# Are You Ready for Real-world Coding?



## LadyRenee (Apr 23, 2017)

I don't feel ready for real-world coding. I passed the CPC exam last month and I'm doing Practicode now. My scores are all over the place. Medical coding is a long-term goal and a stepping stone for me to start a medical billing company after I retire in a few years. When I feel "proficient" at coding, I want to get a part-time coding job to pay off the outstanding balance on my credit card for the course and to save towards taking the medical billing course, and start-up money.

I see a lot of people posting that they've just gotten certified and are looking for a job. They must be really smart, or studied really hard.  There is no way I feel ready to walk into any door and ask for a coding job. I know my skills aren't there; there are a lot of little things that I miss in Practicode, like assigning status codes where needed. I've completed 63 exercises out of 600 so far, and my percentage is still hovering just a bit north of 70. Not exactly bragging rights. Thank God I have a full-time career job, with a long range goal in mind for coding, otherwise, I'd be panicked right about now. 

Just based on my personal, honest assessment of where I am, I'm thinking like an employer, and I wouldn't hire me.  This field takes practice and practice takes time. 

Sometimes I go through posts just to read the thoughts of others and to learn from others. I'm always impressed by coders who know the answers to coding questions and help others out. These ladies and gents have earned their stripes. Brag on! I want to be like them one day. So I keep on practicing in Practicode, hoping eventually that all the basics will stick and I'll be ready to tackle the real world of coding when I'm ready to start looking for a PT gig.

I feel that the AAPC online learning course did not prepare me to be proficient, rather, it prepared me to just pass the certification by a few points above what was necessary. So I wonder if the broader view (among employers and AAPC students) is similar to mine. What do you think? After your training, do you feel ready to code on your own?

I'd like to open up a discussion here to talk about the realities of coding, like how long does it really take to become proficient in this profession? How long did it take you to become an expert? How long did you need to ask for help on every case before you became sure of your coding skills? Do you feel that AAPC fully prepared you for an entry level position after certification? 

Please share your thoughts on this topic. I think we can all benefit from sage insight. 

Thank you so much!


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## amparisie@gmail.com (Apr 25, 2017)

I am in the same boat. I am certified and working through Practicode, but my scores are all over the place. I make notes and correct issues for similar cases the next time around. But there are so many difference scenarios, I don't feel like Im ready for an actual coding job. I'm hoping to find a place locally that will allow me to do an internship of sorts, before applying for a coding job. Im not sure if others have had success with that or not?


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## greatbiller (Apr 26, 2017)

I hate to be a negative Nelly, but passing the CPC exam does not show that you know how to code.  It shows that you can pass a multiple choice exam.  In the real world, you are not given a scenario with 4 possible answers.  You are given a patient record and you need to figure it all out from the information you have been provided.  

Knowing what should be coded and how to code it takes time and lots of practice!  

This is not meant to devalue the CPC certification, as the exam is difficult and most employers are now requiring a CPC credential in order to be considered.


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## nomerz (Apr 26, 2017)

I agree with the above post... the CPC credential is almost a necessity these days, however, it does not mean you know how to code. My training, education, and experience all came from my jobs, both past and current. While I feel confident in my current coding/guidelines, I don't think I'll ever feel like an expert. Coding is constantly changing, therefore you're always learning and growing. That's the beauty of it, in my opinion.


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## hperry10 (Apr 27, 2017)

greatbiller said:


> I hate to be a negative Nelly, but passing the CPC exam does not show that you know how to code.  It shows that you can pass a multiple choice exam.  In the real world, you are not given a scenario with 4 possible answers.  You are given a patient record and you need to figure it all out from the information you have been provided.
> 
> Knowing what should be coded and how to code it takes time and lots of practice!
> 
> This is not meant to devalue the CPC certification, as the exam is difficult and most employers are now requiring a CPC credential in order to be considered.



Thank you for posting this. It's aggravating to see so many threads from newly certified coders with no experience who believe that they are an expert because they passed the exam and did well in the course they took but don't understand why they can't get a job even though they are "an expert". I am not saying this to bash anyone, I think people have to have reasonable expectations and understand that there is much more to coding than course work and an exam.

As for the original poster's question - I learned coding at my local community college. I feel that I was pretty well prepared for the job that I got after I completed the courses, however our physicians choose the codes and the coders review them. I don't feel that I am prepared - even now- to dig thru surgical notes and extract data. I need a lot more practice for that and I've been doing this for 2 years.

Heather CPC-A


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## LadyRenee (Apr 27, 2017)

*Don't Know What You Read?*



hperry10 said:


> Thank you for posting this. It's aggravating to see so many threads from newly certified coders with no experience who believe that they are an expert because they passed the exam and did well in the course they took but don't understand why they can't get a job even though they are "an expert". I am not saying this to bash anyone, I think people have to have reasonable expectations and understand that there is much more to coding than course work and an exam.
> 
> As for the original poster's question - I learned coding at my local community college. I feel that I was pretty well prepared for the job that I got after I completed the courses, however our physicians choose the codes and the coders review them. I don't feel that I am prepared - even now- to dig thru surgical notes and extract data. I need a lot more practice for that and I've been doing this for 2 years.
> 
> Heather CPC-A



Hi, Heather. I think a lot of us believed the marketing line: "Assures a broad knowledge in reviewing and assigning the correct procedure and diagnosis codes for professional (physician) services." Extracted directly from AAPC's marketing material for the online course. Hah!  Yeah, right. That's a hoot. 

This stuff is hard. I'm not sorry about my decision to take the course but I do feel just a weee bit mis-led by the sales pitch.  But I'm gonna keep on practicing, because I really do want to "crack the code" one day and feel bells go off! Yureka! By George, I think I've got it!


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## LadyRenee (Apr 27, 2017)

amparisie@gmail.com said:


> I am in the same boat. I am certified and working through Practicode, but my scores are all over the place. I make notes and correct issues for similar cases the next time around. But there are so many difference scenarios, I don't feel like Im ready for an actual coding job. I'm hoping to find a place locally that will allow me to do an internship of sorts, before applying for a coding job. Im not sure if others have had success with that or not?



I'd like to hear from others, too, about their success in pursuing that track. I'm thinking about tapping my own doctors (primary and specialists) and asking them if I can sign a HIPAA agreement and intern for them when I finish the Practicode exercises.

Have you considered asking your own personal doctor or the doctor of any relatives you know? I think you can open up your own pathway. And because they know you personally, they may even be more help to your learning. Ask them for only redacted cases to work on and let the doctor or their staff grade you and explain the real deal on selecting codes.

I wish you the best!


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## LadyRenee (Apr 27, 2017)

greatbiller said:


> I hate to be a negative Nelly, but passing the CPC exam does not show that you know how to code.  It shows that you can pass a multiple choice exam.  In the real world, you are not given a scenario with 4 possible answers.  You are given a patient record and you need to figure it all out from the information you have been provided.
> 
> Knowing what should be coded and how to code it takes time and lots of practice!
> 
> This is not meant to devalue the CPC certification, as the exam is difficult and most employers are now requiring a CPC credential in order to be considered.



I don't think you're being negative at all. I think you're being right on point. You are right through and through. 

I think there should be workshops offered through local chapters that allow students and recently certified coders to come in and work on real cases. I bet there are chapters like that around, but I haven't seen such offerings in my local chapter. But I think that idea would go a long way in helping students and new coders put theory to practice, as well as open up an opportunity to ask questions directly from experienced coders. I also think it would boost the value of AAPC by going beyond the mere mechanical fundamentals of coding simplistic scenarios that are never encountered in the real world, and certainly haven't shown up in my Practicode exercises.


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## LadyRenee (Apr 27, 2017)

nomerz said:


> I agree with the above post... the CPC credential is almost a necessity these days, however, it does not mean you know how to code. My training, education, and experience all came from my jobs, both past and current. While I feel confident in my current coding/guidelines, I don't think I'll ever feel like an expert. Coding is constantly changing, therefore you're always learning and growing. That's the beauty of it, in my opinion.



Love your opinion, Noon. I love the constant newness and replenishment of coding material, i.e., growth. But at some point, I'd like to stop crawling and get up off my knees.  Just not feeling like that yet. How long did it take you to really feel solid in your skills? 2-3 years? 3-5 years? More? Less?


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## SusanLyons (Jan 25, 2018)

I don't feel prepared either.  I got my certificate in medical coding and billing last July and passed the CPC in Sept.  My teacher put in a good word for me at two hospitals in the area for a couple of positions.  When I submitted my resume to the first hospital they wouldn't even interview me.  The second hospital gave me an interview and asked me to come back and test on some coding and 3M encoder.  Not having any experience extracting real information from chicken scratch doctor's notes and working with 3M encoder I didn't do well - don't think I will be hearing back from that place


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## ajudd (Jan 26, 2018)

*Interesting*



LadyRenee said:


> I don't think you're being negative at all. I think you're being right on point. You are right through and through.
> 
> I think there should be workshops offered through local chapters that allow students and recently certified coders to come in and work on real cases. I bet there are chapters like that around, but I haven't seen such offerings in my local chapter. But I think that idea would go a long way in helping students and new coders put theory to practice, as well as open up an opportunity to ask questions directly from experienced coders. I also think it would boost the value of AAPC by going beyond the mere mechanical fundamentals of coding simplistic scenarios that are never encountered in the real world, and certainly haven't shown up in my Practicode exercises.



Hopefully your chapter asks for feedback from it's members. I believe my chapter has, in the past, done a workshop like this at one of the monthly meetings - they asked people to de-identify records and bring them for a practice coding session.  While i did not attend that particular meeting, I am certain many found it to be very helpful.  It's a great experience to have real charts and use your books to determine the best choices.
I agree, real life coding you don't get 4 potential answers and you rule out what's wrong until you come up with the correct option. It doesn't work that way. But I'm not sure if they could make the exam a fill in the blank AND grade them in a timely manner. If someone had to read every answer booklet and grade them, the process would be way too time consuming.  So a bubble sheet is probably the only way to go.  

Real life coding is difficult, and I don't even do CPT coding at all in my job.  But I continue to learn all the time.  

I also agree that people either take the self study or go to school for coding because they think they are going to get a job right away, making a ton of money and they will work at home right away. I see this on the Facebook page ALL.THE. TIME. It drives me crazy.  When you are new to the career, you should want to be in an office and I think it's rather unreasonable to think you'll pass your test, and get a job immediately.  
I also get baffled to read stories that people feel duped.  As with any career, did you do your research?  I love it when you see people from small towns that complain they can't find a job. They are unwilling to travel so they are all mad at AAPC for it.

Coding can be, and is, an excellent career choice.  But.... it's not for everyone. I love trying to help people and I want to be supportive of others.  But I also think some people need to be reasonable.  You're not going to get a work at home full time job right off the bat making 50 grand a year.  Advertising from schools can be misleading, I agree.  They just want the enrollment.  You, as a student, need to look at the career (anything you're going to school for), and see what the starting pay is for entry level and make a decision.  You don't get to be a head chef at a restaurant as soon as you graduate from culinary school.  You don't get partner status at a law firm right of your bar exam.  So, why would you expect anything different on something as critical as coding a person's medical record?


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## HangarPilot (Jan 26, 2018)

ajudd said:


> ...I also agree that people either take the self study or go to school for coding because they think they are going to get a job right away, making a ton of money and they will work at home right away. I see this on the Facebook page ALL.THE. TIME. It drives me crazy.  When you are new to the career, you should want to be in an office and I think it's rather unreasonable to think you'll pass your test, and get a job immediately.



Couldn't agree more!

Ever do one of those exercises back in middle school where you were given a list of words and asked to look them up in a dictionary? Of course I'm dating myself, they probably don't teach how to use dictionaries anymore... At any rate, the exercise was to test your ability to use a dictionary and look something up to find the spelling, definition, and pronunciation.

The CPC exam is far from perfect, but I think it is a fair assessment of your ability to use coding manuals. To pass, you have to demonstrate your ability to locate codes and understand guidelines. The multiple-choice aspect allows them to test a wider range of knowledge (versus giving you maybe 5 charts). Practicode has some merit, but "real life" coding only really happens in "real life" on the job. Plus, coding is not black-and-white. Take two identical visits but one has Medicaid and one has United Health Care ... the coding for those claims will be different because the payer wants them coded a certain way. You have to learn the coding "style" particular to your workplace and insurances. I also deal with 6 different providers who each document with their own particular style.

Care for an Air Force example? My first job was working on airplanes. In technical school we learned the principles and then went on to our first assignment. I graduated with flying colors ... but felt I knew nothing. Among other things all of the hands-on training I received was based on B-52 bombers. I was assigned to a cargo aircraft base. It took a years of on-the-job training to learn how to apply the general principles I learned to "real world" work.

This is actually quite similar. If you've completed a program and passed the test ... you know how to code. You know how to use the manuals and look something up and read the guidelines to code this first or not code that. The transition to "real world" is about applying those general principles to your situation.

Hang in there! The road is just a little rougher and little longer than most expect.


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