Enhancing Knowledge…Coding Education is a Must!

mra medical coding team members reviewing education materials at a conference table

Medical coding professionals are in a field that requires continuous learning. The volume of regulatory changes that comes with ICD-10-CM/PCS and CPT code changes in today’s healthcare is huge. It takes dedication to keep up with these changes and education is the best approach to take. Having medical coding education certainly results in enhancing knowledge but there are other benefits as well. Management can play a role in ensuring that their medical coding staff have ongoing education to meet current demands.

In many professions there are not only requirements for ongoing education and learning the “trade”, but also educational requirements to maintain an individual’s credential or license. These often required specialized and specific learning to enhance knowledge. Within the “Medical Coding or Clinical Coding” world that is a reality also. Those who are a “Coding Professional” must have education throughout the year (ongoing), it is a basic part and even a foundation of the work and job performed.

The Office of Inspector General (OIG) has seven (7) elements for a Compliance Program and that includes education, so this can be looked upon as a required compliance element. Here is the list of the seven key elements for a Compliance Program:

  1. Standards of Conduct
  2. Compliance Officer and Board/Committee
  3. Education
  4. Auditing and Monitoring
  5. Reporting and Investigations
  6. Enforcement and Discipline
  7. Response and Prevention

When someone says “coder” today we might get the image of a computer programming expert. But the Medical coder or Clinical coder is a healthcare professional who will know or perform the following (this list is not all inclusive):

  • Review patients’ records, translate and assign alpha-numeric codes for each diagnosis and procedure following Official Coding & Reporting Guidelines
  • Possess expertise in the ICD-10-CM/PCS and CPT coding systems
  • Knowledgeable about medical terminology, anatomy/physiology, disease processes, and pharmacology
  • Strong understanding of Clinical Documentation, Billing, Reimbursement systems and methodologies
  • Support Revenue cycle and Compliance

The above is often also thought of as “competencies” of a medical coding professional. Thus, we have an obligation as coding professionals to learn more about the topics/subjects within these core competencies.

Another aspect to think about, is having written policies and procedures (P&P), as these are essential and having a policy that outlines what the educational expectations are is also essential. In my experience having a “Coding Education P&P” can really help to guide one’s staff and also the management team on those important educational expectations.

A policy on “Coding Education and Maintenance of Credentials” should include requiring annual coding educational hours; this relates to the annual ICD-10-CM/PCS, IPPS, OPPS, CPT and Physician Fee updates. These annual updates of education to me are the very minimum that a medical coding professional should obtain. There is other educational topics, venues and opportunities that should be present in the department, facility, practice, or company to support the employee’s educational needs.

  • Start with a review of the continuing education unit (hours) requirement for the different coding credentials as they do vary.
  • Require annual proof of credentials; this is usually done upon hiring
  • Maintain copies within personal files
  • External staff as employee’s or consultants…Should also show evidence of credentials and maintenance
    • Required as part of the contract with external vendor or consulting firm.
  • Education hours should include content that aides in enhancing knowledge which in turn should support their professional credential or license.
    • Example: 10 hours annually that relate to Anatomy, Physiology and Disease process; 12 hours annually that relate to coding classification system(s).

It has long been said that keeping up with coding education is a fact for anyone working in the Health Information Management (HIM) profession, but it also is a requirement for the individual professional also, so there is some responsibility for not only management but also the individual.

For management, you can create an actual “Coding Education Program”; the Coding Education Program might include the following:

  • Quarterly educational programs, or more often is ideal
  • When there are changes in regulations this can result in more education
  • Staff exposure to news, information, and other sources (including clinical and new medical technology)
  • Hours per year provided or obtained through
    • Live-Webinars
    • Face to Face
    • Online – independent
    • Reading – independent
  • A quiz or a test with each educational session to confirm a knowledge transfer has occurred

Annual coding changes occur and have a wealth of information and details. We need to learn about these changes and be ready for the implementation date. Now is the time for all hospital inpatient and outpatient (including physician office) coding professionals to learn the new coding guidelines and changes, as well as ICD-10-CM/PCS code changes (new, revised and deleted), for FY2024. These ICD-10-CM/PCS changes apply to encounters of and discharges on October 1, 2023, to September 30th, 2024. It’s also important for CDI professionals to review and understand these changes as well.

Remember the others benefits to having coding education and creating a culture that supports ongoing education include:

  • Improve employee retention
  • Job satisfaction and growth
  • Enhance the quality of coding
  • Increase coding accuracy & productivity
  • Reduce coding related denials
  • Improve communication between staff and management

Whatever the educational venues are or the volume of educational hours that is provided or obtained, all should support credentials and enhance knowledge which has a positive impact on learning and improving coding skills.

So, take the time to look over the structure and process of your own personal coding education. As managers or those in management we need to understand that medical coding takes education, these go hand in hand. Enhancing one’s knowledge is foundational and a must for each and every coding professional.

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AHIMA Approved

This program has been approved for continuing education unit(s) (CEUs) for use in fulfilling the continuing education requirements of the American Health Information Management Association (AHIMA). Granting of Approved CEUs from AHIMA does not constitute endorsement of the program content or its program provider.