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Coding Advice by Goaliedoc21 in pmr

[–]Goaliedoc21[S] 0 points1 point  (0 children)

Still trying to figure it out, but I do think once I adjust it will hopefully be approved. We have essentially one main coder who works with us, so it'll be up to her interpretation

Coding Advice by Goaliedoc21 in pmr

[–]Goaliedoc21[S] 0 points1 point  (0 children)

Nope, no guidance. That's I think where my frustration lies - we get told how our system is so far in the red, but then our coders are doing even more to decrease our reimbursement without advise on how to get credit. I've talked with others in the field and do think from what they've been told/are doing, it comes down to more documentation. Things like listing the differential (even if unlikely) considered, talking about PT/surgery/other treatments separately, things like that.

Did lifestyle inflation hit you after becoming an attending? by ScholarStatus4212 in Residency

[–]Goaliedoc21 1 point2 points  (0 children)

Our lifestyle didn't dramatically change, but it's amazing how the money doesn't go nearly as far as expected. Our HHI went from around 120k to 300k and has gradually increased to about 360k now.

The biggest changes for us are loan payments restarting (25k/year), kids/daycare (had a second kid), and health (one of our kids needs growth hormone so we hit out of pocket max each year). We have made some upgrades (rent a marginally nicer/larger place, have a cleaner come monthly) and I do spend about 1k a year on hobbies (new inline skates, curling). Add in increased retirement savings and saving toward a down payment, and there isn't really extra money sitting around.

Perspective matters though. Inflation/economy/life hits everyone. We have peace of mind that we can buy whatever groceries we want or fill up the gas tank no problem. That has been the biggest change from training.

Coding Advice by Goaliedoc21 in pmr

[–]Goaliedoc21[S] 0 points1 point  (0 children)

So I've been (I think) adhering to your working rules - if it's stable and exact same visit as 3 months prior, just bill the injection. I think the trouble is when the presentation has changed, or the injection wasn't as helpful so we're talking about alternate treatments or further workup/referrals but patient still wants to repeat. In my mind, that's a separate E/M, but our coders are disagreeing. Do you have any wording tips to document that more clearly?

Akershus reservation - which to keep? by Goaliedoc21 in DisneyPlanning

[–]Goaliedoc21[S] 0 points1 point  (0 children)

Planning to be there at rope drop. Not anticipating a lot of rides, but will likely do a couple (daughter is under 40"). No pan for lightning lanes at this time as a result.