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PRACTICODE

Allysaloop said:
Hey all, hope you're still hanging in there! I had another scenario I was wondering if anyone else experienced. OPD7293 in Practicode lists Depression and Hyperlipidemia under Dxs while the visit was for Hypertension, Dorsalgia, and Sleep Apnea. The claim being since they are chronic conditions that don't resolve, they should be coded even though they weren't in the assessment. I thought we are only supposed to code what was actually addressed in the encounter? Another case listed Depression and Hypothyroidism in the problem list, but they weren't coded with the reason for the visit which were Hypertension, Paroxysmal SVT, and A-FIB. At this point I just want to know what is considered addressed or not addressed at an encounter; has anyone noticed this and what do you think? :)
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This is EXACTLY the type of thing that I've been talking about. Inconsistencies in the simplest of fundamentals that make us all question what is going on and whether we are not understanding something or not. I notice that it says "history" of depression AND that she is off of the meds for it, but it is still listed in her "problem list". However, I've gotten things counted wrong that were listed in the problem list before, so it's unclear to me whether it has anything to do with what should/should not be coded.
 
Allysaloop said:
Hey all, hope you're still hanging in there! I had another scenario I was wondering if anyone else experienced. OPD7293 in Practicode lists Depression and Hyperlipidemia under Dxs while the visit was for Hypertension, Dorsalgia, and Sleep Apnea. The claim being since they are chronic conditions that don't resolve, they should be coded even though they weren't in the assessment. I thought we are only supposed to code what was actually addressed in the encounter? Another case listed Depression and Hypothyroidism in the problem list, but they weren't coded with the reason for the visit which were Hypertension, Paroxysmal SVT, and A-FIB. At this point I just want to know what is considered addressed or not addressed at an encounter; has anyone noticed this and what do you think? :)
Click to expand...
I agree! For that case exactly I did not list the Depression and the hyperlipemia because it was only on the "Problem List" and not in the "Assessment". I have reported sometimes too many of the Problem List issues (that were similar to the CC of the visit mind you) to only be marked wrong as the rationale only listed what was on the Assessment. I feel like I'm constantly 'guessing' (definitely second guessing myself) and that this is like a pulling the arm of a slot machine in Vegas! Hardly ever hitting the jackpot....odds constantly against me. Often times I am close and follow the best I can to the guidelines, etc so take that little bit of confidence to code the next similar case, to just get them marked dead wrong. With abysmal rationales. I really hope this is not experience and feeling it would be like coding in the 'real world'? So to reiterate here, @Allysaloop, I totally agree, noticed this and just think it's very inconsistent and I get a feeling that I don't trust it all the time.
 
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I just found this thread and it is making me feel so much better! I have had such a difficult time with the practicode cases even though I did really well in my course and on the exam. I have really be struggling if this was a good move for me. I keep get points deducted because I add things that I guess shouldn't be added. It is really confusing to me and I have felt extremely stupid since starting practicode.
 
ady8e80 said:
This is EXACTLY the type of thing that I've been talking about. Inconsistencies in the simplest of fundamentals that make us all question what is going on and whether we are not understanding something or not. I notice that it says "history" of depression AND that she is off of the meds for it, but it is still listed in her "problem list". However, I've gotten things counted wrong that were listed in the problem list before, so it's unclear to me whether it has anything to do with what should/should not be coded.
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I experienced the opposite I got deducted for adding a chronic condition (DM Type 2 with insulin)
 
BMSorensen said:
I don't understand the "E" and "N/S". I submitted R14.0 and it now has a red "E". The answer key has R14.0 and a red "N/S". With the 0%, it seems everyone is wrong. It's also unclear as to when I can submit "post coding notes" - it seems I can't leave the graded screen and come back and then post a note. Any feedback is appreciated.
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I found the Practicode feedback often disappointing and unhelpful. It usually only gives you the index pathways to find the correct codes but does a pretty poor job of justifying the answers. If it did that, it would be an invaluable nugget of information that I could apply in similar cases.
 
Allysaloop said:
Hey all, hope you're still hanging in there! I had another scenario I was wondering if anyone else experienced. OPD7293 in Practicode lists Depression and Hyperlipidemia under Dxs while the visit was for Hypertension, Dorsalgia, and Sleep Apnea. The claim being since they are chronic conditions that don't resolve, they should be coded even though they weren't in the assessment. I thought we are only supposed to code what was actually addressed in the encounter? Another case listed Depression and Hypothyroidism in the problem list, but they weren't coded with the reason for the visit which were Hypertension, Paroxysmal SVT, and A-FIB. At this point I just want to know what is considered addressed or not addressed at an encounter; has anyone noticed this and what do you think? :)
Click to expand...
I'm in the same boat. My first instinct is to code everything in the assessment and use the rest of the note for more specificity. I also code things in the problem list and note-body that I believe would likely be coded because they seem like risk factors such as tobacco-use and anxiety even when it's not in the assessment or explicitly addressed in the visit. But that backfires around 50% of the time and seems very fickle. I get punished for coding those things and for not coding them.
 
vtoria82 said:
At least I know now that it's not just me. Practicode is killing my self-confidence :(
I hope when I get a job there will at least be someone to help answer questions quicker than Practicode
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I've trying to find any method to that madness myself. I wanted to think it's not random and that there was something about the cases where things like smoking are and aren't coded that I missed, some pattern or detail that I haven't seen yet.
 
I was doing my Practicode cases and I got confused why code Z71.2 was appropriate for case OPD7458 but not for case OPD7460. Was it because OPD7458 was only about reviewing test results while OPD7460 involved both that and addressing other present issues?
 
leosailor@icloud.com said:
I will make a confession that I use ChatGPT to both check my work and guide me to the right codes. Anyone else use ChatGPT or a similar ai platform like Claude?
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Just curious if AI is leading you to the correct answers. I too have been struggling through Practicode and just stumbled upon this thread. I phone a friend, as my sister and niece have been "real-world" coders for several years. My sister has been doing this for 17 years (coding, auditing and educating) and has told me over and over again that in the "real-world" it would be coded the way I think it should be not the way Practicode grades it. I send appeals and argue my case all the time, sometimes I win and sometimes I lose.
Even Google sees the difference between Practicode coding and real world coding.

Based on general real-world National Correct Coding Initiative (NCCI) guidelines and standard orthopedic coding conventions, modifier 25 does not need to be appended to the E/M code when billed solely alongside an X-ray. [1, 2]
Diagnostic X-rays carry a global surgery indicator of "XXX", meaning they do not have a global period, do not bundle with evaluation and management services, and do not inherently require modifier 25 to unbundle the encounter. [1, 2]

⚠️
The AAPC Practicode / Exam Exception
However, if you are completing an official AAPC Practicode module, AAPC curriculum case, or a Certified Orthopedic Surgery Coder (COSC) practice exam, you must follow a known AAPC-specific grading quirk. [1]
AAPC training modules utilize automated grading rationales stating that any procedure—including those with XXX global days like radiology—technically triggers the requirement for modifier 25 if a separate E/M occurred. [1]
  • For Real-World Billing: Do not use modifier 25. The prevailing convention is to report the E/M and the X-ray code without it, as there is no NCCI edit between them.


    [1, 2, 3]
  • For AAPC Practicode Grading: Append modifier 25 to the E/M code (e.g., 99203-25 or 99204-25). If you do not append it within the Practicode environment, the automated grading mechanism will likely mark your answer as incorrect. [1, 2]

Are you preparing for a specific AAPC certification exam (like the CPC or COSC), or are you looking to resolve a payment denial with a specific commercial insurance payer?

















  • AAPC

    Avoid These Traps When Reporting Modifier 25 and Know That ' ...
    Nov 25, 2013 — Modifier 25 can only be reported when the physician performs a separate and significantly identifiably E/M service in addition to ...

  • AAPC

    Modifier 25 and X Rays in MD office Setting - AAPC
    Jan 29, 2020 — A Modifier 25 is used to override an NCCI edit. If there's no NCCI edit between the office visit and the xray code, there's no rea...

  • AAPC

    Don't Bundle E/M and X-ray : Reader Question - AAPC
    Coders might be tempted to append modifier 25 (Significant, separately identifiable evaluation and management service by the same ...
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I've been coding and auditing for 12 years. And Practicode makes me feel like an idiot. I code only what's discussed in the A&P, I'm marked off for not coding things in the patient's history, like their shellfish allergy. (They were there for URI symptoms.) I code everything, I'm marked off because not all of the conditions were relevant to the visit. I didn't code the activity and place codes, since they aren't required, and was marked off. I coded a muscle strain as unspecified because it was, and apparently I should have known it was this specific type. That one, I argued with them about. I said "show me where in this note it uses the words [whatever they were, I've blocked it out.] Because that is a medical judgement and I'm not a doctor." I code just the E/M--because it was an E/M module--and was marked off for leaving out the other procedure. Next one was a hospital case, and I code the E/M, procedures, and imaging. Wrong, I was only supposed to code the physician's E/M.

After about the fifth time I fought them over these kinds of inconsistencies, I gave up. They can keep my $60 (I paid for 2 modules.)
 
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