How to Cross-train Your Coding Staff Now

by Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA

Our healthcare institutions are remaking themselves in response to these extraordinary times. The normal range of demand for hospital services is being replaced by the particular needs of the COVID-19 patient. Outpatient services and elective procedure volumes are way down at some hospitals across the country, leaving outpatient coders with less work to do.

Cross-training has always been a smart strategy to ensure adequate coverage for the ebbs and flows of the coding process. It is a particularly useful strategy dealing with the uncertainty of this pandemic.

My suggestion is to take your best and brightest outpatient coders and train them for inpatient coding. Identify the coders who you believe have the best chance of success: the ones who like a challenge, who work a coding problem until they know the answer. If you have a pre-employment inpatient coding test, use that to select those who could best rise to the challenge. (If you don’t have a test available, Libman Education has assessments that you can purchase to help with this.)

Use your existing inpatient coders (who may be seeing a change away from complex surgical cases to more medical cases) to train their outpatient colleagues on your own records. Supplement this mentoring with structured coder training that presents complex concepts tailored to the coding challenges we are seeing today.

This may work especially well for those outpatient coders who were trained in ICD-10-PCS alongside the inpatient coders during ICD-10 implementation. They had initial training and now it is time to put that training to use. Even medical cases can have ICD-10-PCS codes that require assignment. In our current situation, start with refresher training on accurate assignment of codes for cases you may be seeing more of now such as mechanical ventilation and other bedside respiratory procedures such as bronchoscopies.

It has been said “Never let a crisis go to waste.” Take advantage of this disruption and any downtime that outpatient coders may have to help these coders prepare for the post-COVID-19 healthcare system. Keep your staff engaged with their profession and with you as their employer. Have them self-assess what they would like to learn and match this to what your facility may need in the future. Help them to use their time wisely now to gain their CEUs in this new completely virtual environment.

A better trained coding staff will provide greater flexibility for you to deal with potential staff shortages or some other unforeseen change that may come. Up-to-date and enhanced coding skills means more job security for your coders who work to maintain and advance their skills.

Getting your coders to focus on this training effort at this time will remind them that life will continue, that we are counting on them now and in the future, and that thoughtful preparation will help all of us be better positioned when our hospital and our world returns to normal.

Look to Libman Education for help in these challenging times.


Hospital CodingAccelerated Outpatient to Inpatient Coder Training
Cross-training for existing outpatient coders. Quickly prepare additional inpatient coding resources to support critical hospital operations. Accelerated Outpatient to Inpatient Coder Training builds on an outpatient coder’s valuable on-the-job experience and knowledge and supplements their skills with the essential training necessary to assume inpatient coding responsibilities. Learn more here.

About the Author

Lynn Kuehn is president of Kuehn Consulting, LLC, and a nationally recognized authority on ICD-10-PCS coding. Lynn was elected to the AHIMA Board of Directors, served as faculty for the original ICD-10 “Train-the-Trainers” program, and authored or co-authored several of AHIMA’s most popular books including ICD-10-PCS: An Applied Approach, recognized as the “go-to” resource for learning and mastering ICD-10-PCS. As a Subject Matter Expert with Libman Education, Lynn’s unique and engaging teaching methods as well as her leadership on the importance of accuracy and efficiency in coding is recognized by clients and students throughout the country.

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