Ultimate Guide to Submitting a Question to the Coding Experts

7 min read

The AHA Central Office serves as the official coding clearinghouse on the proper use of the ICD-10-CM, ICD-10-PCS and HCPCS Level II classification systems.  Because of our commitment to the CDC, we review and process your medical coding questions free of charge.  

So, what do you need to do when you have a medical coding question? There are three basic steps to follow.  

Step 1: Refer to the Alphabetical Index, Tabular List, Official Coding Guidelines, and Coding Clinic

We recommend you consult these resources first to determine if there is previous guidance to help answer your question. If there is no guidance, then proceed to step 2.

Step 2: Gather Your Documentation

Include medical record documents that provide context to the question being submitted; it helps if you include HIPAA-compliant supporting documentation with your request.  

Please note, our office cannot provide clinical interpretation, and any request asking for clinical interpretation will be returned unanswered. Additionally, do not submit any document that contains:

• Personal Health Information (PHI)
• Physician name(s)
• Hospital name(s)

Any question submission or related document that includes PHI, physician names, or hospital names will be rejected. The question will not be accepted or answered.  

Step 3: Submit Your Question

It’s time to submit your question to the AHA Central Office! Please remember that you must first create an account on the Coding Clinic Advisor website before submitting a question.  

When you write your question, be specific as possible and explain what the coding problem is. Finally, be sure to specify the type of care setting (e.g., inpatient, outpatient, long-term acute care hospital, home care), as the answer may vary depending on applicable rules or type of encounter.

Please Remember: Medical Coding Questions Only!  

It is our honor to help answer your medical coding questions. However, there are certain things we cannot do:

1. Provide guidance on payment or coverage issues.
2. Answer questions related to:
   1. Outpatient procedures
   2. Clinical issues or clinical criteria for diagnoses or procedures. This includes requests asking what clinical components are inherent to a diagnosis and/or procedure. These clinical matters may be best addressed by querying the provider.  
   3. The completion of OASIS (the Outcome and Assessment Information Set) or IRF-PAI (Inpatient Rehabilitation Facility Patient Assessment Instrument) forms.
   4. ICD-10-CM Index or Tabular List problems or conflicting instructions. If you have a question related to these topics, please reach out to nchsicd10CM@cdc.gov [mailto]. For more details, visit the CDC website.  
   5. ICD-10-PCS Index entries, ICD-10-PCS device definitions, ICD-10-PCS Reference manual, or the General Equivalence Mappings (GEMS). For proposal submission, please use the Medicare Electronic Application Request Information System (MEARISTM), found at https://mearis.cms.gov/public/home.  For more details, visit the CMS website. 
   6. HCPCS questions/inquiries from physician providers related to CPT-4 and HCPCS level II questions related to durable medical equipment, prosthetics, orthotics, and other supplies.  
   7. MS-DRGs and reimbursement. The MS-DRG Grouper is the responsibility of the Centers for Medicare & Medicaid Services (CMS). To recommend MS-DRG changes, complications/comorbidities (CC) or major complications/comorbidities (MCC) and other MS-DRG-related issues, please use the Medicare Electronic Application Request Information System (MEARISTM).  
3. Code an entire medical record or operative report, or to validate a code assignment. This includes requests to identify the principal diagnosis and/or the objective/root operation of the procedure. This is outside our scope of services.
4. Provide clinical information or clinical interpretation.  

What Will Happen After I Submit My Question?  

The question will be entered into our internal database that the AHA Central Office reviews daily, and you will receive a tracking number for your question. The tracking number will be emailed to you, and it will also appear in your “My Questions” list on your account. You can log back in any time to check on your question's status. For more information about the question status types, please visit the FAQ page.