ICD-10 to usher in new generation of tech-savvy medical coders

Hospitals are starting to hire younger, more diverse people to handle the new coding. The shift will likely benefit healthcare organizations in time, but it won’t happen overnight.  
By John Andrews
09:41 AM

The transition to ICD-10 is already beginning to change the make-up of coding staffs.

While ICD-9 coders, aka Niners, tended to be predominantly middle-aged women unready or unwilling to learn the new ICD-10 codes, the next generation is poised to be younger, more gender diverse and tech savvy.

"We saw some Tenners hired a year ago before the delay was announced," said Pauline O'Dowd, senior director with Chicago-based Huron Healthcare. "Some of the older coders delayed their retirement, while others left."

The rationale among many ICD-9 coding veterans: Too much to learn, too late in life … might as well retire.

The difference in volume between ICD-9 and ICD-10 is staggering: 69,368 diagnosis codes and 87,000 procedure codes under 10, compared with 13,500 diagnosis codes and 4,000 procedure codes under 9.

A self-described Niner, Diane Rivers said if things progressed according to that script, she would have followed many of her colleagues out the door.

Instead, Rivers ended up becoming an expert in ICD-10.


This article is part of a Special Report on ICD-10. Other stories include one data scientist’s view that providers can recoup millions of dollars by running advanced analytics against denied claims datasets, and the growing concern that the transition will get more difficult on Oct. 1, 2106, when CMS and commercial payers begin demanding greater specificity. 


"I saw the handwriting on the wall in 2012 and thought by the time ICD-10 hit I'd retire and become an artist," she said. "I reached a crossroads and I could either join my friends in retirement or take it seriously. I decided to buckle down and learn it."

Admittedly, Rivers "begrudgingly" began learning ICD-10 and found the experience trying at first, but through arduous commitment she began to "see it for what it is ― a new language and a way to keep my mind sharp."

The effort landed her at a job as coding practice director for Jacksonville, Fla.-based CSI Healthcare IT, a third-party coding firm, where she supervises a staff of 60.

Indeed, Rivers stands as evidence that the evolution from Niners to tech-savvy Tenners won’t come overnight.

For one thing, the one-year delay caused some staffing confusion within coding departments and, because the Centers for Medicare and Medicaid Services and commercial payers are not denying codes as long as they’re submitted in the same “family,” it has prolonged the career of Niners.

As auditor, coder and supervisor, Rivers is overseeing a team made up of younger generation Tenners.

“That includes an influx of young males,” she said, “who are grabbing the job by the horns and showing more confidence about the opportunities that exist."

Opportunities that will only expand when payers start demanding greater specificity and denying claims that lack proper documentation come October 1 2016. 

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