Cross-Training Coders: Four Tips to Consider

Developing the Coders You Need – Part 3 of 4

By Lisa A. Eramo, MA

Let’s face it. Change is hard. Really hard. This is true in our personal lives, and it’s also true for coders transitioning from outpatient to inpatient roles out of a desire to earn more money and promote professional growth. It’s no wonder why fear reigns supreme. There are novel workflows and codes, new coding guidelines, and so much more to learn and master—all while meeting and exceeding productivity and accuracy goals.

“There’s a huge fear of doing this—of moving into inpatient coding,” says Carrie Corbeau, RHIT, CCS, a coder at MaineHealth who is in the process of completing an inpatient apprenticeship program as well as Libman Education’s Practical Coding Experience: Inpatient course that provides learners with hands-on coding practice coupled with detailed guidance on correct ICD-10-CM and ICD-10-PCS code assignment. “People are scared because there’s a lot of knowledge involved.”

Course author Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA, says the vast amount of information in an inpatient record can be daunting. “It takes practice to find the necessary information and turn that into accurate codes that completely describe the case. Many new inpatient coders can get lost in the weeds.”

We asked Corbeau and Cynthia Greathouse, MHA, RHIA, manager of inpatient clinical coding at MaineHealth, to share their thoughts on overcoming coder fears as organizations embark on workforce development initiatives to combat coder shortages. Here’s what they had to say.

1. Set realistic expectations for yourself. “My biggest fear was just not knowing enough,” says Corbeau, who joined MaineHealth’s apprenticeship program after graduating from Kennebunk Community College. She was initially hired as an outpatient coding apprentice and worked for the hospital first in ancillary and clinics coding and more recently ambulatory surgery coding. “However, I’m coming to the realization that I will never know everything. Inpatient coding is a position where you constantly need to be learning.”

For example, Corbeau thought she knew ICD-10-PCS coding fairly well; however, after taking the Practical Coding Experience: Inpatient course, she discovered she needed additional training. As a result, she’s going to take Libman Education’s course ICD-10-PCS Guidelines: A Case Study Approach.

2. Use competency assessments. “Managers need to understand where each staff member is in terms of experience and knowledge and then provide extra training when needed,” says Greathouse.

Libman Education can also assist with skills assessments to help determine targeted learning opportunities, adds Kuehn.

3. Be flexible. Although managers should expect to see coding quality generally improve over time, they shouldn’t be discouraged if a new inpatient coder has a bad week or month quality-wise unless it’s a repeated pattern, says Greathouse.

4. Build coder confidence with immediate feedback. “When the answers about how to correctly code a record comes hours or even days later, this can cause a disconnect,” says Kuehn. “Providing immediate education reinforces the relationship between the record content and the correct codes.” Healthcare organizations can provide this feedback through one-on-one mentorship; however, they can also consider self-paced education that provides the feedback in more of an immediate manner.

Overcoming coder reservations about cross-training requires a commitment to ongoing education combined with realistic expectations that promote growth and confidence—not cause fear and anxiety. Coding managers who approach upskilling with an open mind and willingness to meet employees where they are will find it easier to promote from within and create and retain a stellar coder workforce.

Editor’s note: Stay tuned for additional blogs on how to ensure a successful coder workforce development program at your organization.

Practical Coding Experience: Inpatient
Coding Workspace™ will make you truly workforce-ready!
Hands-on coding practice coupled with detailed guidance on correct code assignment. Using Libman Education’s proprietary Coding Workspace™ format, learners sharpen their coding skills on real-world inpatient cases appropriate for the newer inpatient coder. Learn more here.

Disclaimer: This article is written for educational purposes only. Every reasonable effort has been made to ensure its accuracy and completeness. It is the responsibility of the reader to refer to the definitions, descriptions, conventions, and guidelines specific to each coding classification, as well as relevant laws and regulations when selecting and reporting medical codes.

About the Author

Lisa Eramo, MA
Lisa A. Eramo is a journalist who has written about HIM for more than a decade. “I enjoy writing about healthcare—and specifically HIM—because it touches everyone. Accurate health information is critical to ensuring positive outcomes and addressing disparities. I strive to highlight HIM professionals who are passionate about telling the patient’s story. My mission is also to shine a light on the important work of HIM, the challenges HIM professionals face, and the opportunities created by thoughtful and innovative HIM professionals nationwide.” Lisa studied creative writing at Hamilton College and obtained a master’s degree in journalism from Northeastern University. Lisa has owned and solely operated her own freelance business since 2009, providing quality writing and editing services to clients primarily in the healthcare industry–and more specifically, in health information management. Lisa is a member of the American Health Information Management Association, Society of Professional Journalists, and the American Society of Journalists and Authors. Contact Lisa at [email protected] or

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