medical coder trainingLooking at the level of training required to adequately prepare coders, it is clear that this is going to cost healthcare organizations a lot. Two approaches to tackling this challenge appear to be emerging. In the first approach, institutions are picking up the tab – in terms of both time and dollars.  These facilities are scheduling the training during work hours and increasing their departmental budgets to cover the related costs. One word of caution here: departments who engage in this method of training must also plan to address the DNFB / un-billed workflow issues created by the coders’ absence from their “normal” workweek.

The second, and less popular, approach places more of the burden on the coders themselves, making ICD-10 training a condition of their employment.  To their credit, the organizations implementing this second method are, most often, paying for the training courses that coders complete on their own time.

Regardless of the method selected, the vast majority of organizations agree that the combined cost of training and DNFB / un-billed workflow issues will still pale in comparison to the long-term costs of post-implementation, ICD-10-related productivity changes.  A permanent loss in coding productivity of 30-50 percent should be expected, although a minority believe that a 10 percent drop is achievable.  Few however, debate that the initial productivity loss will be at least 50 percent – a drop that will very likely last for several months.

To identify the potential impact of lost labor at your organization, consider the following equation:

–          Each FTE represents 2080 hours per year.

–          Assume 80% of those hours are productive, leaving 1664 available for actual coding.

–          If 500+ of those hours are required for ICD-10 training, you will lose 30% (or more) of productive hours per FTE.

HIM Directors and financial executives need a plan for dealing with the financial impact of ICD-10. This can range from forecasting the financial hit and living with it, to hiring more staff or backfilling with outside contractors throughout the transition period. If using outside contractors is your option, lock them in now. The best coders are being signed-up even as I blog.  On your mark, get set…