Most healthcare organizations develop internal coding guidelines to address medical conditions, procedures, and clinical scenarios not yet covered by official coding standards. This session reviews several high‑impact coding issues that currently lack formal guidance, including prescription drug management, “mild” condition definitions, acute vs. chronic musculoskeletal disorders, complete vs. incomplete rotator cuff tears, simple vs. complex procedures, viable vs. non‑viable open wounds, and diagnosis linking related to discontinued modifier 53. Attendees will also see examples of internal coding policies used to address these scenarios, offering practical strategies for developing consistent, defensible coding practices.