TED GRIGGS

The country’s aging population, insurers’ increased scrutiny of medical tests and procedures, compliance issues and the push for data collection and analysis mean that the demand for qualified medical coding professionals will grow faster than other areas of healthcare.

LSU’s Medical Coding Certificate Program is hoping to fill some of that demand by providing students with the skills and training they need to land those jobs, said Lisa Graves, program coordinator for LSU Continuing Education.

The coder’s job is to transfer the diagnosis a physician places in a patient file into the proper terminology for billing purposes, Graves said. So they must be trained in that terminology and those codes, such as ICD-9 or International Statistical Classification of Diseases and Related Health Problems.

“The ICD-9 codes, normally there’s three volumes of codes, are revised yearly. I couldn’t begin to tell you how many there are. It’s just phenomenal,” Graves said. “That’s one reason why there’s a need for experienced, meticulous coding professionals.”

Medical coders must also contend with Health Insurance Portability and Accountability regulations, as well as the codes for medical services and procedures, Graves said. All of the rules, regulations and codes mean that people in the medical coding profession must be well-organized.

A survey by the American Hospital Association Central Office and American Health Information Management Association found that 15 percent of hospitals had a very difficult time filling medical coding slots. Of the hospitals surveyed, 30.2 percent needed four to six months to fill a vacancy; 9.9 percent needed seven to nine months; and 13.3 percent needed 10 months to a year.

Hospitals are attempting to fill the shortfall in a number of ways, from investing in automated solutions and outsourcing their coding needs to paying sign-up bonuses and training existing employees who want a career change.

Graves said moving to medical coding from another job is common, and LSU holds all of its courses at night to accommodate students

The coding profession draws people looking for a new career or those interested in an area that’s growing, Graves said.

The American Academy of Professional Coders, founded in 1988, has 64,000 members worldwide. The American Health Information Management Association has 51,000 members.

LSU’s program began in the mid-1990s and was modeled on the University of New Orleans’ program, Graves said. LSU wanted to provide a training environment on the professional level without requiring college credits; all a student has to have is a high school diploma.

And medical coding students don’t have to enroll at LSU so the costs are much lower, Graves said. The program requires students to take 10 courses, which cost $420 to $490 apiece, and students can pay as they go.

The courses cover everything from ICD-9 and Current Procedural Terminology (CPT), or medical services and procedures to Healthcare Common Procedures Coding System (HCPS), which covers supplies and pharmacology, to anatomy and legal issues, Graves said. LSU tries to keep the classes small, less than 25 people, so that instructors can spend more time with students.

The school has also avoided offering the courses online for the same reason, she said.

“We really feel that, especially for this type of training, the environment is important, the knowledge and expertise of the instructors is important, so that hands-on experience they give you will prepare you better for the industry,” Graves said.

Most medical coding students complete the courses in a year to 18 months, Graves said.

The starting pay for coders with no experience or health training background is around $9 an hour to $11 an hour, Graves said. But the pay increases with a person’s experience level and certifications.

“There are coders who can make, with many years of experience, $70,000 to $80,000 a year,” Graves said. “The national average is $55,000 a year. In Louisiana, I would say you’re looking more realistically at about $38,000 to $40,000 a year.”

Graves said after completing LSU’s certificate program and gaining some real-world experience, coders can take national certification exams from the American Health Information Management Association or American Academy of Professional Coders.

Diane Radcliffe, new member development officer for the Baton Rouge chapter of the American Academy of Coding Professionals, said the coding shortage allows certified professionals to be more mobile.

Radcliffe recently took a job with an employer in Dallas for three weeks. Although she didn’t want to leave Baton Rouge, the money was good, and after the try-out period, Radcliffe said she will be allowed to transition to remote coding.

“With the advent of electronic health records, all I need to do my job is my laptop,” Radcliffe said.

The most common employers for coders are insurers, such as BlueCross BlueShield of Louisiana, hospitals, clinics, and physicians offices, Graves said. There are also coders who work in the legal field, gathering information or providing expertise for attorneys.

However, Radcliffe said that local physicians’ offices tend to use clerks or their nursing staff to handle coding work.

While the nurses are well-qualified to do so, many times clerical staff lack the training needed to perform the job efficiently, Radcliffe said. The physicians cost themselves money because billing opportunities are missed or done incorrectly.



February 2008