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The coming medical coding crisis and what to do about it

For LDS Business College BrandView

Published: Saturday, Oct. 12 2013 2:40 p.m. MDT

In the coming months, the healthcare industry will face a growing lack of qualified medical coders to help the industry function.

Associated Press

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Come October 2014, the medical industry could find itself facing a crisis of not having enough qualified medical coders to meet what will be a burgeoning demand.

Medical coding is the process of translating medical diagnostics into numbers — the codes — that allow hospitals and insurance companies to transfer information for billing. With thousands of different codes to remember, medical coding is a profession that requires the proper amount of training, commonly two-year certification. But as the demand for qualified coders increases, the market in charge of supplying them has fallen behind.

The main reason this is a problem is that by next October, the current coding system — the International Clarification of Diseases 9, or ICD-9, which has been in place for more than 36 years — will be replaced by the more efficient ICD-10 nationwide.

“ICD-9 has about 13,000 three- to five-character codes,” explains Ashok Selvam on modernhealthcare.com. “ICD-10 allows for more detailed descriptions with about 69,000 codes between three and seven characters. The new standard also allows the use of more letters, increasing the uniqueness of the codes and leading to more precision.”

With such large changes between the old system and the new, a large amount of training is necessary, with old coders having to be retrained and new programs created to train new coders. With only a year left until the change is set to take place, “few coders have the needed ICD-10 skill sets,” Selvam says.

Indeed, it is not a lack of potential coders that’s causing the problem; Selvam points out that though Labor Department information shows medical information technical jobs are expected to grow by at least 37,700 jobs in 2020, “there's no shortage of candidates interested in coding jobs.” With an average salary of $48,925 and work-from-home opportunities, for those with certifications it’s an attractive career choice — but lack of adequate training and programs available is holding the industry back.

With drastic losses of revenue expected if the medical industry isn’t adequately prepared for the change, everyone from private training companies to hospital-provided training and better school programs are rushing to be able to properly train the next generation of medical coders.

While having hospitals themselves retrain the current coders is an option, it is an expensive one that not many hospitals have the resources to commit to. Selvam claims that according to independent research, “The ICD-10 transition will cost a three-physician practice $83,290.”

This leaves educational institutions and the coder industry teaming up to be one of the more viable options.

LDS Business College has already started to prepare for training the next generation of coders, partnering with the Utah-based coder training company Aviacode and Florida-based HRAA coding to present a new coder training program for ICD-10. The key part of the new program, according to Louise Brown, director of public affairs at LDSBC, is the fourth and final semester consisting of a college-provided internship, allowing coding students to get on-the-job training and experience before they even graduate. “We call it ‘blurring the lines,' ” Brown says. “It mixes school and work (in a way) that helps them learn.”

In his article Selvam agrees that on-the-job training is vital for new coders. “It's not just the right code sets, but the right skill sets.”

If the health care system is to effectively transition, better training programs have the best potential. But the whole industry will have to work together to ensure success.

This article was paid for and produced by LDS Business College

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