Wednesday, September 5, 2012

Code for the Day: Is Now a Good Time for a Z56.1 (Change of job)?

In case you haven't been paying attention lately, there are a few things happening in the health care industry.  We have Obamacare, the insurgence of accountable health organizations, implementation of electronic health records (EHRs), and a firm date for ICD-10.  If you google "fastest growing industries" you will find many of the top 50 jobs are within health care.  And according to the US Bureau of Labor Statistics, the job outlook for a medical records/health information technician (including coding) is projected to grow faster than average at 21% by the year 2020.

For a lot of people pondering a change in careers, these statistics might seem like a no brainer, yet the transition to ICD-10 has a lot of people wondering:  is now a good time for a Z56.1 (Change of job)?

A selection of my codebooks - note the ancient green SNODO book!
I do get email from people asking me this very question.  Is now the right time to become a coder, or should I wait?  The job of a medical coder is very attractive because most coders work from home and many work on a flexible schedule.  I've had Facebook friends from high school and other walks of life telling me that they are passing my blog information onto their friends and family because they are interested in coding.  But I continue to hear the question - is now a good time?

In typical coder fashion, there is no short answer!

First things first, though.  Now is a great time to become a coder.  But it's not going to be easy if you decide to start now.  We do have ICD-10 coming up on October 1, 2014.  But most coding programs will have you graduating before then, which means you will learn both ICD-9 and ICD-10 (oh, and CPT too!  But CPT isn't changing).  You could wait a couple of years so you don't have to learn both systems, but here are 10 compelling reasons I think you shouldn't wait:
  1. Coding is 25% the codes themselves, 25% the coding guidelines, and 50% knowing how to navigate the massive word search that is a medical record (or operative report) and only abstract and code the right stuff.  This last 50% is the hardest part about being a coder and it takes equal parts natural skill and practice (lots of practice!).  Start practicing now.
  2. The industry is abuzz with talk about what current coders will do when ICD-10 is implemented.  Some have already said they intend to move on.  You will want to be trained and ready to go when their positions are vacated.
  3. You'll be "closer to the books" when it comes to ICD-10 and will probably get more intensive training than coders in facilities (except the coders I intend to train, that is!).
  4. Training to become a coder takes time.  You can't finish a class on September 30, 2014 and expect to land a job on October 1, 2014.  You won't be ready.
  5. Employers are about to freak out.  They have to implement ICD-10 in 2 years with limited resources and lots of moving parts.  They need to train their existing coders and my guess is, in about a year, they will not be as willing to take on a newbie as they are now.  If you wait, you may find it hard to get a job in 2014.
  6. When it comes to ICD-10, all coders are on a level playing field - except for that 50% abstracting thing - which means you will have the opportunity to roundtable and network with experienced coders who will be just as clueless about ICD-10 as you are.  But you will have an advantage - they will be pulling up lots of old ICD-9 references and you will be asking them "why" a lot (e.g., "why can/can't I code X with Y?").  While you might think you are naive, this is critical to everyone learning ICD-10 - you will give the experienced coders something to think about and you may find you know more than you think.
  7. Experience, experience, experience.  In coding, nothing is more of an asset than experience.  You could have all the coding credentials in the world, but without experience, they mean nothing to your future employer.  The more experience you have before October 1, 2014, the better.
  8. There are lots of great cost-effective and maybe even free opportunities to network and learn.  All coders are looking for ways to come together and learn ICD-10 right now.  In Colorado, our ICD-10 Task Force has created ICD-10 Coffee Chat Meetups every other month.  We come together with cases and discuss ICD-10 coding in a roundtable format.  And it's free.  Your local AAPC chapter or AHIMA component state association may also have something available, so check it out. 
  9. Attitude is everything.  If you tell a potential employer, fellow coder, or educator that you plan to wait because it doesn't make sense to learn ICD-9 and ICD-10 too, it's a huge red flag.  What it tells me is you don't want it badly enough.  Will it take extra work to learn ICD-9 and ICD-10?  Absolutely.  Will learning both pay off?  In spades - and it's not just about knowledge, it's your attitude to tackle the unknown.  I will take a positive attitude and willingness to learn over a stubborn attitude with experience any day.
  10. ICD-9 will not be used on claims after September 30, 2014, but it will still be needed and we will still need people who know how to use it.  Many auditing entities, including Medicare's recovery audit contractors (RACs) are several years behind in their auditing and someone will need to double check audit findings and verify their validity.  Likewise, various groups and agencies who use coded data (e.g., Health Grades) are looking at old data as well.  If you can code both ICD-9 and ICD-10 and better yet, compare data between the two, you will be an asset.
So what are you waiting for?  Get going!

Do You Have the Skill to be a Coder?

Perhaps you got stuck on the word "skill" above.  If you did, you're very astute.  Try as they might, not everyone has the skill to be a coder.  It takes a lot of knowledge in the medical sciences, detective abilities, and knowledge of coding guidelines.  Do you have what it takes?

I usually ask people who want to be coders if they like word searches.  A prompt "no" makes me a little wary.  Because medical records are word searches - you won't truly read an entire medical record because there simply isn't time.  And, as I am fond of telling some of the newer coders who find their way into my classes, just because there's a code for it, doesn't mean you assign it.

Here's a little word search for you to test out your skill.  The words are some that we see often in coding and are found forwards, backwards, up, down, and diagonally.  Yes, it's hard - but so is coding!  I will publish the solution tomorrow.

C S R G N V T S Y R O T A R I P S E R U T C A R F T A L S V I D B Q O U I N E I 
S U P K K H N I G C Y D G E V I T A R T S I N I M D A I H K V D Q G U Z X G R W 
E B V Y S L Q S O H I X P C C Y L Z P V P E G G K U P W T C O L W T B X B P I X 
L A T N E M P O L E V E D O R U E N S S X O Y V M G U V H Y R N M R X X B B V I 
O C S M Q O E R O M F E G N C V N E Z S G M P Q L I C M C B C Z H L H O H V J V 
G U R U U V O E I O A H L S D D H U B I F X I T P K M T R E M I V N I H O S V S 
S T T U E C Q L S T S T A T U S G L V U W N L B N T Y M R C M M G X P P Q U D S 
H E D P L J J C Y H O V U R M V N F J O P R T X J H A E K T E G Y G Q G S P Q I 
U W H Y A C M S H E O L C U O O I N P A V R M N K B P D B X W Z Q V F Z W X B J 
F Q X Y E T E O P R F U O C I U N I T A B E D C Y S F E Y B E C T C Z M O A I L 
C N S T P S I R B A T E M T G Z E I P S B M N X F C Y Y U J H O B K V K L U H H 
I W D I U E R E I P N H A I E G E P T T Y I I F O Q K R H P Q E L G H L E K B X 
U E C D S Y R H N Y S C R V S N R H I O Q S I E T K J R L O R R N Y R Q M E Z P 
M A N I F E S T A T I O N E T O C D A X R S X C V O B T P I L P K E L E F H P S 
W R U B C I S A E L B A E G A T S N U E K I Y B C X V O P R Z V V D H D L T I M 
F M K R V O I M P N E G G C T T A I S I S O N G A I D M I J P C H K X H U W Z R 
X Y A O U Q H M O I S N H O I T E I E T Y N I G A G O J V J N S O H X J E P L Q 
C F F M Y N O I T A N I B M O C S N T J M O X T T B E X N F V E D J P L X P J V 
A S T O Z C T P G Q O S V M N T D Y E S P C I D Y C H X C I P J Z F N W U C I P 
P A E C R A S F Y P E O Y E A Q X P B D T L S P W F A T E H E K X C X W Y C V S 
Q I R K U D U E V R H D G N L M B K A K O O A G T N W Q W W F T G U H D N R W X 
X V C L U D O E V I E R C C P Y B V I G M S H C N V Q Y R M G X V J Y X L K C V 
V G A U E I I A U N T E R O H E L U D I S E A S E Z V T Q A D W K O E X B U G N 
S V R J H T T P H C G D Q U A V Y M L L K R J U S W O X S K V V F I Y V F M C Y 
E S E P T I C E M I A N T N B C R I C A X M L R F D H Z E X L H E M Z Z O C C V 
N D N I O O E L J P M U T T E L T R W T T F C G V T C L C E F W Q H X Z Y R E I 
R K M N D N F M M A S A E E T W I I H N C O Q E M W T D A O Y P M Q M D U G E L 
W N N T N A N G I L A M N R I S B Z V E N X R R X C Z B H S B O Q E I X N K O S 
P S Z E P L I C H L T A L J C H R O N I C F F Y J J C D D O D H X W R Q H R O K 
E U M G D N L K U W S U Z T A O B R R C T W Q M E K T A D W M V B M C V R Z M G 
T T O R E W U E F R D H J X T T G X U N D Y U A A V W P H H A T G J Z J A J G C 
N E L A D W S S X J L U V O M W A C B V I P S Z Y O P G P O T L G F N K Z I J J 
R R D L U P N V F G I H D Z B W L A X J W I V M I O H X Z L T R O F X X X M O Q 
W G L U Y H I Z L L N K D U Q B K O T K K P Q C V F K K I U T C C X F L B H T K 
W D O B E M A A D Y T O R A N P R X S S N Y V S X D Q N X Y D N Q T T R E H V K 
M N H A F U P K N E F K S A P Y H W M D N G O S N Z D O N X C X E E V H K K R P 
H Q L T D H W G K R P Q P F U V V E Z J J N O X Y I R I V N V A Q U F M Q W A E 
I W E O C D A K I A S N R G L I M H D E Q B H M O X F N K U I A T U V J C Q R Y 
F W N T B A I Z O W V M H J O T K N X S A N M K S H X F F D O C N S S E A H A O 
F A C L G Y M L E P P E Z L J A H I R H Y B K N H L M Z C L G R L R E E D C T G 
 
Word List: 
ACTIVITY
ACUTE
ADDITIONAL
ADMINISTRATIVE
AFTERCARE
AHA
AHIMA
ALPHABETIC
AMBULATORY
AMI
ANATOMY
APPROACH
ATHEROSCLEROSIS
BURN
BYPASS
CAD
CEREBROVASCULAR
CHEMOTHERAPY
CHRONIC
CMS
COEXIST
COMBINATION
COMORBIDITY
COMPLICATION
COPD
DIABETES
DIAGNOSIS
DISEASE
DRG
EGD
ENCOUNTER
EVALUATION
EYE
FRACTURE
GESTATIONAL
GLAUCOMA
HYPERTENSIVE
INFECTIOUS
INFLUENZA
INPATIENT
INSULIN
INTEGRAL
MALIGNANT
MANIFESTATION
MONITORING
MORBIDITY
NCHS
NEURODEVELOPMENTAL
NEWBORN
OBSERVATION
OUTPATIENT
PAIN
PHYSIOLOGY
PLACE
PRINCIPAL
RECONSTRUCTIVE
REMISSION
RESISTANCE
RESPIRATORY
SCREENING
SEPTICEMIA
SEQUELAE
STATUS
SUBACUTE
SURGERY
SYMPTOMS
TABULAR
THREATENED
UHDDS
ULCER
UNDERDOSING
UNSTAGEABLE
VAP
 
Word search created using http://puzzlemaker.discoveryeducation.com/.   

2 comments:

  1. I was in a big smile while I was reading your post and even a bigger one when I saw your word search activity. Concepts on medical billing and coding give me headache a lot but still it fascinates me.

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  2. This comment has been removed by the author.

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