Health Information Management

What will the future hold for coders when ICD-10 takes effect in 2013?

JustCoding News: Outpatient, May 5, 2010

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The ICD-10 countdown is on. Although some facilities may be relieved at the thought that it won’t be implemented until October 1, 2013, in reality, this date should motivate providers to throw their implementation efforts into high gear. CMS representatives have repeatedly warned providers that implementation will take place without delay and without exception.

Many HIM and coding professionals are bracing themselves for the obvious initial decrease in coder productivity. But what are industry insiders’ expectations in terms of how ICD-10 will affect the coding profession and, in turn, salaries?

“I’m confident that salaries will go up because the majority of this additional clinical learning that will be required for ICD-10 will not occur while coders are on the job,” says Glenn Krauss, BBA, RHIA, CCS, CCS-P, CPUR, PCS, FCS, C-CDIS, CCDS, an independent coding consultant in Milton, WI. “Coders will need to take the initiative to read lots of handouts and attend seminars, and if I’m taking the initiative to learn more, I would hope that the payback will reflect the wages that go with it.”

Most coders don’t have time to do a lot of reading or study on the job, so they can use this as an opportunity to demonstrate their initiative to learn the new content on their own, starting by recognizing their own deficiencies, says Krauss.

ICD-10 will prompt the healthcare industry to recognize the value of competent coders. However, the necessary clinical expertise required to code with ICD-10 might invite others to join the coding profession, says Rose T. Dunn, MBA, RHIA, CPA, FACHE, chief operating officer at First Class Solutions, Inc., in Maryland Heights, MO.

'“Clearly, our existing coding professionals would be wise to expand on clinical knowledge now as much as possible so that they can effectively compete with others who may have this clinical expertise,” Dunn says. “I think salaries will have to go up with ICD-10. I think supply and demand will push that.”

Take into account age distribution
The current age distribution among coders may also factor into how ICD-10 will affect the profession. According to the 2009 JustCoding Salary Survey, consider the breakdown of the more than 500 survey respondents by age:

  • Under 20: 0%
  • 21–30: 5%
  • 31–40: 17%
  • 41–50: 36%
  • 51–60: 35%
  • 61–70: 7%

The fact that only 5% of coders fall into the 21–30 age range but more than 70% of respondents fall into the 41–60 age range suggests that, overall, the supply of younger coders is not going to keep pace, says James H. Braden, MBA, corporate director of HIM at Health Quest health system in Poughkeepsie, NY.

Also, when people retire or move on to other careers, this will just exacerbate the current coder shortage, Dunn says. “However, the implementation timetable of ICD-10 corresponds with the electronic health record initiatives and the possibility of using artificial intelligence and natural language processing to support computer-assisted coding [CAC]. CAC may also help relieve some of the supply and demand issues,” she adds.

“There needs to be more awareness of coding as a profession among young people,” says Roxanne Parrella, RHIT, CHP, CCS, CPC, director of HIM at Vassar Brothers Medical Center in Poughkeepsie, NY.
Krauss agrees. “Someone who has been coding for 29 years will probably not stick around for ICD-10,” he says.

Others view the anticipated mass exodus of a significant number of coders as more of a myth. “I just see it as another transition to another coding system,” Parrella says. “I have heard people say, ‘That’s it for me. I’m going to retire.’ But I don’t think you’re going to see that. I think that it will be no different from when we went from ICD-8 to ICD-9.”

What is more certain is that coding schools will be overwhelmed with the need to train new coders and retrain existing coders in ICD-10, Dunn says.

“Skill sets will change, so job descriptions will change, requiring clinical courses and clinical expertise,” explains Dunn. “This will in turn change the value assigned for that job title, thereby increasing the rate of pay.”

Don’t underestimate transition management
Managing the transition to ICD-10 will play a greater role in job satisfaction than coder salaries, Braden says.

“I don’t think that there will be a direct correlation between ICD-10 and financial compensation,” he explains. “I think that the degree to which we manage the transition will have a direct correlation to job satisfaction and the ability to maintain talented staff.”

If organizations do not devote the resources and time to effectively engage their coders and nurture them through this change, they will lose these valuable staff members, Braden says.

It’s important to consider that 35% of survey respondents said they were 51–60 years old.

“This is more than a third of your coding resources. They may say that ICD-10 brings too much change, and the transition is not well managed, so it’s time to bail,” Braden says. “This tells me that we have to do a very good job of managing and preparing people for change. A good process has to be in place to support people at what is clearly the last trimester of their professional careers.”

Editor’s note: This article is an excerpt from the 2009 Coder Salary Survey: A Special Report. The complete report will be available to JustCoding Platinum members May 12. E-mail questions to Managing Editor Doreen V. Bentley, CPC-A, at

To learn more about ICD-10 or to read about recent ICD-10 news, including reports from the 2010 ICD-10 Summit in Washington, DC, April 12–13, subscribe to the ICD-10 Watch blog by JustCoding.

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