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Redpen and fellow coders, infusion? - jm

Posted: Jun 24, 2010

What is your opinion on the ICD-9 Procedure code for an infusion of Remicade for rheumatoid arthritis or Crohn's disease? Since this is considered a high-risk drug, the CPT codes are in the antineoplastic category. But matching up a ICD-9 is not clear. Since Remicade is a biologic response modifier you can go down that path. It is also a monoclonal antibody, so you can go down that path. So far I have come up with 99.28, 99.25, 00.18, and the usual 99.29. What does your facility do? Thanks. No one seems to have a clear answer on it.

I used to know, but I've forgotten - so I am no help at all

[ In Reply To ..]
I worked as a biller in oncology, and since we had a fully-staffed and equipped infusion center, we also did non-oncology infusions, including Remicade, Zometa, and the like.

It's been about 3 years since I left that job... but back then, at least, we used the non-chemotherapy infusion codes for Remicade. Of course, they were changing the infusion coding systems every single year, so it could be anything at all now.

Also, we were a private practice, not a hospital, so that too could make a difference, I suppose.

I don't know either, so I'm also of no help - Never knew in fact

[ In Reply To ..]
nm

Thanks! - jm

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Thank you for responding even if you didn't know. I appreciate that!

Interesting question! - Redpen

[ In Reply To ..]

You asked: What is your opinion on the ICD-9 Procedure code for an infusion of Remicade for rheumatoid arthritis or Crohn's disease? Since this is considered a high-risk drug, the CPT codes are in the antineoplastic category. But matching up a ICD-9 is not clear. Since Remicade is a biologic response modifier you can go down that path. It is also a monoclonal antibody, so you can go down that path. So far I have come up with 99.28, 99.25, 00.18, and the usual 99.29.

This is an interesting question! There does appear to be a lot of room there for confusion. I'm a firm believer in two things . . . reading exactly what the code book says and also using reputable references. So, I'll do both of those here.

You want to code an infusion of Remicade for an immune disorder, not a neoplastic condition. First I'll find the CPT codes, then the corresponding ICD-9-CM procedure codes.

In CPT, the infusion code we want begins with "Chemotherapy administration, intravenous infusion technique. . . "

The section heading above that code says "Injection and Intravenous Infusion Chemotherapy and Other Highly Complex Drug or Highly Complex Biologic Agent Administration."

What is this really saying? Let's look higher up. In the first paragraph of the instructions, it says that these codes apply to anti-neoplastic agents used for noncancer diagnoses and also to substances like these nifty monoclonal antibodies and biologic response modifiers. Note that it isn't saying the monoclonal antibodies and biologic response modifiers are being used AS antineoplastic agents, but just that administration of these substances is included here. It explains that this is because they are both highly complex, etc.

In the next paragraph, it clears up any confusion we might have had about "chemotherapy" turning this stuff into an antineoplastic agent. It says that "chemotherapy" as used in these codes "includes other highly complex drugs or highly complex biologic agents."

So, nothing here ever said the monoclonal biologic response modifier we're coding is an antineoplastic agent, nor did it say that it was being used as an antineoplastic. The codes are just written to include BOTH antineoplastics AND highly complex drugs and biologic agents.

We're just going to use those codes because they're the correct codes for highly complex drugs and biologic agents, and we're going to modify our thinking about a "chemotherapy" agent to include those things.

The AMA's Principles of CPT Coding, Sixth Edition, expands on this some and confirms it.

Now we have a CPT code for a monoclonal antibody that is chemotherapy, yet not antineoplastic. Keeping that in mind, let's look this up in ICD-9-CM.

If we look up Infusion and skim down the entire list, we'll see Infusion, antineoplastic agent, but . . . we don't have an antineoplastic agent. We therefore cannot use 99.25 or 99.28. Infusion, biological response modifier, antineoplastic agent 99.28 has the same problem . . . we aren't coding an antineoplastic agent. No antineoplastic activity is happening here.

On we go until we get to Infusion, therapeutic substance NEC 99.29. And that appears to be the only possible match in that list.

In the tabular list, 99.29 is Injection or infusion of other therapeutic or prophylactic substance.

99.25 is Injection or infusion of cancer chemotherapeutic substance, but this isn't for cancer. 99.28 is Injection of infusion of biological rsponse modifier as an antineoplastic agent, but, again, we don't have any neoplasm.

99.29 is the only possible option. What we're doing isn't specifically excluded from 99.29, either. It isn't going to be 00.18 because 00 is Procedures and Interventions, not elsewhere classified. This is classified as 99.29.

Once you get to the tabular list, it becomes more difficult to sort these out. If you select the code in the alpha index, however, it is quite clear.

You just have to avoid thinking that the drug is "antineoplastic," because nothing in the CPT manual said it was. It appeared that it kind of did, but close reading showed us that it did not say that. Once you eliminate that word from your thinking, the choice in the alphabetic index is clear enough.

I think it is, anyway. :)

Yes! - jm

[ In Reply To ..]
Thank you, Redpen! Your demonstration of drilling down through to find the answer is THE answer. Always go back to the books. If you use the Encoder, you get many pathways that seem right, but it can be confusing. I did go back to the books, but I didn't take it deep enough or take time enough, which is what it takes. Thank for that perfect lesson!

Amazing demonstration! I loved 'watching' it. - Thanks plus small message

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jm, I was also interested in your comment about the Encoder not leading you to the right answer. Interesting.

Encoder - jm

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The Encoder is a great program. It will go whatever way YOU pick, but the coder needs to know when it is right. This particular scenario has a lot of picks/paths that seem viable due to the complicated nature of the selection involving using chemotherapy for immunosuppression. It is the coder that needs to do the background work! When I first started coding, I didn't even use the Encoder until I knew how to find the paths myself using the book. In this case, it was giving me too many choices that seemed legitimate, but I failed to return to my roots and really dig in. I needed to go in and break each answer down, as Redpen did beautifully.

Well, not perfect . . . - Redpen

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Well, I wouldn't call it perfect. It was a little wordy.

Did you see where you went wrong, though? I didn't say it right out, hoping that you would catch it on your own.

This is a hard one to get, even if you hadn't seen CPT first. But, seeing CPT threw you.

In ICD-9, when you looked at the alphabetic index, the entry you needed was way down and looked nondescript. Something in us doesn't want to use entries that look like that.

You found the right thing, but those other two just sounded sooo much better . . . if it weren't for that pesky "neoplastic" bit. You might have been able to climb over that had you not seen CPT.

CPT made you think that this got coded as an "antineoplastic" procedure, so your mind slid into thinking this WAS antineoplastic. Well, you know, chemotherapy is antineoplastic, and if CPT says it is . . . and I'm using an antineoplastic there . . . probably best to be sure the ICD-9 procedure matches that . . . and there was no hope after that.

The key was in seeing that CPT really didn't say this was antineoplastic. It just declared chemotherapy to include those highly complex "other" things AND the true antineoplastics, and created a code that covered the highly complex stuff in general. It really wasn't just for antineoplastics at all--it was for those highly complex drugs.

It wasn't easy to see that, though. It would have been even more difficult with an encoder, so if you used that, you might not have seen half of what you needed.

Finding help with it would have been difficult, because few coders ever need to find both a CPT and an ICD-9-CM code for this.

I'm glad there aren't more of these things in coding, but I think there may be more in the future as new technology arises.

When you're stuck like this, a really good source of information is the drug manufacturer. They often have a coding staff that works out exactly what you need to do for expensive and hard-to-get-reimbursed new drugs and procedures. I use them quite often when I need to provide evidence to resistant thinkers.

You might try googling Remicade and digging around in their website until you can find the reimbursement page. Happily, they agree with me. :)

went wrong - jm

[ In Reply To ..]
My problem was not the antineoplastic. I knew they weren't using it as such, but rather for immunosuppression. So that led me to look up the drug and find that it was a monoclonal antibody and a biologic response modifier, bingo! I got stuck on that notion. The encoder "helped" me out in this. I'm not at work so I canâ��t post the paths, but by golly I could get to those monoclonal antibody codes and the biologic response modifier codes if I pushed the right buttons! Not so fast, I needed to do my research on each of these ICD-9 codes. It does take time and work and I do appreciate it.

Wow, thanks for this post Redpen! sm - Coding Student

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And this, my friends, is why I'm happy I'm an Andrews student! :)

Andrews - workingmt

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And yet another unsolicited advertisement for the Andrews School.

I'm sorry. - Coding Student

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But you know what, I did NOT intend for my comment to be an "unsolicited ad" for Andrews. It was mainly meant to show a deep appreciation to Redpen for the time she takes to help ALL of us out on this board. She doesn't have to do it, you know. She does it because I believe she cares about the field, coders, coding students... regardless of whether they are students at Andrews or not. I do not understand your bitterness. And my gosh, I am amazed at how rude people can be.

Hey, if you are proud of your school, then tell people about it! A lot of people come here seeking info about where to go to school. So if my comments help get them to look into Andrews, then great! It was not my intent in making that comment, however.

No apology need from my point of view - The more positive comments the better

[ In Reply To ..]
Your comment made me smile. I love seeing it when people are happy about their choices. Thanks for posting your comment!

Thank you & small note - Redpen

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Thank you. This is why it's a good thing to write out your answers, you see?

WorkingMT, my student did not do the advertising. If anyone did, it was me, and it wasn't unsolicited.

I was ASKED to provide an answer. As a non-coder, what you don't know is that this question is extremely difficult. It has been asked on internet coding sites all over the place without an answer.

It took me about an hour to figure out where we kept going wrong, and if I can post an answer for this to the internet and know that other coders will see it when THEY have trouble, I'm happy to do that.

When JM asked it, she mentioned ME. She tossed her glove at my feet. I was left to choose between answering and slinking away with my tail between my legs. How could I resist?

I answered to help JM, along with everybody else who will have this question.

I also answered to help students --everybody's students -- see what they'll really be doing as coders. My students will see references to things I tell them and now they'll understand why I tell them those things.

I'm sorry if you felt this was advertising, but I'm more guilty of showing off.

advertisement - jm

[ In Reply To ..]
All people genuinely interested in coding, students of coding, and coders alike will find this to be very valuable information.

It doesn't look like the comment was aimed - at Redpen

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Rather, it was in response to the little chirpy so glad to be an Andrews post, which added nothing but that little piece of product placement to the discussion.

Alert: Be careful not to be 'chirpy' or you might offend someone - nm

[ In Reply To ..]
nm

To JM - workingmt

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You are absolutely right in regard to my comment, it was not directed at Redpen at all. The references to Andrews may not be intentional, I would call it subliminal advertising.

to workingmt - jm

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I do know what you mean about seeing the banner and seeing the name connected to the school. It puts you on guard. It is a natural reaction because there are so many scammers out there. But when the information is solid and educational, which a lot of Redpenâ��s posts are, we want to hear it - all of it. We are hungry for information from a knowledgeable source. All of the reactions to her post were just a natural occurrence of events. None of this particular thread was contrived. It was a great coding workout. But I am glad you are posting your red flag. Some may want to bring that into their decision process.

I would invite the instructor who taught me to come and participate - but I learned by machine LOL

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I guess I could say that I learned by machine. I don't recommend it. I had to supplement it and I've never developed the confidence that I know what I'm doing. If I had learned from a knowledgeable coding instructor, I would invite that instructor to participate in our discussions. Professional coders who are interested in helping to promote professionalism in coding would want to come here if they knew this resource existed, but evidently they don't. I come here to learn, whenever there is anything here to learn about coding.

Remember back on this board when nothing ever happened and nobody ever wrote anything? Then there were a few questions but no answers. No other instructors have ever been willing to come in and answer questions or talk about coding to us. I am hereby challenging everyone to go get a coding instructor or supervisor and invite them here so this board will continue to be interesting and informative and Redpen won't be alone in helping us out with our questions. There has to be other knowledgeable coding instructors who care enough to be here with us.

Thank you JM - workingmt

[ In Reply To ..]
Thank you for your note. I know Redpen posts here and answers questions only because she loves to share and help people learn, it is obvious that she is very intelligent. I had actually wondered if the coding question was on one of the final exams if it has been asked several times! I've read all the posts on this topic and if nothing else I opened up a healthy discussion. I love reading the messages in the forum. I'm sure I over reacted, but over time it has seemed to me that Andrews students are here a lot, and it does seem to me that the school gets promoted quite enthusiastically by the students. I'm glad they are happy, apparently Andrews has the best thing going. Then again, M-Tech and Andrews are the only 2 schools running banner ads here, and unfortunately I did form an opinion. I've shared things in the past about my educational choice and have been told by a few people (Linda Andrews included) the things that were wrong with it. I'm sure it was not meant as anything against me personally but I began to feel that some of the discussions were slanted in a certain direction. Not mentioning the name of our school should not mean that we are ashamed, it should mean that we respect each other regardless of our chosen educational path. We all have the common goal of learning all we can and putting those skills to use after we graduate. We should be here to help each other, not to point out that one school might be better than another. I'd better sign off before I open another can of worms, lol! Thanks

I appreciate knowing where people go to school - See message

[ In Reply To ..]
I actually appreciate it when people let us know where they are going to school when they are comfortable doing so. If you aren't comfortable giving that information, that's understandable. I hope it won't keep anyone else from sharing that information though, because it's helpful and interesting.

Absolutely! I found it fascinating. - More please

[ In Reply To ..]
nm

I thought she/he made a pleasant and appropriate comment - It is no crime to be happy

[ In Reply To ..]
nm

If I remember right, several from other schools have also posted happy posts - I see no harm in it

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It doesn't offend me when any of the students or graduates post that they like or don't like their schools. It's information. We get to take it or leave it. I find it helpful.

Did someone get up on the wrong side of the bed this morning? - Cheer up

[ In Reply To ..]
nm

Cheering up - workingmt

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I am the one who owes all of you an apology. Apparently I am the only one who feels this way but I have a problem with the fact that the Andrews School runs a big banner ad on MT Stars and then in addition to that the board is occupied by one of its instructors, the owner and several of the students. There are a lot of successful coders from many other programs, it is not mandatory to attend Andrews to be able to problem solve. Every time a topic comes up or someone asks a question, someone brings the Andrews School into the discussion. Again, I am sorry if I offended any of you but I can help what I think.

My thought - MTLC

[ In Reply To ..]
I for one am very interested in who is giving this advice - Watching an actual coding instructor "at work" will help me choose which course to take. For me, the teacher is almost as important as what is being taught.

When I first learned MT at a clinic, the MT they used was very good - to a point. She liked the word, was good at it; but it was just a job and her teaching reflected that.

When I first got a job at a hospital and was learning acute care, I got pretty much the same kind of training - adequate but "just a job." THEN, an MT was hired who was passionate about the field as well as very good at what she did. Wow! What a difference that made. She not only taught me things that filled in the gaps, but infused me with a higher respect for what I do and that has lasted for 20 years.

So, my point is, I want to learn coding from someone who loves the field, is good at it, and explains it in a way that I will understand.

You know what would be nice? If coding students from other programs who also appreciate what/how they are being taught would ask their instructors to come on the boards once in a while and let us see how they work. Then we will see WHY that program is liked and the angle from which they teach coding. Since not everyone learns the same way, it would be a great way to "advertise" what the other programs have to offer.

To MTLC - workingmt

[ In Reply To ..]
Thanks for your note. Like you, I was taught MT, both in school and OTJ by people who were passionate about it and I feel that way after 30 years. I like your suggestion. I would like to see students and working coders helping each other with coding questions, problems or interesting things we have learned or encountered. We all have knowledge to share regardless of where we work or what school we attend. There are a lot of "gray areas" in coding. No one is going to have the correct answer 100% of the time, even someone who is an instructor. Why is it not possible to share without mentioning the name of our school or instructor, just relating our work experience or what we have learned? That is what I would like to see.

I agree up to a point. We shouldn't have to hide or be ashamed of a school - I also like to know where the info came from

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When I see information given, I like to know where it's coming from. It's also an advantage to anyone who has a dislike for any particular school. They can just ignore any information, guidance, etc., from anyone who ever attended or instructed at the particular school that you don't prefer. That's a win/win solution. Nobody should be ashamed to reveal their credentials. That would be just silly (and not the way we do things in America, in my opinion.

I disagree. I want to know the name of the school if one is being discussed - or - please see message

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If we are being taught or advised by an instructor, the instructor should have the decency to reveal their credentials and, if they teach for a school, the school they teach for. That's only fair. Hiding that information from us just doesn't seem quite right.

Now if they want to jump into a conversation about coding and not talk about schools in general or any specific course, that's fine, but it seems more professional not to be ashamed of any school you do teach for, in my opinion. If I had attended a school, for example, and was telling all of you what I learned from it, it would only be fair for me to give the name of the school.

Also, if someone says they teach coding, then tell us where. Also include your credentials so we can decide just how much credibility your opinion has. We don't have to be rude and tell you that you don't know what you're talking about, but if you have credentials, you obviously know enough to have passed some tests. That means you know a lot more than I do. LOL.

Well, if Redpen posted credentials and where she works - sm

[ In Reply To ..]
every single time she posted, then people would probably be complaining about that! Honestly, if you read this board a bit and catch up, you will know exactly who Redpen is and where she teaches. She shares knowledge with us all freely, and who are we to make demands on her to prove who she is every time she posts? If we wanted that, well, then I guess we all need to post our real names, the school we attended, and the name of our employer on all of our posts, too! If Redpen was trying to get people to enroll at Andrews, maybe you would have a point. But she does not attempt to recruit anyone.

I think you misunderstood me. Redpen does post appropriately - She is appropriately identified

[ In Reply To ..]
I don't think we're disagreeing. I'm not criticizing the way Redpen posts. She has identified herself appropriately and she has also given her credentials somewhere on here I think. She has lots of them and they are impressive. She doesn't promote any one school, even though she has told us that she is an instructor at one of them. She has never said that we should rush to enroll there and has never offered us any special deals if we sign up now. In fact, I remember once when she was talking up some other course someone was considering and helping the poster decide between two courses, neither of which she was connected with as an instructor.

I was saying that if we had other professional coding instructors on here, it would be helpful if they would do the same. I'm all for learning as much as possible from the most talented coders out there. At the same time, if we don't know their credentials or their affiliations, how are we to know that they have any knowledge at all? The credentials are helpful. Knowing where they teach is also helpful.

One more point is if a coding instructor kept trying to get us to enroll and maybe making special 'deals' for a limited amount of time, that would be offensive and inappropriate. Nobody has done that yet, but if they did, I would object. Otherwise, knowing who is talking to us about the different aspects of coding is helpful. We know how much confidence we can have in what they say, because of the credentials they possess, etc.

Oh, okay. I definitely do agree with that! - sm

[ In Reply To ..]
Thanks for clarifying. :)

Really, people WOULD complain! - Redpen

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I don't post my credentials every time because people DO complain. Besides, it seems excessive. I don't even use all of them in my signature anymore.

It's fairly obvious that I teach for Andrews. I've used this name since about 1996--and I think most of the MT community recognizes it. When I sign as "Redpen," I'm telling you who I am.

I've provided my credentials here in the past. If you want to know what they are, email me through the school and I'll tell you. (There's a contact address on the website.)

As for posting a real name, that's just unsafe.

I don't think it's appropriate to expect someone to post their employer's name, either, or the exact capacity in which they work there. Sometimes we can't because there are confidentialty issues, or security issues, or conflict of interest issues. Suffice to say that I do have a "day job" and it's a responsible position with large and excellent healthcare provider.

MTLC - I so agree with your last paragraph! Everyone please read - Not-so-great coder

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I hope everyone will read what MTLC wrote and ask your instructors to get in here and get involved. I love to see people who are passionate about the work they have chosen to teach. That is so rare and refreshing. Show us what you've got! Help us learn about the profession. Talk to us about what coding is and why it is important. We want to learn.

Apology accepted. If only the others would come and contribute - Everyone is welcome

[ In Reply To ..]
I haven't seen any others willing to contribute, but they would be welcome if they would. There might be a few healthy debates or discussions. I would love it!

Advertising - Coding Student

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I don't see a banner ad for Andrews on this page. I do see some Google ads for some other companies, though. I've also seen a banner ad for MTEC. And I've seen an Andrews ad off and on in the past. I guess they all cycle through? So why do you have a problem with this? The ads are there for 2 reasons. I would imagine that MTStars sells the ads so that they can make money to help pay for the costs associated with running this site. The different companies and schools buy ads because that is just good business! Businesses advertise on sites that attract people who might be interested in their services. Just don't look at the ads if you don't like them!

And as for Redpen being here? I'm SO glad she is here! I think most of us are glad. I was glad she was here before I enrolled in Andrews, back when I was trying to self-teach coding because I didn't want to pay for a course. I have never seen Redpen or Linda Andrews try to "sell" their program to anyone. If answering questions is a way of "selling" their program, then hey, that is good business, too! Good for them! But I honestly don't think that is their motivation.

No one ever said Andrews is the only way to go. If you look through old posts, you'll see where different people have talked about several different choices. I know I've said in an older post that while Andrews works for me, we all learn in different ways and thank goodness there are lots of options. So honestly, I just don't understand your point. My "chirpy" comment, again, was simply stating that Redpen is one of the main reasons I am at Andrews now. As someone else mentioned, I wanted an instructor who is passionate about the field and interested in helping ME become a successful coder. And hey, my MT training was from MTEC, and if someone asked where they should go for MT training, I'd say MTEC. Because MTEC worked for ME. It is my recommendation based on my experience. And for me, the best option for coding training is Andrews. For you it might be Career Step or community college. I honestly don't care where you go to school. If I were still looking for a school, though, I would be very interested in where you were going and what you thought of it.

And yes, it sure would be great if some instructors from other schools would come join our conversation!

Bottom line, I am going to feel free to talk about whatever I want on this board. I will not be made to feel I have to hide where I go to school for fear of hurting the feelings of someone who is feeling defensive for whatever reason. And I'll stand up for Redpen and Linda Andrews...because I would hate it if they were made to feel uncomfortable posting on this board. I feel safe in saying that the great majority of us welcome their participation!

Good-bye and good luck - workingmt

[ In Reply To ..]
No message

I think you totally missed the point. - Larry Tate

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No one said you had to be ashamed of where you went to school. Nobody said a word to Redpen. If there is a thread about good coding schools, by all means speak up. But it begins to come across as product placement if you find a way to work Andrews School into every thread when it is neither a thread about schools or a question as to the 'cred' of someone giving an answer.

Don't know if you want the Colbert Show, but one night he was raising money for a charity and was paid a set dollar amount for every time he said Bing so of course he used it several times in each story, sometimes just tossing it out there for no apparent reason. There are times that the way Andrews works its way into a thread no matter the reason has the same feel.

A question for you - Coding Student

[ In Reply To ..]
I certainly don't have time to go through and read ALL of the posts on this board. But I scanned through the posts above this thread, as well as all the posts in the 6 or 7 threads below this thread. And guess what. Not a single mention of Andrews! Not one. Seriously. So honestly, what are you talking about when you say Andrews comes up in "every thread?" Because while that may be your perception, if you look at the posts you will see that what you are saying is not true.

If I may butt in here - MTLC

[ In Reply To ..]
I took the poster's comment as a spontaneous exclamation rather than a "product placement." As far as paid endorsements, I think the coding student is the one who pays to make the comment (tuition), not get paid!

In any case, I think there is value in that poster's comment in that it is apparent that the instructor of the course teaches pretty much the same way in a forum and in class. While not everyone would want to learn that way, there are others who appreciate the detailed explanation of concepts for understanding coding.

So now people have a better idea of what they are getting in instruction from this particular school. I really wish I could get that kind of information about the other schools. A student who says "I am learning a lot," doesn't help me as much as watching an instructor in action.

BTW, I am not a student of that course, but it is on my short list of considerations.

Correct! Not paid, not even any extra credit! (nm) - Redpen

[ In Reply To ..]
nm

LOL! Yes, I'd give my REAL name - Coding Student

[ In Reply To ..]
if I thought I could get some extra credit! :)

Maybe some of the instructors of other schools will help answer questions here too - Everyone is welcome

[ In Reply To ..]
If any of you are students or graduates of other schools, why don't you see if your instructors are willing to volunteer to donate some time discussing coding with us. Maybe they could be instructors who have expertise in some specialty that we haven't discussed yet. It would be great to see a discussion between several experts, but so far nobody but Redpen has been willing to step up.

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Aug 30, 2010

Would I write the following with subscript? I thought subscript was frowned upon. Would I abbreviate part of "per cubic gram patient weight" The patient received a total of 224 x 10 to the eighth nucleated cells or 0.37 x 10 to the eighth with a total CD 3 dose of 16.96 x 10 to the sixth per cubic gram patient weight. ...

May 04, 2010

I have been working for this hospital a year, after having worked from home for 15 years. They brought their transcription back in-house and hired me and another transcriptionist around the same time. From the beginning, I was more productive than the other transcriptions, but there was not a minimum quota set at that time that we were aware of, so we were just cruising along. Well, the work started getting behind and they started looking closely at the minutes we were doing, and I w ...

Nov 04, 2010

I just wanted to take the time to thank all of you guys for being so caring about each other. When the system went down, you were right there encouraging each other. Somebody gave the site address of the Red/Yello/Green status (which I admit I had forgotten and could not get into E-mail to retrieve it). I went to the site and clicked right and made a shortcut. Others gave instructions on what to do for down time. I just think you all are GREAT!!! It is so nice ...

Nov 18, 2011

hire on with Accentus!! Not only will they load your PC with junk software that will make it crash (mine has 3 times so far), but they will be rude and claim you abandoned your job!! Very rude staff and the poster below is an owner. I am just trying to warn others. That is my last word on the issue. ...

Aug 04, 2012

Can someone help me get a job there? I am a very hard worker, not afraid of ESL, stick to my schedule, QA 99-100%. I just finished the test, but I was wondering how they grade, based on what, because I didn't get a chance to explain things like headings, use of BOS (using mL for cc, is that already expected throughout the industry) or was everything supposed to be strict verbatim? Also, punctuation and grammar now is expected to be perfect, but if it doesn't interfere ...

Jul 21, 2010

STONE TWO FRIENDS WERE WALKINGTHROUGH THE DESERT .DURING SOME POINT OF THEJOURNEY, THEY HAD ANARGUMENT; AND ONE FRIENDSLAPPED THE OTHER ONEIN THE FACETHE ONE WHO GOT SLAPPEDWAS HURT, BUT WITHOUTSAYING ANYTHING,WROTE IN THE SAND ,TODAY MY BEST FRIENDSLAPPED ME IN THE FACE .THEY KEPT ON WALKING,UNTIL THEY FOUND AN OASIS,WHERE THEY DECIDEDTO TAKE A BATHTHE ONE WHO HAD BEENSLAPPED GOT STUCK IN THEMIRE AND STARTED DROWNING,BUT THE FRIEND SAVED HIM.AFTER HE RECOVERED FROMTH ...

Oct 11, 2011

I am now down to 3 companies (from 4) trying to make a living at this, wondering what I should do next. I'd like to go get my coding diploma and move on from there as I cannot take this anymore. Four jobs and between all of them I got $700 last week and am still waiting for checks to arrive. I asked one of them why it wasn't DD and they said they would cut and mail the check. Lord knows when the other one will arrive. I don't know, don't YOU ...

Feb 28, 2013

Nuance actually had the nerve to send out an email about referring fellow MTs to their company. Either they are that brazen or just clueless as to how bad their company is. I don't advise anyone looking for a job to even consider this field, let alone the worst company I've ever worked for. ...

May 14, 2015

Code was callled briefly as she deteriorated. Her symptoms worsened as she was laid flat for initiation of s/l blunt ridge fusion, which was stopped quickly. Totally stumped. ...

May 03, 2010

Fellow team members yahoo IDs? Or is it frowned upon? My company frowns on interacting with fellow employees. It makes you feel so isolated though. Is this a common practice with companies cause I've never really encountered it before? This is my first time working for a big national though, so maybe that's why I haven't encountered this before. ...

Jun 06, 2010

It is very disheartening to hear what has happened to our fellow MTs who have recently been terminated by Transcend. To add insult to injury they turn around and have an abudance of openings they are now hiring for. I will not apply there and I feel no one else should either. Make them sweat it! I know it is tough right now and we all need a good job. This has got to stop and the only way these companies won't get away with it is if we don't tolerat ...

Jun 10, 2010

I'm totally getting burned out at MQ. If it's not the NJA with requests to change schedule, then it's the lack of primary and getting other unknown accounts slowing me down. I've gone from full-time at MQ down to working part-time with another part-time job to make up lost income now for the past 7 months. When I started MT'ing so many years ago, the pay was great and being able to set my own schedule was a real plus as well. It was the ...

Jul 29, 2010

FT IC Radiology Per minute 0.95 per minute until out of QA 1.05 per minute following release from QA 600 minute minimum per pay period. Above 120 minutes = 1 and 1/2 x 1.05 per minute I have over 15 years of experience. I need to know if this can pay my bills but it is hard to gauge without knowing the account (how many templates/normals are used, if cherrypicking takes place, if the account is overstaffed or if there is working during the afternoon shift). ...

Aug 02, 2010

As a former “newbie”, I would like to offer a little bit of advice to other newbies. When I first got into medical transcription, I thought that some of the advice given on these boards was a little harsh and sometimes downright nasty. Without a doubt, there are always going to be some nasty people on message boards, but overall, I think most of the advice given here is well intentioned. Let me explain a little bit of my story. I was unemployed for about si ...

Nov 28, 2013

out there. If you are working ~ hope there is plenty of work and if you are off ~ hope you have a blessed day with family! ...

Apr 01, 2010

Looking for more work, need a company with plenty! ...

Oct 03, 2011

feels at Thanksgiving ...

May 20, 2012

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Dec 31, 2012

I just wanted to wish all of us good health, and a happy and prosporus New Year in 2013! I think we all could use a break from worrying, working too much or too little and see a future in medical transcription without our jobs being ripped out from under us through outsourcing or smaller pay. I know it's wishful thinking, but Happy New Year to all of you. MT2 ...

Apr 15, 2013

company work song (like they do in Japan)! Suggestions? ...

Mar 09, 2015

I have been off your payroll for one week and three days. This has been the happiest days of my life. I do not miss you at all. What you have done is take medical transcriptionists and make them into editors. If we wanted to check what some computer or some foreigner had typed, we would have taken that course in college. We transcribe. It is what we do. It is what we do best. When you expect us to edit, you take away our ability to create, which is ...

Nov 30, 2010

First, I suppose I have come across here in a tone that was bitter and hateful. I ask forgiveness for that. Now, to tell me I am wrong for venting my hatred (wow, where did that come from) and venom on here was extremely hurtful to me. I have read many, many, many posts here on this board; which is meant to be a place where we can share and vent supposedly without recrimination and some empathy. And there are many who are also long-time employees who have serious medical ...

Jul 20, 2011

I don't mean to sound like a dink, but I'm wicked exhausted from working my fingers to the bone, 7 nights a week for several weeks now, because people who were hired to work the graveyard shift are flaking out and not showing up or pulling their weight. No, I don't HAVE to work 7 nights a week, and yet I'm doing it because I'm terrified the wonderful little company that I've worked for, for nearly 11 years now, will lose this really big acc ...