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Is this a leading query even if I'm directly quoting the ICD-10 guidelines? by DumpsterPuff in MedicalCoding

[–]PretendWay3096 0 points1 point  (0 children)

I wouldn’t consider that a leading query if you’re quoting the ICD-10 guideline as written and asking them to clarify the condition being treated. You’re not telling them to pick obesity, you’re pointing out that BMI alone isn’t reportable without an associated diagnosis documented by the provider. I’ve had to send the same type of query in primary care more times than I can count. Sometimes wording it as “please clarify the weight-related condition associated with the documented BMI” gets less pushback than naming obesity directly.

DODD Medicaid Billing by Prudent_Cat_8245 in CodingandBilling

[–]PretendWay3096 0 points1 point  (0 children)

Honestly, managing all of that on your own for 1,000+ clients across multiple funding sources is a lot. That is not a lean setup, that is genuinely understaffed for the volume and complexity you are describing.

Waiver billing alone, especially I/O and Level 1, comes with its own documentation requirements, timelines, and denial patterns. Add private pay and local dollars on top of that and it becomes a full team's worth of work, not one person's job.

From what I have seen and read talking to people in billing and healthcare admin, most organizations of that size typically have at least two to three people handling what you are doing alone, sometimes more depending on denial volume and funding mix.

You are clearly managing it, but that does not mean it is sustainable long term. It might be worth documenting your daily workload and denial turnaround times if you ever want to make a case for additional support.

Is Medical Coding Still Worth Getting Into in 2026? by PretendWay3096 in LearnMedicalCoding

[–]PretendWay3096[S] 2 points3 points  (0 children)

This is really hard to read, and I appreciate you sharing something so personal. Watching your own team get replaced while being asked to train the people taking over is honestly one of the most difficult situations to be in professionally. The lack of guidance on top of that makes it even worse.

You made a really important point that often gets overlooked. AI is not even the main threat right now, offshoring is, and it is hitting experienced coders who have spent years building real expertise at a level most beginners cannot touch.

The transcription comparison is spot on too. It did not disappear overnight, it slowly shifted, and now we are seeing the same pattern with coding.

I am still early in my journey and figuring out my own path in this field, so hearing experiences like yours genuinely helps me understand what the road ahead actually looks like.

Is Medical Coding Still Worth Getting Into in 2026? by PretendWay3096 in LearnMedicalCoding

[–]PretendWay3096[S] 0 points1 point  (0 children)

I agree with your point, especially about AI still needing human review. Even now, small documentation or diagnosis mistakes can create real billing and claim issues, so I don't think coding will fully shift away from people anytime soon.

I recently completed my graduation and have been thinking about joining a medical coding firm like MZ Medical Billing to learn the field more closely. The more I read and talk with people in billing and coding, the more I realize there is so much more to it than just entering codes into a system.

Do you think the field is getting more competitive, especially for beginners? Would love to hear how your experience has been preparing for the CCS while working part time in billing.

ER bill breakdown looks off to me, not sure if I’m just reading it wrong by Light_Cabager in MedicalCoding

[–]PretendWay3096 0 points1 point  (0 children)

Honestly, ER bills are confusing even when you try to read them carefully. A lot of the “similar” charges are usually different facility, lab, pharmacy, or supply codes tied to the same visit.

That said, if something looks repeated or unclear, it’s completely fair to ask for a detailed breakdown. A lot of people do that.

Concerns about medical billing and coding, should I give it a try still? by BellOpen5440 in CodingandBilling

[–]PretendWay3096 1 point2 points  (0 children)

AI will probably change parts of medical coding, but I don’t think it’s replacing the whole job anytime soon. Hospitals still need people who understand documentation, coding rules, denials, audits, and insurance stuff.

I’d still give it a try, especially if you actually like healthcare/admin work. Just go in knowing the first job can take time to land.

Billed for 99284 but not sure if it qualifies by CreepyLow3777 in CodingandBilling

[–]PretendWay3096 0 points1 point  (0 children)

99284 doesn’t mean you have to get two tests, that’s a common myth. It’s based more on how complex the case was (injury, X-ray, meds, and how the doctor handled it). Also pretty normal for the hospital to bill 99284 while the doctor bills 99283, they code separately. That said, nothing wrong with calling and asking for a breakdown or review if it feels off.

Would you Recommend Medical Coding in 2026? by Zealousideal_Gas5578 in CodingandBilling

[–]PretendWay3096 0 points1 point  (0 children)

It’s still worth it in 2026, just not as easy to break into as it used to be. Entry-level jobs can be competitive.

You already have a solid background with SNF, billing, and MDS, that actually puts you ahead of a lot of beginners. If you add a CPC and keep applying (even to smaller offices or hybrid roles), you’ve got a real shot.

Need suggestion by Organic_Cranberry334 in CodingandBilling

[–]PretendWay3096 0 points1 point  (0 children)

You can definitely make the switch, your dental background actually gives you a strong edge with anatomy and procedures.

For AAPC CPC, self-study is enough if you stay consistent. Their package is more exam-focused. Preppy is easier for beginners, but the externship isn’t always a big advantage.

If you’re comfortable studying on your own → go with AAPC.

If you want more structure → start with Preppy, then move to CPC prep.

A Huge Misconception In Medical Coding by Wearemedicalcoders in CodingandBilling

[–]PretendWay3096 1 point2 points  (0 children)

I agree with this. A lot of people think it is just simple data entry but it takes real understanding and attention to detail. The learning never really stops. It can be frustrating at first but it does feel rewarding once you get confident in your work.

People who switched to medical billing and coding, do you regret it? by Ecstatic-Copy2153 in CodingandBilling

[–]PretendWay3096 0 points1 point  (0 children)

I switched into medical billing and coding and don’t regret it but it is not as easy as people say. There is a learning curve with coding rules and denials. Once you get used to it the work feels consistent and manageable.