Major Challenges Face Coders in 2019 and Beyond

Major Challenges Face Coders in 2019 and Beyond
ICD-10 Monitor – December 10, 2018

by Deb­o­rah Grider CPC, COC, CPC-I, CPC-P, CPMA, CEMC, CCS-P, CDIP

ddress documentation and coding issues up front, rather than correct them later.

Coders have had many challenges throughout the years.  When I started in the industry, we did not submit claims electronically; they were submitted on paper and we used an IBM Selectric Typewriter to complete what was then the HCFA 1500 (CMS 1500) or UB-92 (UB-04).  There were a few medical policies but very few and the coding was simple.  In fact, many payers did not even accept the CPT® or ICD-9-CM codes but just wanted a narrative description on the form.  How the world of coding has evolved and will continue to evolve and change in the future.  Coders play a vital role in the financial success of every organization small or large.

What challenges lie ahead for coders?  There are numerous challenges now which will continue in the future.

  1. Code Changes and Staying Up to Date

One of the challenges coders always face each year are the coding changes.  Reviewing the code deletions, additions, guidelines revisions, and code revisions from all code sets CPT, HCPCS, and ICD-10-CM/PCS.  Communicating these changes to the practitioners is always a challenge.  Changes in the National Correct Coding Initiative edits has been and will be an ongoing challenge. Keeping up with codes bundled and when you can and cannot use an NCCI associated modifiers is always a struggle.  Practitioners don’t keep up with bundled code pairs and it is up to the coders to educate the practitioners and keep on top of the changes in the bundles. Coders should know what is included in each code they submit so they don’t submit an incorrect claim. Keeping abreast of these changes is key in submitting accurate claims to the payers.

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