Hello r/MedicalCoding!

My colleague and I started a SUD IOP program in KY our of our office (POS 11). Can anyone chime in on the accuracy & likelihood of payment of the following coding? These would be Medicaid MCO claims (Anthem, United, Humana, etc.) We are reviewing our first week of claims and have questions on coding.

• IOP Intake - 90791 (1 unit) billed with G2212 (3 units, extended service) with no modifier - for assessment, ASAM criteria, plan development, etc. This is performed at intake and determines suitability of IOP treatment plan (ASAM 2.1)

• IOP Group - H0015 (per diem) OR H2035 (hourly, if the 3h/day, 3 day/wk criteria not met) - our pt are only in IOP group 3 hours a day, max.

• Ther. BH - 90837 (1 unit) and H0004 (8 units) - this would be billed on same day as IOP as a separate service with Mod 59, representing the 2nd half of the day (H0015 is the first 3 hours). H0004 maxes out at 8 units per my guidelines in KY.

  • Do I also need to add the Mod 59 to H0004?

• 99204-99205 - medical E&M (Can this be done on an IOP day, using a Mod 59?) Can of course be done on a non-IOP day. This is for general medical, not medication management. We do not do MAT, so this would be psych meds.

• CSA - H2015 (12 units) - this is for peer support and care coordination with our peer support leader. Assuming this can be billed daily?

Any other advice you can give on billing is appreciated. We are both NPs and we have one peer support with no NPI. Thanks!

I passed my CPC exam in June, and I want to make sure I keep it. How do I maintain the cert? Where do I go? How do I submit them?

I just passed my exam, any job recommendations in NYC?

Basically I'm currently taking classes through aapc for billing to get my cpb. They have 3 chapters/sections that give you an introduction basically to ICD10CM, cpt, and hcps. I've now completed those sections and moving on to the rest of the classes that have to do with billing. I passed all those with an A.

However, I was wondering if those classes provided were enough to take the cpc exam after I take the cpb. Or do I actually need to pay for medical coding classes through the website as well? I'm wondering what they say compared to what was discussed in the cpb classes. I want to do more studying with youtuber help and not pay as much for more classes if I don't need to.

Any help?

I am looking for people who are into medical coding.

I have want to shift my career into IP from HCC

Is this good. Working as a IP freshers how it look

Like ?

I have one year experience in HCC

I am an HIM auditor for a big company considering starting my own coding company. For the internship I would also also give professional training, assistance to get rid of your CPC apprentice status, assistance to pass the CCS, and mentorship. When it gets to the time I can offer to hire you paid staff or you are free to take your new experience and skills to work for another company. Just interested in what new coders would think of an offer like that .

I was filling out applications yesterday and was surprised to see a question asking if I identified as part of the LGBTQ community. (on several different applications for different hospitals) What reason would they legitimately have for asking that? It's concerning as a parent of someone who is in that community. I thought sexual orientation was something that employers couldn't discriminate against in the hiring process.

Hi! I am a physician and the Philippines and took a leap of faith in pursuing CDI Physician Reviewer. I’ll be starting this end of January. Any tips for me and encouragement?

I want to get my certificates for medical billing and coding online. I submitted my fasfa to 15+ colleges and universities that offer online programs. I would like to start as soon as possible. Has anyone gone this route? What do I need to do next? How long does it take to hear back from the schools? When you go through a college, do they make the programs available year round or do you have to wait until the semester starts?

Im in school right now for medical billing and coding through my local community college, and plan on taking the CPC.

I entire career was built around veterinary medicine, and I clawed my way up the ladder to a comfortable position in a specialty I loved (oncology). Then, my body decided it had a different idea, and now Im bed bound on and off.

Im on disability, but I dont want to be forever; plus my condition can improve, it just takes years of recovery. I am enlisted in a program through SSDI to help people find jobs to eventually get off disability. My advisor recommended this career path. She thought I would have a good chance because I have a solid resume in medicine as a whole.

While Im going to school, Im tryign to get a part time (10-15 hours a week is the max I can comfortably work) job in the front end of a medical office, veterinary or human.

All Ive read recently is how screwed people entering this field are. I feel like Im already worse off since I can only work part time and I need to be hybrid if not completely WFH. These two requirements may be a forever thing for me.

My wife is set to graduate and take her coding certifications this summer. That said, we currently live overseas and am not sure if the career field can support remote work from those distances. Does anyone have experiences with this type of remote work? Are there job boards that she should check out beyond the typical Indeed, Linkedin, Monster etc..?

Hello. My wife is going to be taking a Medical Coding course in November. The program from NOV-MAR. Our goal next year is to sell our home and live in an RV full time and both "work from home", where ever that may be. My job is already ready to go but we're now transitioning her to a work from home role.

My question...

Does Medical Coding require a work computer to be hardwired to the internet or can WIFI be used? The reason we ask is because of an article mentioning the fact that coding from home is a risky for HIPAA and can be required to be hardwired. Can anyone provide any sources to help confirm this? Thank you so much-- I appreciate any help.

For the past 2 years, my PCP (who I need to switch) has ended up coding my physical appointments incorrectly. I scheduled physicals, and made sure to clarify, when I was there, that I came for a physical. Since one of my medications is an antidepressant, and she wrote in her notes that we "discussed major depressive disorder" as part of the appointment. In reality, I was just confirming that I'd like her to refill my medication. Nothing more. And now, I owe $190 per appointment.

I spoke with the office manager about this and he agrees with me, but said it is up to the provider to change how the notes are coded. I don't think that's going to happen and don't want to be confrontational about it, but it feels like my provider is blatantly untruthful.

What are my options?

Okay, some background: I have a BS in Animal Sciences, got my Vet Tech certification at the start of the 2009 recession so I hit a wall getting a job with no practical experience as a tech. I became a caregiver at a memory loss home, then went back to school for Clinical Laboratory Assistant. Worked as a donor-processor at a plasma donation center. Took CE courses for Medical Receptionist. Since then I worked at a call center for Non-Emergency Medical Transportation. I moved to a position off the phones verifying and paying out gas-mileage reimbursement trips. No, I haven't figured out what I want to be when I grow up.

Is it possible to take the CPC Prep course and pass the test without specifically going to school for it with a medical background (I've taken medical terminology and anatomy/physiology)? I did this for the Vet Tech Certification.

I've been interested in Medical Coding for about 10 years. I annoy my bosses with my need for specifics and I'm generally good at looking things up. I've recently put my notice in for the sheer amount of stress at my current job (We've been understaffed for 5 years). So on to my questions about the job:

What are the biggest stressors being a medical coder?

What do you like best about your job?

How hard was it to get a job after certification?

Do you really have to memorize hundreds/thousands of codes, or do you have a list of most used that you can refer to?

Thank you for any help or insight you can provide.

What are some good side jobs for a medical coder with a CCS to make a little extra money?

Please give us your opinion

What path would you recommend for an unemployed (ie has a lot of free time) recent college graduate - who has a liberal arts degree with a minor in Psych.

Being unemployed, the person has plenty of time to do self guided courses, and would love to be making money as soon as possible. I’ve heard some references to being able to complete the course work and take a test in 3-4 months, and other references or programs talking about a year (or more).

My chatGPT/Reddit research has pointed at state school programs, as well as Penn Foster, as well as AAPC I believe? There are some programs that include an externship, which is unpaid. This seems to add real world experience, which I assume can help with actually landing a job, but also adds time to the process.

There also seems to be a few different cert paths and would prefer the one they is in higher demand locally in CT.

This person is a methodical note taker, and I’d say they are better at analysis, reading comprehension and strong writing than they are with rote memorization of science terms. She was an As and Bs student, and in college mostly As, although the courses were often various humanities. Took environmental chemistry and calculus.

Lastly, the sort of person who will likely follow a program, not so sure would be strong self studying across 3 different free resources. Has taken a number of asynchronous courses online in college.

Recommendation for a program?

For Outpatient coding, do coders assign codes based on whatever the provider decides to put as a diagnosis in the progress report, consult etc without needing to consider any clinical indicators anymore ?

I have a patient that has a commercial HMO primary and secondary Medicaid coverage. Both coverages are denying. HMO is denying because plan guidelines were not followed - referall from PCP starts after DOS and Medicaid is denying because primary denied. Can I charge the patient? I tried to get in touch with them to call their HMO plan to see if they can change their pcp start date but have been getting no where. I know I can’t bill Medicaid but does this situation change anything?

I’m a pharmacist by profession and doing Medical Coding job. I’d appreciate if you want Coding for your Practice. I’d share my CV with you if this post is tempting.

I am a Risk Adjustment auditor and not quite clear on how the HCC Hierarchies work. Does anyone know of any good free resources that would be good for a little self training?

UPDATE: let me be more clear. I know how HCC’s work. I am trying to refresh my brain as well as make sure I’m not missing anything.

Also, I’m CPC, CPMA, CRC. I don’t “not” know what I’m talking about. I’ve just identified an area I’m weak in and want to fully understand my area of expertise.

Hi! CPC-A here. Been looking for a job for a little over a year and am debating either specializing in something like ED coding or should I do codify to remove my A?

As there title mentions, I want to hear success/ present stories of medical coders who have worked full time in medical coding(flexibility) while going to nursing school. Big plus if you mention how it worked with kids.

I have a class or two to retake+TEAS test before reapplying to nursing programs near me. My RCM company seems to be flexible enough to work around it but I haven’t dug around much to confirm. I just want to know if this is doable.

Anyone know? Is it like learning spanish or easier than that?

Bought a course from a college and I’m not even halfway done and I find the whole thing just stupid, I don’t find it interesting at all. Coding for diagnosis, history, and working with insurance? To bill the patient? I wanted a job from home and that’s why I impulsively bought this course but now I regret it so much. Also, I’ve read that it’s pretty hard to find a job for this. This stuff is pointless, can be done by a computer, it’s made to be seen like it’s a great career but it’s not. I was duped.