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AbbyTibb30

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Hi There,

Okay I've been working as an Emergency Medicine Coder for about 7 months now. Here's what I've learned and what I'd like to ask:

Being in emergency medicine is both rewarding and challenging at the same time. Learning to use the MDM Grid and determining what your E/M level is what I particularly enjoy. There's also multiple procedures / specialty CPT codes you get used to, like EKGs, X-Rays, laceration repairs, fracture care/orthopedic, and other miscellaneous things & the like. It's all centered around ED visits. Physician-based, not hospital.

Now having said that, I do feel like I've built up some knowledge (not all) about how to do this job & what I particularly like.

However what I find challenging is knowing that I'm 7 months in, and more recently I haven't been passing my L2 Corporate Audits. 95% accuracy is the standard for this job. I always seem to be 1 off from reaching that.

The CPH standard is 36.

So from production & quality standpoint, I'm thinking thats about average.

Whats weird is I did great in training, I was released as a regular Coder in the allotted time-frame of 16 weeks, and I was at 95-96% and at full production, but now here I am back at square 1, thinking maybe I made a mistake?

Is it time to find another job? Maybe one that'd be easier than having to keep track of all the things we have in this job? There's so many I can't list them all. APCs, TOCs, all the policies, payer rules, and then updates of course.

But again I'm thinking all of that goes into this job is normal. Its what is expected.

But now I'm thinking what if I try finding a coding job that just focuses on 1 set of codes? Off the top of my head I think RISK Adjustment/HCC, or Anesthesiology.

Something that we could say would be "easier" when it comes to coding.

And if so who here can say that their job in Coding is easy? Lol

I just like to hear what you all think about this, and any advice or recommendations would be appreciated. I don't want to leave this job, but I just have the notion that maybe this particular area of coding is not my cup of tea?


Thank you.
Abby.
 
There are certified coders with a wide variety of knowledge working all sorts of jobs you may have never even thought of.
7 months experience to me means you should grasp a lot, but as a manager, I would not expect you to know everything about coding. I've been doing this longer than many of you have been alive and I certainly don't know everything about coding, not even everything about the subspecialty I work in. It is constantly evolving and changing. Now, no one but you can decide whether or not you enjoy your work and should continue what you are doing. Some people want "easier" jobs. Some people want "challenges." Even a job that is a perfect match for 1 person, could be a poor fit for another. It's like having friends. Some people want friends they can go to clubs on Friday night with. Some people want friends they can camp by a fire with. Some people want a very small group of friends. And even throughout your life and career, what you are seeking and what makes you happy and fulfilled could change.
My personal opinion is that with 7 months experience, you are still learning. I enjoy learning and interpreting nuances of guidelines and would not look for a simpler job. If you are very close to meeting your metrics, does someone simply give you the score? Or do you have the opportunity to discuss the findings and learn from them? Are you making the same errors now you made 4 months ago? Was there a guideline change in 2024 you didn't realize? If you are learning from your errors, you will see improvement over time. I would wonder regarding the expectations, whether the organization has set slightly unrealistic goals, or whether the other coders are all meeting/exceeding the goals. I suggest having an honest discussion with your supervisor/manager.
Now, if you don't enjoy what you do (regardless of your metrics and scores), then I would consider moving on, whether there is something within your organization, or outside.
Either way, good luck on your career path!
 
I agree with what @csperoni said.

Also, I would not assume that any particular specialty was going to be easier because it only uses a limited set of codes. Often, when a specialty's code set is small, the rules, nuances, and guidelines for using them are complicated.

I think back to when I started coding radiation oncology. My employer was looking for someone to fill a position and asked if I wanted to learn it. I thought, "It's just a few pages of CPT codes, not even a whole chapter - how hard could it be?" Little did I know!

(It worked out in the end because I really enjoy my specialty. Even though I didn't realize what I was getting myself into at the beginning!)
 
Seven months is hardly enough time to consider yourself experienced, and far too soon to become discouraged. If your employer is not giving you a hard time about your productivity or accuracy, I'd hang in there. If after a couple of years (or if your manager has a heart-to-heart with you about your coding skill set), you might consider another avenue. If after 7 months you're just a point or two off from your expected productivity/accuracy, you're doing great! There is no 'easy' coding. All areas and specialties have their own individual challenges, and coders vary in their skills and aptitudes. One size won't fit all.

You've discovered the secret of coding that a lot of new coders don't know.....this is not easy work. But you seem to be catching on, so don't give up so quickly. Good luck and keep moving forward.
 
csperoni said:
There are certified coders with a wide variety of knowledge working all sorts of jobs you may have never even thought of.
7 months experience to me means you should grasp a lot, but as a manager, I would not expect you to know everything about coding. I've been doing this longer than many of you have been alive and I certainly don't know everything about coding, not even everything about the subspecialty I work in. It is constantly evolving and changing. Now, no one but you can decide whether or not you enjoy your work and should continue what you are doing. Some people want "easier" jobs. Some people want "challenges." Even a job that is a perfect match for 1 person, could be a poor fit for another. It's like having friends. Some people want friends they can go to clubs on Friday night with. Some people want friends they can camp by a fire with. Some people want a very small group of friends. And even throughout your life and career, what you are seeking and what makes you happy and fulfilled could change.
My personal opinion is that with 7 months experience, you are still learning. I enjoy learning and interpreting nuances of guidelines and would not look for a simpler job. If you are very close to meeting your metrics, does someone simply give you the score? Or do you have the opportunity to discuss the findings and learn from them? Are you making the same errors now you made 4 months ago? Was there a guideline change in 2024 you didn't realize? If you are learning from your errors, you will see improvement over time. I would wonder regarding the expectations, whether the organization has set slightly unrealistic goals, or whether the other coders are all meeting/exceeding the goals. I suggest having an honest discussion with your supervisor/manager.
Now, if you don't enjoy what you do (regardless of your metrics and scores), then I would consider moving on, whether there is something within your organization, or outside.
Either way, good luck on your career path!
Click to expand...
Thank you for your words. Helped me out A LOT! I do like this job, it appeals to the meticulous part of me, and I really enjoy diagnosing & figuring out what is going on with the patient. And to be fair, E/M coding does take time to master, just like anything else.

I just sometimes need the words of encouragement.


Thank you very much!!!
 
sls314 said:
I agree with what @csperoni said.

Also, I would not assume that any particular specialty was going to be easier because it only uses a limited set of codes. Often, when a specialty's code set is small, the rules, nuances, and guidelines for using them are complicated.

I think back to when I started coding radiation oncology. My employer was looking for someone to fill a position and asked if I wanted to learn it. I thought, "It's just a few pages of CPT codes, not even a whole chapter - how hard could it be?" Little did I know!

(It worked out in the end because I really enjoy my specialty. Even though I didn't realize what I was getting myself into at the beginning!)
Click to expand...
I hear you. Thank you for the heads up 👍
 
Pam Warren said:
Seven months is hardly enough time to consider yourself experienced, and far too soon to become discouraged. If your employer is not giving you a hard time about your productivity or accuracy, I'd hang in there. If after a couple of years (or if your manager has a heart-to-heart with you about your coding skill set), you might consider another avenue. If after 7 months you're just a point or two off from your expected productivity/accuracy, you're doing great! There is no 'easy' coding. All areas and specialties have their own individual challenges, and coders vary in their skills and aptitudes. One size won't fit all.

You've discovered the secret of coding that a lot of new coders don't know.....this is not easy work. But you seem to be catching on, so don't give up so quickly. Good luck and keep moving forward.
Click to expand...
Thank you, I appreciate your words.
 
Great advice from the seasoned folks that participate in the forums here a lot. Like @csperoni, I too have been coding longer than some of the folks have been alive LOL. I would go so far as to state it takes at least 2-5 years for someone to fully grasp a particular subspecialty or even general coding overall. It took me probably three years to fully understand and be able to teach others E/M (back when it was the "old" way). I still learn new things every day after 20+ years. There are days when I wonder if I even know what I am doing when I get a complicated audit or code set I am not really familiar with. :ROFLMAO:

If you like what you are doing and it appeals to you, don't change roles. Ask for more feedback and training or areas of improvement. ED coding is difficult due to all the variables. As Christine said, do you just get a "score" or does a mentor or supervisor actually give feedback and information about it? Are the expectations reasonable? Are others meeting the metrics or is everyone struggling? If everyone is having an issue with the error rate and/or production it may not be you...it could be the metrics. Are you responsible for 100% abstraction or only cleaning up edits/modifiers, etc.? There are a lot of variables.

When I was training new coders in orthopedics, I would tell them it takes a minimum of 90 days just to get a small grasp of even how the practice/coding works. It takes at least a year to have some basic understanding of things and be independent. Now, if someone came in and said they were "experienced" and had a certification in the specific specialty, or told us they had 10 years doing it, that would be a different story and the expectation would be different. Not a brand new coder though.
 
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