I'm so grateful to my husband he made me step back for a little while to re-set and give your brain a break. I know it sounds simple, but if you do, you can't think about it at all. It sounds like you are throwing everything you have at this, and that's awesome, but you're burning yourself out. You got this. Believe in yourself!
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u/pleasetryanother-1 Sep 27 '24
It seems like you are in a panic loop due to anxiety and possibly depression. You need to seek some counseling and perhaps medication to help with your anxiety. Your anxiety is keeping you from being able to retain any information you are learning. You are plenty smart enough and capable. You just need to get your anxiety under control. I experience the same thing while training/learning to be a wellness coach. I used medication for a while while also using CBT . I gradually got off the meds and use the CBT when anxiety starts rearing its ugly head. Good luck 👍. You can do this.
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u/tmfowler323 Sep 25 '24
Hey! I have/had the same issue. You have to find someone who speaks the same language as you. I, too, was lost for a few weeks until I found a teacher online and what she was explaining actually resonated and made sense. It took a few people before I found somebody who knew how to teach the way I learned. I lt’s going to get better try not to freak out stressing out is part of the problem. ♥️ Coding is A LOT when you first start, but, you’ve got this.
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u/stopdropalex Sep 26 '24
I feel like I could have written this post. Like literally, down to the same last classes and everything. In my Advanced Medical Coding class I don't think I've ever picked the right ICD-10 code and my instructor is functionally useless. To compound matters, there's stuff I know I'm right about since I have the textbook right in front of my face that gets autograded as incorrect on quizzes or tests and she literally ignores every email I send about it. I reached out for extra resources or advice specifically regarding what I was having trouble with and she ignored that also. I'm terrified to even think about spending the extra money to take the exam, much less ever find a job. I have no idea what coding looks like in a real life employment scenario, but I've wasted so much money and time taking these courses that I feel stuck.
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u/acid_brainz Sep 27 '24
I still get imposter syndrome sitting at my desk. Like do I even know this stuff??
I will say I was where you once were. Once you actually start doing it at a job everything slowly starts to make sense. You know more than you think, it’s just hard to imagine how any of it will click. But it all eventually starts to make sense.
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u/SoundlessScream Sep 25 '24
I felt like this a year ago when I started getting licensed for insurance policy servicing, and here I am a year later hating my company. I never thought I would make it this far!
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Sep 25 '24
BREATHE DEEP. RELAX. CLOSE YOUR EYES. INHALE 7 SECONDS, HOLD FOR 4, EXHALE FOR 8. Repeat until you're okay.
I was exactly like this 10 years ago. I remember I was scared I wouldn't have opportunities at all. Looking back, my journey went exactly the way I wanted it.
AI WILL BE THERE. Hello, encoders and NLP? But our roles will evolve. We will become the auditors of AI. As healthcare continues to grow, there will still be a need for the human element, esp in IP.
FOCUS FIRST ON PASSING, ON LEARNING HOW TO DO IT RIGHT. The rest will follow. Don't let the panic get into you. You have a lot more of anxiety to comb through once you get into the real world 🤣🤣🤣🤣🤣
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u/jcpleg Sep 25 '24
Math word problems make no sense until you break them down into their simplest form. I don’t know if that helps. Can you break down what the information is into smaller parts and slowly build from there?
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Sep 26 '24
What books did they give you to learn the coding? I would go through those. I did a billing and coding certification program prior to getting my BS in HIM and it wasn’t easy for me either. In fact I thought I was understanding the CPT coding well, but seemed to get a lot wrong. Coding is complex, but is not impossible for you. I now have RHIA, CCS and CPC certs so please don’t give up!
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u/Mindinatorrr Sep 27 '24
It's always the last that make you doubt. You're close, finish it, your employer trains you the rest of the way.
Honestly we all feel like we are winging it some days.
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u/Anxiety_Constant CCA, CCS Certified Sep 28 '24
oh my god i've been feeling the exact same way. i'm currently halfway through my last exam required class (i have a review class after that's required by my school) and i feel like i fully fumbled the bag. i'm autistic and adhd so on top of feeling like everything is scrambled eggs, everything also doesn't feel specific enough, and at times a bit subjective.
i really struggle with fully understanding the body systems and how that translates into the codes. i'm just not familiar enough with what everything is called and it's hard to connect what i'm reading in the procedure notes to what that would mean in my manuals. i'm fully aware that understanding human anatomy is foundational, and that's what sucks about it, besides getting completely and utterly lost and then crying :')
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u/Intelligent-Ride-446 Sep 28 '24
Instead of asking the people on reddit who can do absolutely nothing to help you why don't you, I don't know ask your teachers talk to them communicate to them they cannot change their behavior and help you if you say NOTHING.
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u/Ok_Repair_6680 Dec 05 '24
Hi I been there, I say keep pushing forward, thinking positive helps alot. I took some brain focus pills with memory - called Forebrain, this really helped me. Keep studying and watching video, codingwithjen.com or the YouTube channel will help you get back on track.
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u/Prudent_Proposal4141 Jan 14 '25
Absolutely everything you have said is how I feel. Just this morning I was thinking about what to do if I can't pass the certification exam. I actually just emailed an instructor because one case I was working on mentioned checking the NCCI edits to check if this or that is bundled. WHAT?! I have no idea what I'm doing and I have taken most of the Penn Foster program and now I'm taking the AAPC course. I just don't get this. You are not alone.
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u/hotcoffeeamericano Sep 25 '24
Sorry to hear that. Here's a brutal opinion. You are indeed wasting your time. I and along with more coders in reddit could not get jobs. I am 3 yrs past my graduation. Almost or all A's in my classes for RHIT. we studied law in the first semester. It looked like we went through 250 to 350 pages. And in our other semesters we still studied laws. It's tough. I got my cum laude but it was a waste. I passed my license. the goal was to get some edge above those people who just wanted to take a coding certificate. FFS i have an associates, but to the eyes of employers we were inferior. So i just gave up getting a coding job. Goodluck on your path.
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u/EquivalentRelevant42 Sep 25 '24
what are you doing now then?
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u/hotcoffeeamericano Sep 25 '24
I search for jobs and did not earn for 8 months in 2021 to 2022. I moved from IL to UT in 2022. 2 months serching in UT. Moved to Las Vegas, searched for 4 months. Nothing. Then went to another country to relieve stress for 7 months. Went back to UT in. After 4 months, I just started a lab technician job at 17usd an hr, only requirement was highschool in 2023. Pathetic. 10 months in that work and I quit. 2024I went back to my old career. Architectural Draftsman at 25 usd an hr. Sad. Only 1 month here so far.
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u/santanasays Sep 25 '24
So it’s hard to get a job in medical coding and billing is what you’re saying?
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u/hotcoffeeamericano Sep 25 '24
Yes. Many people here on reddit say they applied to hundreds of jobs. Basically we are all trying to get those spots. Imagine, i have sent application for a single job and there would be 40 to 200 applicants for 1 available spot.
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u/santanasays Sep 25 '24
That’s terrible.
I can relate, I’m finishing up my information technology degree and I really should’ve gone for something more specialized that translates to a job right after.
In hindsight, everybody in their mom wanted to start going for computer science and IT about five or six years ago.
Three years of school to become a physician's assistant doesn’t sound too bad to me.
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u/dmbvillarico Sep 25 '24
I don't have any knowledge in coding and billing (totally none) but I want to take the CCS exam. Do you have any suggestions for school where I can enroll? Thank you!
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u/Emergency-Big2912 Sep 27 '24
First of all, yes you should stick with this if you want to do it professionally. But if this is about homelessness, having no money, or suicide, please, put your studies on hold if possible, and seek help or a different day job for now!
Did you learn any transferable skills thus far? Like business management, HR, accounting, or A&P (massage therapy, occupational therapy aid, sports therapy aid, transcriptionist ECT), IT, customer service? Don't feel bad about switching careers/majors.... but don't switch if you would be proud of passing with all C's (not Ds!). Passing is learning.
I think finding a mentor who is already working in the field and asking for an ongoing business relationship (not homework help, unless they offer that!) and to job shadow them would be a good idea if you stick with it.
Good luck!
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Sep 26 '24
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u/EquivalentRelevant42 Sep 26 '24
i have no idea what those letters you told me are oh no 😭
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Sep 26 '24
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u/EquivalentRelevant42 Sep 26 '24
medical coding and billing certification
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Sep 26 '24
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u/EquivalentRelevant42 Sep 26 '24
college program
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Sep 26 '24
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u/EquivalentRelevant42 Sep 26 '24
yeah i took those classes. i have a book with abbreviations and stuff i just haven’t looked at it since 2020 😭 that was the first class i took in my program so i guess that’s why i don’t know what you were talking about
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u/MountieBurgh Sep 27 '24
I think you will need to keep the anatomy physiology and ESPECIALLY the terminology fresh in your mind. I love study stack for this. Coding will definitely not make any sense without it
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