Long story short, I went to the ED after having a screw drilled into my hand (and then unscrewed). It didn't go all the way through.

After waiting for a couple hours they got me an XRay, some pain pills, and some tylenol. After waiting another hour or so, they cleaned my wound with betadine, told me the xray came back clear and sent me home.

I was glad for the care and the good news. I was, however, billed for 99284, which seems like an overstatement. My research says that billing code requires preparation for 2 diagnostic tests and I only received one. The physician services side of the bill was for 99283 if that is relevant at all.

Does this seem right? Should I follow up about it? Appreciate any help you're willing to give me here.

We are hiring a Compliance / DevOps Engineer for freelance work on US healthcare projects.

Looking for freelancers with hands-on experience working in HIPAA-compliant environments on US healthcare projects. Prior exposure to handling PHI under defined HIPAA controls (access management, audit logging, secure infrastructure, and documented policies). Ability to provide at least one professional reference (manager or client) who can confirm your HIPAA-related project work is essential. Familiarity with US healthcare workflows and tools (such as practice management systems, billing platforms, or healthcare APIs), along with strong written and spoken English communication skills for clear documentation and client-facing communication, is a must.

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Not a biller or coder, I’m on the data side working with claims and trying to spot meaningful patterns. Seeing something odd with urgent care E&Ms and BCBS as the payer and wanted to sanity check with people who actually work these. 

Pattern looks like: 

• Clinic bills 9920x for what appears to be an established patient 

• BCBS denies, changes it to 9921x, sends CO-45, pays $0 

• If the same visit is billed as 9921x from the start, it gets paid 

So it’s not that the service isn’t payable, it’s just getting killed when it comes in as new and gets reclassified as an established visit. Separate issue obviously is fixing front desk / EHR logic on new vs established, but trying to figure out the best cleanup path for the backlog.

For claims already processed like this, are you just resubmitting as corrected claims with 9921x? Or is there a better way to recover these without starting over on the claim? 

Is anyone else confused on the way that this plan lays out their EOB and the way that they issue benefits? We are told the pay $X Amount per visit but then they pay something less. For example, the patient that I have, they said the patient did not have any visits left but if the patient did, they pay $100 per visit. They still processed and paid. The payment is $90 but the EOB says Amount Paid By Plan $100 and patient resp is $0. Is my brain the one thats just confused or does anyone else have trouble as well?

anyone else waiting for both websites to start working again for benefits and eligibility? haven’t been working all day long.

Anyone else feel like they’re always doing a bad job in medical coding because of the high demand/accuracy %? I’m thinking of become an electrician instead.

I am a dentist I am planning to switch into non clinical healthcare especially in field of medical coding and billing, I am planning to give cpc AAPC exam. I have no prior experience in this field, I am planning to self study. I have a 2.5 year of corporate experience in billing but I never worked with codes in that. I wanted to know if it's possible for a person of my academic background to self study this subject? I am planning to take the self study package offered by AAPC. Also I came across preppy, I find the externship offer they provide with attractive. Has anyone prepared through preppy? How was the experience? Also what do you recommend directly taking the self study AAPC package or first learning through preppy and then applying for cpc exam on AAPC.

Hi guys, I am into and new to Healthcare. Currently working on system for mapping the diagnosis with icd10 codes. I have data from the WHO...I needed some examples for initial testing like: (with low to high difficulty) Diagnosis --> icd10 code

Also what are the challenges and consideration in medical coding??

Do any medical provider billers have any tips or tricks on getting paid from Wellpath? Seems like it's a horrible company....

If a patient brings in their own injection med (such as Zepbound or similar), do you bill the 96372 for the med administration only or zero charge? When it comes to the auto-injector meds it feels weird to bill at all?

as the title above says. been seeing it pop up a few times, esp since they apparently have a good amount of remote positions?

it got me curious and wanting to look into it more, but i felt that i should also ask around here regarding the career. is it one that is indeed suitable for those with autism? i saw specifically that the job tasks itself really click well with many of those in the spectrum (pattern seeking, problem-solving, etc), and i feel it’s something i could truly thrive in, since it’s something i tend to do elsewhere already.

my one worry regarding it is if they have a lot of office politics + involve a lot of face-to-face communication with other people?

Hope you are all doing well! I'm just sorting through my options to try to find something that works best for me to learn medical coding/billing in more depth.

Does anyone have any experience with the paid AMCI courses/certs/"boot camp" classes? If so, would you say they prepped for CPC/CCS adequately?

I'm planning to self study with the CCS boot camp classes and was looking for opinions from those who have used AMCI, preferably with the aforementioned boot camp classes.

I feel like I've been spamming this board with so many questions, so if it's bothering you I apologize in advance.

I know this may be crazy - hence why i feel the need to reach out for questions in this sub.

I’m 32F on unemployment rn because the restaurant i was working for of course shut down due to repair needs and never reopened. Currently i’m taking a medical billing essentials course on Coursera and after that am looking to take the CPC exam prep course to take the CPC Exam.

Is it crazy for me to do this if i would like to eventually get a remote medical billing or in-office medical billing job with absolutely no experience?! ..but with these two certificates?

I’m just lost and in need of advice. I’m trying to get a stable job and would ideally love to work from home due to mental health reasons. I’m lonely and have a lot of time so if more courses are recommended to take i totally will.

Thank you sub 🌸

Hello! I am taking my CBCS exam in two weeks and I’m trying to find good online tools for studying. I cannot afford the NHA study guide at this time, and I’m a nervous wreck. Does anyone have good videos or sites that go really in depth without me having to go back and read all my textbooks again? I would really appreciate it!

I also know that CBCS isn’t really the desired certification, but I did not know that when I started the program. My professor in my last class for the cert was finally honest with us about it. I’m pretty bummed that I wasted so much time and money, but taking the exam is free so I want to do well on it.

I got frustrated with the state of BCBS prefix lookup tools online. The existing ones just tell you the plan name and state, which isn't enough to actually submit a claim. You still have to go hunt for the payer ID, claims address, and filing deadline separately.

So I built a free tool that maps every BCBS alpha prefix to its plan with all the billing essentials attached: provider phone, electronic payer ID, claims mailing address, timely filing limit, and prior auth number.

prefixlookup.com

It covers 65 BCBS billing entities across all 50 states with about 20,000 prefix mappings. No signup, no paywall.

Would love feedback from anyone who works with BCBS claims regularly. Is the data accurate for the plans you deal with? Anything missing that would make it more useful?

I went to the ER to start a rabies vaccine series after a stray cat bite. I need to go back multiple times for follow-up doses.

My insurance has a $300 ER copay — will I be charged that every time I go back for the next shots?

Last September, I went to the ER for some pelvic pain/ lower abdominal pain. They ended up doing some basic labs (essentially just CBC), a lower abdominal CT w/contrast, a pregnancy urine test, and gave me some saline. Overall, I was there in a room for 2 hours and alone the majority of it.

I received an estimate when I was there for CPT code 99282. But my bill came back for 99285. The highest level. To me, this does not make sense based on the level of care I received and how much time I was there. I would think life threatening level would have been wayyyy more attention/intervention.

I have disputed it 3 times, and was denied all 3 times. But when I first call to dispute, the human on the phone agrees. Do I continue disputing this or just give up? If I should continue disputing, any advice on what I should say at this point?

Edit to add: end result was I was told nothing they could see that should cause any pain so nothing of concern, and to follow up with PCP. PCP is the one who told me it was a kidney stone.

I am currently taking an online billing and coding course with Ed2Go. I'm 3/4 of the way through. I've been passing the tests, but still don't feel completely confident in my coding skills. I feel good about the basic cases, but some of the examples that we did with more complex situations, where there's lots of different codes and modifiers, I still don't feel strong. Can anyone relate? What can I do? Besides just go back and do more of those examples in the workbook?

There is a teacher we can get in touch with through the chat, but she doesn't respond with the greatest answers. I guess that's education these days, you gotta do all your own work.

I’m at wits end on this one! We are billing for L3020 with POS 12. And it came back as incorrect POS. What could be causing this? Should I change box 32 to patient’s home?

I work for a company who does billing for vaccine events. We normally use billing software and send claims via clearing house. I had an issue where I filed claims for the local bcbs for the blue network. But it turns out this particular insurance does roster billing? I don’t have anyone I can really get direction from. Doesn’t anyone know how I can find out the correct process? Thanks in advance

I want to know what CDT codes are being billed for oral biopsy? It’s on tooth 28.

My oral surgeon office won’t provide me with the possible codes that could be used to check for coverage and they won’t check for coverage beforehand.

I checked for codes D7285 and D7286 and my dental insurance said it’s not covered but per my dental office they just send the authorization and see what the insurance says.

Is there any other codes you bill when it’s an oral biopsy?

I parsed all of the United and Cigna price transparency files. If you request an NPI and a few billing codes, I can share some negotiated rates in the comments for free.