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Focus on Staffing: Coder retention in the run-up to ICD-10

Published on September 8, 2014


As healthcare organizations look forward to a post-ICD-10 world, being prepared with HIM capacity and efficiency will be essential for financial success. Coding is a vital issue – and is at a stage of evolution similar to that of transcription 20 years ago, before the advent of today’s high-performance services delivery model. The evolution of coding technology – encoders, CAC, automated query systems – can provide much-needed leverage to enhance staffing models and allow necessary futuristic transformation of the coding process to occur.

Staffing models for coding will have to change post-ICD-10, because coding will take longer, especially when assigning codes for inpatient procedures (ICD-10-PCS). Some states require both ICD-10-PCS and CPT for outpatient procedure coding, so that must also be factored into the equation. Transforming coding today will help reinforce CDI and revenue cycle programs sooner, maximizing benefits.

Optimal staffing is not without its challenges, of course, and these remain despite the ICD-10 delay. Some estimates suggest that there are 30% more medical coding positions than qualified coders in the United States. The job market for medical records and health information technicians is anticipated to grow 22 percent from 2012 to 2022, according to the U.S. Department of Labor. Despite this, multiple surveys over the last year show there are worries that a shortage of qualified coders will persist. Most recently a May/June 2014 survey by eHI and AHIMA revealed that 31% of respondent plan to hire more coders to mitigate productivity losses, 29% plan to purchase computer assisted coding (CAC) technology or similar tools, and 28% plan to contract with outsourced coding companies.

This coder shortage may be compounded by the fact that many coders may retire once ICD-10 is implemented.

Against this backdrop, retention of coders stands out as a top priority. Organizations should aim to drive coder satisfaction by showing commitment to these valued team members, investing in training, and providing stimulating and rewarding career options. Plus, experienced coding team members can address issues quickly by leveraging their organizational relationships and insights. This is a win-win for employee and employer, keeping qualified people happy and on-board, building careers and minimizing the need to expend resources on recruiting.

At M*Modal, we are committed to meeting needs for outsourced coding – particularly for outpatient coders – through our industry-leading training programs for our medical transcriptionists and new coders. These 3-6 month programs have the goal of providing a career path for long-term HDS personnel interested in coding and also an exciting learning and onboarding environment for new coders, including recent HIM/HIT graduates or candidates with some coding credentials but limited work experience. Our company provides baseline HIM education and coding training and, during later phases , candidates transition into live account production with 100% quality monitoring until achievement of specified program benchmarks. The response has been very positive.

“I’ve been trying to switch from transcription to coding for a few years now, but haven’t had much luck because of lack of opportunities in my local area or cost-prohibitive on-line programs. This program provides me with an opportunity to receive quality training while remaining with my current employer …I truly believe that without this program I would not have a future in coding.”

Looking forward to ICD-10, already over-worked coders may find themselves up to 50% less productive, creating cash-flow backlogs. Identifying resource gaps and developing strategies now – in areas such as coder career development, clinical documentation improvement programs and outsourcing – will make all the difference when October 2015 arrives.

About the author

Becky Buegel has over 32 years of experience in healthcare information management. Currently Director, Education Services, HIM Services Division for M*Modal, Ms. Buegel developed training programs in ICD-9-CM, ICD-10-CM/PCS and CPT coding for several different companies. She also developed the Health Information Technology Associate Degree Program at Brookline College in Phoenix, AZ. A published author and an accomplished professional speaker, Ms. Buegel holds the RHIA, CHP, and CDIP credentials from the American Health Information Management Association (AHIMA) and is an AHIMA-Approved ICD-10-CM/PCS Trainer. She also holds the CHC – Certified Healthcare Compliance – credential from HCCA (Health Care Compliance Association.) Ms. Buegel actively volunteers for both her state and national professional associations; she also volunteers with ACICS, the Accrediting Council for Independent Colleges and Schools as an evaluator for HIT and coding programs.