The following article is drawn from our recent roundtable discussion on the Impact of COVID-19 on the Coding Function. To view the complete roundtable discussion, see The Impact of COVID-19 on the Coding Function: A Roundtable Discussion.
MODERATOR: What are some of the new (and emerging) roles for coders during COVID-19 and beyond? For example, do you think skilled coders will move into CDI roles? What are some of the barriers and challenges?
“We’re working on creating clearer career paths to move up in the organization whether it’s in coding or other areas of the revenue cycle or even the professional coding side.”
AUGUSTE: I think coders can move into data analyst roles and be more involved in conversations about how data is used for value-based contracting, mergers, and acquisitions. They could also move into outpatient CDI; however, they would need additional training on how to communicate with physicians.
TAKEI: I think coders are able to expand into roles beyond coding. For example, coding provides a great foundation for individuals wanting to expand their careers into areas such as CDI (inpatient and outpatient), clinical validation, APC and DRG auditing, and revenue integrity to name a few. Our inpatient coders work closely with our CDI team, and we have two coders who recently obtained their CDI credentials. Our coding team has access to CDI educational modules with clinical scenarios and guidance to help identify clinical indicators for use in a compliant query. We also have a couple of our coders participating on our Automated Simple Coding task team. I think the greatest challenge will be in person interaction with physicians.
HARMON: Some coders at our organization have already moved into CDI roles, and our CDI department is staffed entirely by coders. I think the idea that CDI specialists need to be nurses has been oversold. HIM professionals know the clinical terms. They may not know how to provide bedside care, but they certainly can read a record. Strong coders with the right experience can be just as effective. There are other new and emerging roles for coders as well. We watched digital voice recognition change the transcription industry. Computer-assisted coding and artificial intelligence is here, and it’s being implemented in increments. For coders, I think a future role will be a deep subject matter expert. Coder as reviewer and documentation coach—this is the future. I also think there are opportunities in quality assurance, credentialing, research, and education.
The biggest challenge for coders moving into any new role is that they need to be able to sell themselves. We can’t be the nameless, faceless person who never comes onsite. Network with providers, follow up after meetings, volunteer to serve on committees. If you show up with quality responses, help to problem solve, communicate what you know, and stay engaged, people will notice you—and opportunities will open up. You will be seen as an asset.
PELLETIER: I don’t see coders moving into CDI because it’s so clinical. I do see coders moving into revenue integrity analyst roles where they review charges, modifiers, CCI edits, and medical necessity. We have also hired work queue analysts who need to be able to think through the coding and billing aspects of a claim.
OSBORNE: We’re working on creating clearer career paths to move up in the organization whether it’s in coding or other areas of the revenue cycle or even the professional coding side. We’ve had coders move into compliance and revenue integrity. Other roles would be auditing, continuing education, and consulting. It all depends on the person.
Our challenge is to provide some additional resources as well as convince coders that they need to stretch themselves in the softer skills—not necessarily the technical skills. It takes an alliance between the employee and manager to identify next steps. It’s a shared responsibility. Our management is working hard on this.
Barbara Auguste, CPC, CPMA, Director of Professional Fee and Outpatient Coding Services at Maimonides Medical Center in Brooklyn, New York
Rebecca Harmon, MPM, RHIA, CCA, HIM Director and Educator in Pennsylvania
Wendy Pelletier, RHIA, CCS, CPC, Director of Coding at Maine Medical Center in Portland, Maine
Maryellen Osborne, RHIA, Enterprise Director of RCO Coding and CDI at Mass General Brigham in Boston, Massachusetts
Cheryl Takei, MHA, RHIA, CDIP, CCS, HIM professional in southern California
Lisa A. Eramo, MA, moderator and freelance writer
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