Changing Roles for Coding Professionals

C. Matheson, RHIA, CCS CDI Leave a Comment

Role changes are on the horizon for coding professionals.

With the implementation of Computer Assisted Coding (CAC), ICD-10 and Hospital Value-based Purchasing (HVBP), clinical coding will take on different forms and new responsibilities. Traditional coding careers may transition to auditors, data analysts or even clinical documentation improvement / integrity specialists (CDIS).

Coders → Auditors

Coders morph into auditors when CAC systems are installed.  For instance, Children’s Medical Center Dallas implemented CAC in 2012. Their coders saw a change almost instantly. According to the Chief HIM and Exchange Officer, “The coders moved into an editor role, freeing up time to use their extensive knowledge base for clinical documentation improvement [CDI] activities, resulting in an increase in queries.” Auditors verify the accuracy of CAC code assignments in accordance with coding rules and documentation requirements.

Coders → Data Analysts

Data analysts dig deeper by investigating coded data such as an increased number of NOS code assignments, unexpected DRG shifts and patient outcome variances.  Coders already familiar with various coding systems, data standards and data mining may want to research becoming a Certified Health Data Analyst (CHDA).

Coders → CDIS

Coding professionals will naturally assume some portion of clinical documentation improvement (or integrity) specialist responsibilities as the two teams come together under ICD-10. A deeper level of code granularity and new clinical documentation terms require both coders and CDIS’s to strengthen their clinical knowledge and understanding. Certified coding professionals working alongside CDIS’s positively impacts patient care, revenue integrity and organizations’ reimbursement

Want to learn more about the job titles mentioned above? Check out these informative links.

Certified Health Data Analysts

Clinical Documentation Improvement/Integrity Specialists

 What are your thoughts on these emerging roles for coders? Please also feel free to share resources for auditor careers.

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