7 Questions to Determine How Best to Conduct Coder Training

by Barry Libman, MS, RHIA, CDIP, CCS, CCS-P, CIC and Lynn Kuehn, MS, RHIA, CCS-P

Regardless of the specifics, all coding managers must answer this important question for any coder training they intend to offer: Will coders use online modules, or will they undergo training on-site? Of course, there is no one-size-fits-all answer to this question, and both options have their merits.

Consider these seven questions when determining whether on-site versus online training is the best option:

1. How many coders work remotely? Although on-site training is convenient for a fully on-site staff, it does introduce complexities when some (or all) of your coders work remotely. For example, if you’re located in the northeast, and you know that training must take place in December, is it realistic to require all remote coders to travel on-site when weather conditions are unpredictable? You may not want to take the gamble, especially when the training is time-sensitive.

Weather concerns aside, it’s certainly possible to train even a large remote staff on-site. If you usually require coders to come on-site once or twice a year, you could provide in-depth training at that time, followed up with subsequent online training. For example, some organizations opt to provide general ICD-10-CM/PCS update education on-site annually, with supplemental specialty-specific online training. This hybrid approach can be extremely cost-effective and efficient.

2. How will you maintain the discharged not final billed (DNFB) during education downtime? How much productive time will be lost when coders undergo the actual training itself, and are you able to outsource some or all of their work so the DNFB isn’t affected? This is less of an issue with online training because coders can complete modules during downtime and/or on their own time, though it’s still something to consider if you plan to build online training time into the workday.

3. What’s the topic of the training? Does it lend itself to a group learning environment in which coders can ask questions and problem-solve together, or is it better suited for individual learning? For example, if you want to train newer coders on how to code complex spinal surgeries, you might want to consider on-site training where students can discuss case studies and the instructor can read students’ body language and facial expressions to assess whether they truly understand the course material.

4. What’s your training budget? How do your online versus on-site options stack up against this allotted amount? When tallying up total amounts for on-site training, don’t forget to include costs associated with travel and lodging for any remote staff. This is especially important when training sessions are offered in succession rather than all at once (e.g., once per week for three weeks or once per month for three months), because it drives up the travel costs for remote staff.

5. What do your coders prefer? This is something to consider, given each coder’s individual learning style, but it certainly shouldn’t be the single deciding factor in your decision.

6. How many coders must be trained? This is important because it dictates the type of physical space required for on-site training. When training a large group of coders, for example, do you have access to enough computers? If not, can you rent space locally, and if so, what are the associated costs? Another option is to split the class size, although one disadvantage of this is that training sessions may be slightly different depending on real-time adjustments in the curriculum.

7. How soon must coders be trained? Even though the rush for basic ICD-10-CM/PCS education has passed, coding managers must continue to remain cognizant of the Oct. 1 deadline for ICD-10-CM updates and the Jan. 1 deadline for CPT updates. Instructor availability is also something to consider as these deadlines approach.

Information in this blog was previously published by the authors in ICD-10 Monitor on March 2, 2017.


Barry Libman, MS, RHIA, CDIP, CCS, CCS-P, CIC, is recognized for his in-depth knowledge of coding and reimbursement issues for acute care hospitals. An area of particular interest and expertise is Long Term Acute Care Hospital (LTACH) coding.Barry is the founder of both Barry Libman Inc., a company that provides coding, audit, and educational services to the HIM departments of healthcare institutions, as well as Libman Education, a leading provider of training for the health care workforce. Prior to forming these organizations, he held a number of positions in the health information management field, working for hospitals, insurers, consulting firms, and regulatory bodies. Barry is often called upon to provide education and training on code updates and coding issues. He received the Professional Achievement Award from the Massachusetts Health Information Management Association (MaHIMA), served on the MaHIMA Board of Directors, and served as a representative to the House of Delegates held at the AHIMA national conference. Barry is a graduate of Northeastern University and received a Masters in Healthcare Administration from Simmons College.

Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA, is president of Kuehn Consulting, LLC, in Waukesha, Wisconsin, a consulting firm specializing in coding for all settings and physician practice management issues. Lynn has been deeply immersed in the ICD-10 coding system and training for ICD-10 and was among the first instructors for AHIMA’s ICD-10 Train-the-Trainers.  She has authored Libman Education’s 3-part series of ICD-10-PCS courses and E/M Coding: Evaluation and Management Coding for Professional Fee Services.

About the Author

Lynn Kuehn is president of Kuehn Consulting, LLC, in Waukesha, Wisconsin, a consulting firm specializing in ICD-10-PCS coding for the inpatient setting. Lynn is a nationally recognized trainer on ICD-10-PCS and other HIM-related topics. Lynn served on the AHIMA Board of Directors and authored several of AHIMA’s most popular books including ICD-10-PCS: An Applied Approach and Procedural Coding and Reimbursement for Physician Services. Together with her co-Author Theresa Jorwic, Lynn received the Triumph Literary Legacy Award from AHIMA for ICD-10-PCS: An Applied Approach. Called the “go-to” resource for learning and mastering ICD-10-PCS, ICD-10-PCS: An Applied Approach provides step-by-step instructions and exercises at all levels, and is used throughout Kuehn’s ICD-10-PCS courses authored for Libman Education.

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