# In need of advice



## Radcoder86 (Feb 20, 2016)

Hi, I am a fairly new certified coder and am feeling very discouraged. I currently code for a family practice but it is downsizing and I am having to look for another job. The more I look the more I realize how little I know.  I paid a lot of money for my coding course, and when I got my job, I quickly learned how much essential information was left out of my course. I have learned a lot through my job by doing research and posting questions on this forum, but there's still so much I don't know. I don't even understand basic NCCI edits, it was something that was just skimmed over in my course and unfortunately, I don't work with anyone that understands them either. I'm nervous about paying a lot of money for another course that isn't going to teach me what a coder really needs to know in order to be great at their job. I want to be able to do more than just primary care coding. I want to eventually be able to work for a hospital, but right now, that is something I'm so far away from being able to do. Can some seasoned coders please give me advice on what I should do, where I should start? Is being a successful coder something a person really needs some sort of medical college education for? We were told in my course with coding jobs, you pretty much learn from experience and you just work your way up, but that doesn't seem to be the case unless you're really lucky.


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## blazingburgundy1 (Feb 21, 2016)

*Free advice and free resources*

Hello Radcoder86:

I certainly understand the frustration and disappointment. Many medical coding courses, whether a degree or non-degree structured education, omit many of the practical areas of coding and billing that medical coders encounter in the real world.  I suggest a couple of ideas:

1) use the internet and research.  You can find out how to use NCCI edits by visiting the Centers for Medicare and Medicaid Services at cms.gov and once you are at the site type in NCCI.  One of the topics that comes up is "How to Use NCCI Edits". You can also download that instructional booklet using this link:  https://www.cms.gov/Outreach-and-Ed...NProducts/downloads/How-to-Use-NCCI-Tools.pdf .  To view the actual NCCI files (published quarterly) search for PTP (Procedure-To-Procedure) or use this link to view both the Hospital files and the Practioner Files: https://www.cms.gov/medicare/coding/nationalcorrectcodinited/ncci-coding-edits.html .  Since the files are so large and divide the CPT and HCPCS codes into two files each, you will have to download two files of the same type (for example "Practioner PTP Edits V22.0...CPT 39599 and CPT 49570" and the second file "Practioner PTP Edits V22.0...CPT 40490 and CPT 00170). The files are named to show the last line of the spreadsheet in which the first CPT or HCPCS code is the one in the last row for column 1 and the second named code is the one that is in column 2 and being compared to column 1".  The legend or key has indicators of 0, 1 or 9.  If the code pair has the number 0, it means that these two codes can never be billed together by the same provider on the same date of service, regardless of modifier (59).  When it has the number 1 next to the code pair, it means that a modifier is allowed, if the documentation supports billing for both.

2) Arrange to do a live internship to gain valuable experience.  Reach out to an Xtern site by visiting the AAPC Project Xtern web page and looking up one in your area.  Each Xtern site offers hands-on training and mentoring and the Xtern will receive practical training and even earn hours towards removing the apprenticeship status, if they are a CPC-A.  Here is the link to look up general information on an internship a site closest to your residence and to locate an Xtern site: https://www.aapc.com/medical-coding-jobs/project-xtern/

3) There are lots of free or low-cost medical coding material online. There is a free online tool that is very useful for ICD-10-CM coding and here is the link: http://www.icd10data.com/ .  There are YouTube videos that are free to view.  Go to YouTube.com and search for "medical coding training" and "CPT coding" and "ICD-10-CM" coding.  There are lots of helpful videos if you make the time to go through them.  CodeBusters offers free ICD-10-CM training using this link: http://www.codebusters.com/icd-10-training-ceus .  Go to Facebook and look for Facebook pages of groups that are about Medical Coding and Medical Billing. 

4) Attend your AAPC Local Chapter meetings.  Most of them are free and you will earn CEUs while learning something and have the opportunity to network and pick an experienced coder's brain.

All of these suggestions will require your time, but not your money.  The advice I am giving you is based on my own true life experience.  Many people were instrumental to my success, but I also had to be bold enough to learn to talk to strangers, to ask for advice from them, and to learn to research a lot on my own.  The education I received at a college for medical coding was inadequate and I learned nothing that I could have learned on my own through self-study.  The knowledge I gained by learning from others and from researching made me a successful medical coder.  I wish you the best.  

G. Elizabeth Wilson
Buffalo, NY


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## Radcoder86 (Feb 22, 2016)

Thank you so much for the advice, encouragement, and links to information. It's so overwhelming when I think of all that I need to learn and I guess I need to just be okay with taking it a step at a time and I do need to work on being more outgoing and reaching out to other coders for help. Thanks again!


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## mhstrauss (Feb 22, 2016)

I totally agree with everything the first responder stated above. I also don't feel that the school I went to was adequate in preparing me for a coding career. I've taught myself so much in the last 7 1/2 years by asking questions here, reading as much as possible on coding and payer guidelines, as well as specialty society articles (I work in a Neurology-based clinic, so the AAN is my go-to site). Google will be your best friend! Attend your local chapter meetings, if possible, and network there! Find a few seasoned coders that don't mind helping you when you get stuck on something (feel free to message me). 

Another website I like is www.emuniversity.com .


HTH some!


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## Radcoder86 (Feb 22, 2016)

Thank you so much, Meagan! I will keep you in mind if I get stuck on anything. It's nice to know people outside of my chapter are willing to help, because I have gone to my chapter for help before and didn't get any. 
I also find it encouraging that you are were able to obtain a job doing neurology coding when you started out like me, because I know that kind of coding isn't easy!


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## klbuechele@gmail.com (Feb 22, 2016)

*Your not alone*

I too felt the same way after attending an Online "Live" course. I knew that I wasn't ready to take the exam and wouldn't sit for it until I felt I had better understanding of the material. So, I reached out to the Educational Officer of my local chaper. I explained my situation and asked if she knew of anyone that would be interested in mentoring me. To my delight, she took on the job herself! We met once a week in our local library for 2 hours going over material. I finally felt ready and in December 2015 took and passed the exam!! It was the best day. I strongly feel if not for her, I would not have passed.  Don't give up. Your local chapter is there for you, all you have to do is reach out.  Good luck in your future coding profession.

Karey Buechele, CPC-A


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## JEYCPC (Feb 22, 2016)

I think we all have learned what we need to know on the job.  I took a course for coding at a community college.  My husband received the same training from the local chapter (same instructor) review class.  I have coded several specialties.  As I start on a new specialty, I read everything available and reread the guidelines.  Also reading the NCCI  Policy Manual is a must.  I reread the parts that pertain to my area frequently.  Don't be afraid to ask and read these forums often as well as the magazine.  My one caution is the hand me down effect.  Make sure you review updates an don't just assume it's so because someone told you.  Good Luck to you.


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## Radcoder86 (Feb 24, 2016)

Thank you, everyone, for the replies. They have all made me feel much better about my future!


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