Coders Certified in ICD-10 Will Be 'Hot Commodity'

February 21, 2013

Physician practices must hustle to either retain or replace their professional coders as a new, more complex set of diagnostic codes called ICD-10 triggers a wave of retirements in that field, according to a new report from the research firm KLAS.

"We are hearing from providers that they are watching out for early retirements," study author Lois Krotz told Medscape Medical News. "The average age for coders is 57. Providers mention, 'Do our coders want to climb another learning curve?' "

ICD-10 stands for the International Statistical Classification of Diseases and Related Health Problems, 10th Revision. As mandated by the Centers for Medicare & Medicaid Services, ICD-10 will replace the current code set called ICD-9 on January 1.

Coders who choose to climb this next learning curve and become certified in ICD-10 will be a "hot commodity" for medical practices and hospitals, Krotz said.

A few numbers show why the learning curve will be steep: ICD-10 contains 68,000 diagnostic codes, roughly 5 times the number in ICD-9; the new codes run to a maximum of 7 characters, whereas the old codes run to 5; and with the new codes come new documentation requirements to justify choosing one string of characters over another. Organized medicine has asked the Centers for Medicare & Medicaid Services for a more simplified code set, but to no avail.

When Should Practices Schedule ICD-10 Training?

In its new study, released December 2011, KLAS checked in with 94 hospitals and a handful of medical practices to assess their readiness for ICD-10 and how much help they were getting from software vendors and consulting companies. KLAS found that many organizations planned to wait until the second half of 2013 to train clinicians and support staff to work with the new codes. One reason for the delay, said Krotz, is that provider organizations are wary of getting their coders certified on ICD-10 early on, lest another organization swoop in and recruit them.

For physicians, the rationale for delay is different, said Krotz. Some organizations believe that if you train clinicians too soon on ICD-10, they may forget what they learned by January 1. "And then they have to train again," she said.

However, the early trainers do not regret it, said Krotz, because they believe they will experience a smoother transition to the new codes and break old coding habits. Along those lines, she said, some organizations are "dual coding" — selecting both an ICD-9 code and an ICD-10 code for a particular diagnosis — to better familiarize themselves with the new order of things in the run-up to 2014.

Larger provider organizations such as hospitals are turning to consulting firms to help them switch to ICD-10, but that is usually not an affordable option for smaller physician practices, said Krotz, noting that their conversion to the new coding system will be less complicated anyway, because their computer systems are simpler.

Many physician practices instead seek ICD-10 guidance from the company that sold them their electronic health record (EHR) or practice management system. Not all software vendors, however, are created equal when it comes to vendor helpfulness, according to the KLAS report. Providers gave the highest ratings to EHR vendors Siemens, Cerner, and Epic Systems. Bringing up the rear were Allscripts and Meditech. The ratings partly reflect how well the vendors keep their customers informed about the conversion process to the new codes, said Krotz. "Communication is the key."

The KLAS report can be purchased on the company's Web site. Survey data on individual vendors are free if physicians complete an online survey about the medical software, equipment, or computer services they use.