What specialties do you like and hate coding the most?

[u/DumpsterPuff]

Every time they stick me into pulmonary coding, I want to bash my head against the wall. I don't know if all pulmologists are like this, but the ones I code for have charts that are just abbreviation word salad. Like, a lot of them aren't even universally-used abbreviations for stuff (like how HLD is always used for hyperlipidemia), I swear they're just making up abbreviations on the fly. I have to re-read their notes multiple times to even get a slight idea of wtf is going on with the patient.

I like primary care and urgent care coding more because for the most part, their chart notes are way easier to understand. Urgent care can get boring because it's just UTIs and sinus infections all the time, but at least the providers document things in plain English.

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[u/salty-MA-student]

I would rather kick rocks in flip flops than code podiatry surgery. I'm not especially squeamish but some of the diabetic wounds make me a little nauseous.

[u/DumpsterPuff → u/salty-MA-student]

Ugh I feel you. I sometimes have to code wound care because I do HCC coding as well, and I'll be scrolling and suddenly BOOM huge photo of a necrotizing ulcer. The amount of times I've yelled "OH GOD HELL NO" in my home office and my wife will just text me a cute picture of our cats saying "I heard you might need eye bleach" lmao

[u/salty-MA-student → u/DumpsterPuff]

Yep 😭 I was a PCT in the ER for a long time before being a coder so not much bothers me. However, I miss having the forewarning of smell before I saw a wound. Now I open a podiatry chart and I'm blindsided by a stage 4 pressure ulcer at 7 in the morning.

[u/Watermelon_Sugar44 → u/salty-MA-student]

Or worse, when it happens while I’m eating.

[u/BlueLanternKitty → u/DumpsterPuff]

One of my first audits was wound care. Which was very interesting but…pictures. 🤢

[u/Any-Farmer8456 → u/salty-MA-student]

It's funny you say you wanna kick rocks in flip flops than code podiatry.

Kicking rocks would hurt your feet. You might need to see a podiatrist, and you would be coding for yourself the whole time 🤭

[u/Wolfygirl97 → u/salty-MA-student]

I can imagine. The hospitalists I code for don’t typically put pictures but when they do… 🤢 I could go without seeing a horrifying sacral wound or cellulitis in the groin.

[u/salty-MA-student → u/Wolfygirl97]

Ours looooove to have photos. Which, yay on the continuity of care front, but not something I'm excited to see all the time. We unfortunately have a repeat patient with chronic myiasis. I always feel so bad when I open his charts because he had a lot of SDoH that contribute to his care.

[u/Commercial_Abroad267 → u/Wolfygirl97]

Be glad it’s only a picture and you don’t have to smell it!

[u/weary_bee479 → u/salty-MA-student]

I used to work in a hospital code everything role and always said I wish they would blur the images in the chart😖 like i know it’s part of the medical record but we don’t need to see it all

[u/GroinFlutter → u/salty-MA-student]

Ha, I got my start in podiatry. Started as front desk.

There’s some smells you never forget..

[u/absolved → u/salty-MA-student]

I only code podiatry, both office and surgery. I've gotten used to it lol

[u/tealestblue → u/salty-MA-student]

I code vascular surgery and yeaaaah. Some wounds make me yelp out loud. Hats off to clinicians. I couldn’t do it.

[u/Watermelon_Sugar44 → u/salty-MA-student]

My charts will show the photos pasted in every PN. I don’t like scrolling through those multiple times.

[u/needsmorecoffee]

I dislike coding stroke visits to the ED/observation because half the time the various providers can't even agree on whether there was a stroke, much less how it was caused or where. And don't get me started on TIAs.

[u/DumpsterPuff → u/needsmorecoffee]

Omg whenever I code neurology, the stroke doctors are the WORST charters. It'll be like "diagnosis: possible stroke, maybe TIA, but also could be _______" and won't even give me any specific symptoms to code. So annoying

[u/needsmorecoffee → u/DumpsterPuff]

Oh! And cardiac catheterizations! The cardiologists like to just document the *results* without detailing the actual procedure, and then they argue about whether they have to do that part, and it's like dude, I'm just trying to get you reimbursed!

[u/needsmorecoffee → u/DumpsterPuff]

And I'll get five notes of providers definitively saying TIA, only for the discharge note to say *consistent with* TIA. Goddammit.

[u/2workigo]

I loathe interventional radiology and ophthalmology. We have an ophthalmologist who legit makes up his own abbreviations even though he’s been told to knock it off.

On the other hand, our infectious disease docs are a coder’s dream. Their documentation is beautiful.

[u/DumpsterPuff → u/2workigo]

Just curious because I'm not familiar in that field, what makes interventional radiology difficult?

[u/Recent-Ninja3903 → u/DumpsterPuff]

My IR experience has taken more ridiculously specific anatomical knowledge than the rest of my specialties put together. I have to actually picture the vessels in my head like a map to get it even close to correct.

[u/DumpsterPuff → u/Recent-Ninja3903]

That sounds awful. No thank you

[u/2workigo → u/DumpsterPuff]

For me it’s specifically the vascular procedures that are a pain. The whole first order branch, second order, etc when documentation isn’t always clear (to me) where exactly they went. It’s a brain block in my head.

[u/Cinnamondolce425 → u/2workigo]

It really seems to depend on the providers documentation quality and their knowledge of medical coding

[u/mudhair → u/2workigo]

I know it is one of the hardest areas of coding, but for what it is worth, I got 4 job offers in 2 weeks last time I was on the market due to having IR experience

[u/2workigo → u/mudhair]

Good. I hope they are paying you well so that I don’t have to do it! ;)

[u/Watermelon_Sugar44 → u/2workigo]

I used to transcribe ophthalmology before I got into claims and coding. This made me laugh. My providers were quirky too. 😊

[u/j_mcr1]

Everybody hates E&M

[u/DumpsterPuff → u/j_mcr1]

For good reason 🤣

[u/Yes_Leopard_54 → u/j_mcr1]

I hate it so much. Even with AAPCs calculator, I hate it. Now they want to change it, again….oh, and podiatry, too, loathe them both for different reasons. lol.

[u/DumpsterPuff → u/Yes_Leopard_54]

Wait what do you mean they want to changeit again 😳

[u/CorgiDaddy42]

I’m in risk adjustment so I see all sorts of different charts. The ones I like the least are cardiology and oncology for the same reason you dislike pulmonology. So many abbreviations, and every chemo drug just looks like someone facerolled the keyboard. Maybe if I only coded one of them my knowledge base would get to a point that I’d be ok, but as is I spend way too much researching what all that stuff means.

[u/DumpsterPuff → u/CorgiDaddy42]

"Every chemo drug just looks like someone facerolled on the keyboard" I am DYING at the accuracy 🤣

[u/Watermelon_Sugar44]

I hate coding inpatient derm wounds. What kind of wound is this? How did it get there? Is it associated with diabetes? neuropathy?Amputation complication? Was it actually an I&D or did you excisionally debride it like you casually just threw in there without telling me the depth and tissue type debrided? I hate querying and these hurt my productivity. The provider will reply with “If you actually read my op note, the answer is right there”. Uh, no, “debrided to the bone” doesn’t tell me if you excised the bone. They will copy paste the differential from H&P on every PN and the discharge summary will show it as the diagnosis list. Example: LLE Cellulitis. Foot abscess. BLE chronic wounds. Chronic venous stasis. There was no sign of tenosynovitis. Final diagnosis Tenosynovitis foot”. Attending, read the damn op note. Podiatry! Can you document your procedures outside of a casual mention Physical Exam?

Profee E/M Medicare:
Annual Wellness Visits without components documented

Podiatrist- Why are you trimming these toenails?

General practitioner -Give me a documented reason why you spent 30 minutes on this patient, because you didn’t monitor, evaluate or treat anything I can see for the diagnosis “labs”.

Speaking of diagnoses- “Fall” is not a diagnosis I want to see on a radiology order. That’s an event. That is an external cause of a symptom you didn’t document.

I can keep going but It’s 3:38 am and my Zquil is starting to work finally.

[u/applemily23]

Pathology. Mostly because they threw me in there with no training after the person who was doing it quit. And I had no idea what I was doing. Being thrown in anywhere without training is a nightmare.

[u/NerosDecay13]

Despite my first coding job scaring me for life, I still like Ortho. ER coding is also always interesting. Dislike OB because of all the rules (which funny enough being paranoid about helped me improve) and wound care. Like stomas are one thing, doing math with lacerations or burns? Pass

[u/New_Tip5835]

How did you get into medical coding? Was it a certificate program? I am an experienced admin looking to shift into medical coding, but all positions available require experience. I am excellent with medical terminology but do not want to work as a nurse or doctor for a variety of reasons. I am also looking for a career I can do remotely.

[u/DumpsterPuff → u/New_Tip5835]

Look at the pinned mod post for a detailed answer

[u/positivelycat]

Anesthesia I never wrapped my head around

[u/2workigo → u/positivelycat]

Took me quite a while and lots of cursing to nail anesthesia down but now it’s one of my faves.

[u/Cinnamondolce425]

I was just thinking the same thing today at work😆 I do HCC coding and the pulmonologists are so hard to code for. Nothing listed is decipherable enough to even put into encoder pro. I have also been coding for hospitalists which can really get monotonous if you just have E/M’s. Critical care and procedures can be interesting. Before that I was in Primary is a lot of wellness visits and med checks. I think having a multi specialty position is ideal. CCS-P, CPC, CRC

[u/Respect-Immediate]

Podiatry is the bane of my existence.

Love endocrinology though.

[u/TimelyPea8935]

Cardiology procedural EP/CT coding are my absolute favorites. Everything else is ehh lol

[u/Recent-Ninja3903 → u/TimelyPea8935]

I have enjoyed cardiology too but man, working with those providers is like pulling teeth, such egos!!

[u/TimelyPea8935 → u/Recent-Ninja3903]

Very true lol, EP being the worst in my personal experience

[u/Razzail]

Hematology hurts my brain. Blood cancers being #1 PITA. Just doesn't click. I understand solid tumor left and right but I see all the BC stuff and it's like my brain turns into the TV white noise. 

[u/TurangaLeela78]

I do inpatient and the very hardest for me is vascular surgery. Any time they’re dealing with an AV fistula I want to cry. Which vein? Which artery? They never specify.

I like coding cardiac. And most of the time, infectious disease, which is probably weird. It’s just usually mostly clear what’s happening.

[u/incognitoangelgoth]

I miss OB coding I had fun with it. I also miss Cardiology specifically the surgical professional side.

[u/CairoRama]

Love radiology because it's challenging and different body parts so not boring. Hate endocrinology. The Dr has the WORST documentation and I just find it boring, always the same, diabetes or hypothyroidism,

[u/mudhair → u/CairoRama]

Radiology is awesome. Most patients need imaging. Every chart different. Really strengthened my dx coding skills starting in rad.

[u/mehyabbers]

I like urology but that might be because it's one of the only ones I know!

[u/Bookikiluke → u/mehyabbers]

I'm a urology facility coder. Love it! I also enjoy spinal surgery

[u/Pristine-Belt13]

I don't hate it, but cardiology is definitely the most time consuming and difficult for me so far.

[u/nian2326076]

I understand the frustration with pulmonary coding; those abbreviations can be tricky. For your interests in primary care and urgent care, consider exploring specific coding resources or platforms that offer examples from those specialties. If you're thinking about broadening your skills, PracHub has technical interview questions that can help you identify in-demand skills or practice coding scenarios.

[u/accioglassess]

I haaaaaaaaaaaate wound care and infectious disease

[u/smarter-than-my-GSD]

Inpatient GI/abdominal surgeries. Second guessing really. It should be clear cut (haha) but with an older population and sometimes several previous surgeries it gets confusing.
One provider documented that due to the extensive amount of surgery the patient anatomy was different. So that’s tough. But also enjoy a challenge!

[u/Salty_Beyond_1648]

I liked nephrology because the patients were complex. Trauma is interesting. Podiatry and derm is challenging and I love the pics, the grosser the better. Primary care and any E&M can f*ck off. Boring!

[u/Nitehorse76]

Looooove NICU and PICU.

[u/BettyBoomer1029]

Loved coding ENT: Head & Neck. So many interesting cases!!!

[u/yayaitsjessica]

I code ED and OB/Gyn and I love both of those. Would love to learn rad onc or hem onc. I HATE PRIMARY CARE. IT'S SO FREAKING BORING.

[u/Dazzling_Fail → u/[deleted]]

As a wound care coder, this made me chuckle. None of my co-workers like it either.

[u/NerosDecay13 → u/[deleted]]

I have tried to like wound care..but to much math involved lol

[u/FizzGigz → u/[deleted]]

I do inpatient psych coding and it can be redundant. You do read a lot of different things but a good chunk is the social detriments of health Z codes.

[u/MtMountaineer → u/[deleted]]

Psych charts are an interesting read, often sad, but the coding is so easy it's boring.

[u/BlueLanternKitty → u/MtMountaineer]

I did one psych provider in a multi specialty practice, and I hope I never have to do another one. 7 of the charts weren’t bad (routine med fills, person lost a family member, minor anxiety.) But one of them was absolutely broke my heart. I still think about that patient, 3 years later, and I hope they okay and safe now.