“CAC does provide streamlining to coding,” Steed says. Grow your network – you’ll absolutely need it. This shortfall has created a need for added roles where coding skills are needed — clinical documentation improvement (CDI) and medical scribing, for example. Here’s what surfaces to the top of our list: These mergers do not consolidate the need for medical coders, however. A successful medical coding and billing process will always need meticulous, educated employees to manage the data and apply expertise. Earn CEUs and the respect of your peers. Moreover, the population is aging … “Telehealth has experienced explosive growth during the coronavirus pandemic, with telehealth claims lines increasing 3,552% from August 2019 to August 2020,” according to FAIR Health. These alterations have greatly impacted the way medical coding is taking place. DUBLIN, March 15, 2019 /PRNewswire/ -- . ICD‑10 has over 14,000 codes for diagnoses. Only now is ‘surprise billing’ a topic that is recognized, discussed, and hopefully eliminated. “Our jobs have continued to evolve even with the increase of electronic medical records [EMRs],” Kirshner says. But change is inevitable. This group convened as part of AHIMA’s transformation, a process that involves the creation of the “Coding Change Story,” a task force designed to envision the future of co… “Additional complexity associated with ICD-10 implementation, regulation, and the shift to value-based reimbursement models more than offset CAC productivity gains, and coding complexity continues to increase.”, The science will continue to evolve, however, and so too will coders’ job responsibilities. The top three applications healthcare executives plan to tap for AI use, according to Optum’s third annual survey on AI in healthcare, are: Of these three applications, Optum’s survey shows that using AI to improve reimbursement coding is hospitals’ top priority. When you see that next wave swelling, don’t panic and paddle in the opposite direction. Individuals in the medical field may be well aware of the fact that there have been a number of coding changes in the recent years. 2. Aubry believes “the pandemic has only begun to teach us important lessons. The truth, … “Poor coding quality also increased payer denials with additional management time required to onboard, train and audit the outsourced offshore coders,” writes Wagner. It is the unrealistic demands placed on many coders that have led industry leaders to look for ways to automate claims processing. After spending time with so many HIM professionals at the AHIMA Annual conference, I’ve come back thinking about the future of medical coders. “KIWI-TEK partnered with six hospitals and health systems to answer the coding industry’s toughest question: ‘Who delivers higher coding accuracy, domestic or offshore outsourced coding services?’” The study results showed an accuracy rate of 90.5 percent for outsourced offshore coding compared to 96.5 percent for outsourced domestic coding. “The key is to be a coder who is flexible and can change with the times. We are looking for thought leaders to contribute content to AAPC’s Knowledge Center. Thus, coding-related jobs are expanding, due to the growing landscape of the business side of healthcare, along with their efficiency to automate large amounts of work. Using a wave analogy, certain trends in healthcare have been swelling for some time now and will peak soon, while others are still stirring underwater, waiting for the right time to surface. When done efficiently and accurately, it helps ensure hospitals are properly reimbursed for the services they provide. Renee Dustman, BS, AAPC MACRA Proficient, is an executive editor at AAPC. Many U.S. coders fear they will lose their jobs to offshore coders. Technology has advanced medical coding and highlighted the importance of medical coders. 4.2.1 Escalating Demand for Coding Services, 4.2.2 Rising Need for a Universal Language to Reduce Frauds and Misinterpretations Associated with Insurance Claims, 4.2.3 High Demand to Streamline Hospital Billing Procedures, 4.3.1 Changing Regulations Related to Medical Coding, 4.3.3 Lack of Adequately Equipped IT Professionals, 4.4.2 Bargaining Power of Buyers/Consumers, 5.1.1 International Classification of Diseases (ICD), 5.1.2 Healthcare Common Procedure Code System (HCPCS), 7. The technological advancements in the healthcare industry and constantly changing classification systems are expected to create potential revenue opportunities for players operating in the target market over the forecast period. Report scope can be customized per your requirements. We are always looking to hire talented individuals with equal and extraordinary proportions of industry expertise, problem solving ability and inclination. Medical coding is the step in the medical billing process that assigns codes to insurance claims so that a patient’s insurance can be correctly billed. With companies banning together to create end-to-end revenue … The need for ICD is increasing across the world, owing to a growing prevalence of diseases. © 2020. “Coding is contextual (not consistent) and utilizes non-text inputs pulled from various sources, all of which encumber NLP efforts,” Erickson says. Be an expert in your business and industry, not just your role. What we learned is encouraging, especially for those of you who are not afraid to tread in uncharted waters. According to the World Health Organization (WHO), cardiovascular diseases is the number one cause of death globally, taking an anticipated 17.9 million lives each year. In addition, data security is a major concern for healthcare organizations, and offshore coding companies are also becoming aware of these data security concerns while understanding that breach in a client's data is likely to result in the loss of business. Veteran auditor, inpatient coder, and college professor Dorothy D. Steed, CCS, CDIP, COC, CPCO, CPUM, CPUR, CPHM, CPMA, ACS-OP, CCS-P, RCC, RMC, CEMC, CPC-I, CFPC, PCS, FCS, CRCR, CICA, CPAR, is not convinced that AI alone is capable of improving accuracy and efficiency in medical coding. “I do not see volume of visits or need for coders to change that much but be prepared for constantly learning new codes attached to new programs,” she advises. Although the technology is relevant, it has a long way to go and is not presently capable of improving data accuracy without coders. “AI is important,” she says, “but I do not think it has reached the level of accuracy required to code neurosurgery, for example.”, Optum’s survey may be a bit overzealous. The business side of healthcare is no exception. Will medical coding be completely outsourced eventually? Not everyone is ready to ride the AI wave, though. Medical coding classifies these for easier reporting and tracking. As per the scope of the report, medical coding is the transformation of healthcare diagnosis, procedures, medical services, and equipment into universal medical alphanumeric codes. Many organizations want someone who knows what their medical billing and coding staff go through. Examples include acute blood loss anemia with no evidence of transfusion of blood products or iron supplements; and acute respiratory failure with no evidence of vent, BIPAP, CPAP. We believe the outlook is bright for billers and coders. There is a high demand for medical billers and coders in the current job market. I see problems with current versus history of conditions based on provider statements. We would be remiss to overlook the elephant in the room. In the near future an entry-level associate degree or coding certificate likely won't be enough education to land a job. To help you with this, we did some research on industry trends and spoke to several long-time AAPC members to get their perspectives on the future for medical coders. In the North American region, the United States holds the largest market share due to factors, such as an increasing geriatric population, along with a growing number of chronic diseases in the country, which is anticipated to stimulate the demand in this region. In short, coding creates good and valuable data. Medical coders continue to play an important role in accurate documentation, owing to their knowledge of medical procedures and terminology. Let’s consider that for a moment. Required fields are marked *. Aubry tells us, “Even with health system mergers and acquisitions, there are still going to be providers seeing patients, so I do not believe the volume of visits decreases, but we have learned to expect the unexpected. Poor communication continues to be the downfall of AI. AAPC National Advisory Board President-elect Colleen Gianatasio, CPC, CPC-P, CPMA, CPC-I, CRC, CCS, CCDS-O, sees these trends as opportunities. Growth for medical … 4. AAPC's annual salary survey gives a good understanding of the earning potential within the medical coding profession. As per the statistics, the incidence of cardiovascular diseases is increasing, which is directly proportional to the market growth. Your email address will not be published. Medical coders are sought after in a variety of healthcare organizations, and those opportunities and avenues continue to grow. A panel of coding experts and health information management (HIM) professionals met in early June to answer this question and others. Medical bills are sent to some kind of insurance company or health program for processing, and then payment is made … The field of medical billing and coding is growing as a result of a number of factors, chief among them being an aging population, an increasing focus on health data and informatics, and the digitization of health records. Future Growth Of Medical Billing And Coding Companies In The USA The ongoing COVID-19 pandemic has created many challenges for healthcare providers in the United States. Paddle harder toward the wave and ride it out. Everything is in a state of decay unless you’re putting constant energy back into it. “With increased opportunity to work remotely, U.S. members have opportunity to secure work and help countries with developing (or evolving) healthcare systems. But, once again, Erickson sees opportunity. Therefore, medical providers have started … There’s an increased demand for managers in the billing and coding field who can offer first-hand experience. “We realized you cannot ensure 100% compliance with all of the HIPAA requirements of a security risk assessment … if you’re using offshore,” according to Wagner. This type of AI uses natural language processing (NLP) to recognize and extract data from medical documents for coding and billing purposes. A medical coder extracts the information from patients’ medical records and converts … Your career is just one example. To understand key trends, Download Sample Report. No doubt, many HIM professionals are moving … Medical coder is a highly paid job profile as far as US healthcare industry is concerned, and this practice is now spreading across the world in a fast pace, creating millions of new job opportunities. Your email address will not be published. As the health care system turns increasingly to electronic health records, billing and coding … The North American market is estimated to hold the largest share, in terms of revenue, over the forecast period, owing to technological advancements and improved healthcare infrastructure in various countries in this region. Some medical coders may even teach a class to show healthcare employees how to avert coding errors in the future… At the conclusion of the study, each participating organization realized a 1 to 3 percent loss in revenue while using offshore coders. To that end, some of the more influential health systems have implemented, or are considering implementing, computer-assisted coding (CAC). “This places coding professionals in a wonderful place to start or expand their careers. “Open and receptive communication from clinicians, HIM/coding/billing front-line professionals, back to the vendor is essential for improvement in accuracy and functionality of software. If you want to do the same thing next year as you did this year, you should be scared.”. Medical coders assign codes to clinical diagnoses and procedures. According to the British Heart Foundation (BHF), 17,06,213 cases of cardiovascular diseases are diagnosed in the United Kingdom alone. The best place for medical coders to place their attention is an area of coding that they are passionate about. Skilled medical … “However, as any computerized program, it can only process what is entered. The current international standard for medical coding is ICD-10 (the tenth version of International Classification of Disease codes), from the World Health Organization (WHO). Ever-evolving medical billing and coding services, complicated healthcare RCM and stressful account receivables have become more complex. Medical billers submit the codes to insurance companies for reimbursement of medical services. “As our insurance reimbursement methodologies continue to shift toward quality over quantity, we need people who are trained in documentation improvement and are able to not only abstract information from a record but also go back to the providers to teach them when there are documentation shortfalls that will become costly in the future,” says Kirshner. Hence, the escalating demand for coding jobs is likely to drive the market studied across the world. “Had EHR vendors asked more doctors and nurses how they used charts during the initial software development process, there would be far fewer user complaints and burnout now,” Aubry contends. Be prepared to go solo – could you today? Medical coding is a key component of revenue cycle management. But to stay relevant, you must keep your eye on industry trends that will affect your role and then educate yourself accordingly — depending on whether you want to ride the wave or create waves. Aug. 4, 2020. https://www.ahrq.gov/news/newsletters/e-newsletter/724.html, The George Washington University School of Business. “My advice to coding professionals is to continue to stay abreast of the changes we are experiencing. That wouldn’t be advisable, writes KIWI-TEK Chief Operating Officer Bill Wagner in a 2018 blog for Healthcare IT Today. Thus, leading offshore coding firms are building a secure environment for the coders to work in. As a contributor you will produce quality content for the business of healthcare, taking the Knowledge Center forward with your knowhow and expertise. Embrace technology; learn to work with it. Audits still need to happen to ensure accuracy of information. Follow her on Twitter @dustman_aapc. Make sure to invest in yourself from both a financial and time perspective. What do you think lies in store … The "Medical Coding Market - Growth, Trends, and Forecast (2019 - 2024)" report has been added to ResearchAndMarkets.com's offering.. The number of professional coders is expected to rise significantly over the forecast period, thus boosting the number of companies providing platforms for medical coding professionals. The Medical Coding Market has been segmented by the Classification System (International Classification of Diseases and Healthcare Common Procedure Code System), Component, End User, and Geography. Level up – push your limits, stack skills, evolve. ICD-10 means more accurate medical billing and coding, which could translate to more jobs and higher medical billing salaries. Medical coding is an upcoming in-demand field in the stream of Healthcare Administration. … “Why the Current Healthcare Industry Outsourced Coding Model Delivers a Suboptimal Result.” Sept. 3, 2019. https://himaginesolutions.com/why-the-current-healthcare-industry-outsourced-coding-model-delivers-a-suboptimal-result, AHRQ newsletter Issue No. According to the American College of Cardiology (2017), cardiovascular disease accounts for 800,000 deaths in the United States. Obtaining new certifications shows your dedication to your profession and gives you the edge in securing new and exciting opportunities.”. Even with AI or with health systems absorbing smaller practices, coders are still needed to help the software developers correctly develop programs, review for glitches, and help with updates as industry requirements change. “CAC penetration is over-stated by inclusion of software in broader bundles sold to systems,” AAPC CEO Bevan Erickson says. “I believe coders will always be needed,” she told us. The U.S. Bureau of Labor Statistics (BLS) reported in its Occupational Outlook Handbook, updated Sept. 1, 2020, that the healthcare and social assistance sector is leading the pack in job growth, and the demand for medical coders is growing at more than double the average rate across all industries. But fear not. According to Imagine Software, “… 65% of patients are open to switching healthcare providers who provide a better payment experience.”. I presume more care will transition to outpatient and telehealth, which is not a bad thing for many patients, but new codes and rules will develop to accommodate those POS.”. CAC software includes 3M’s 360 Encompass™ Professional System, Artificial Medical Intelligence, Inc.’s EMscribe®, and Pulse8’s Popul8. 5. This survey also indicates that “56% of health care executives believe AI deployment will create jobs, not destroy them ….”. According to BLS, employment for medical records and health information technicians (i.e., medical coders) is projected to grow 8 percent from 2019 to 2029, which is “much faster than average.”. Documentation is still challenging as coders and clinical documentation integrity (CDI) staff attempt to obtain accuracy in reporting. “In facilities using AI,” Aubry says, “I see the coder’s role becoming more of an auditor responsible for reviewing cases to be sure the software performs accurately.”, Physician coding auditor, educator, and consultant Angela Clements CPC, CEMC, CGSC, COSC, CCS, AAPC Fellow, is also optimistic. This system of medical coding ensures that healthcare … One thing you can bank on is that nothing in healthcare stays the same. If you put stock in statistics, you’ll be reassured by the numbers that indicate medical coders are in high demand and will be increasingly so in the future. There are many other factors influencing the future role of the medical coder in the United States, probably more so than AI. Payers are increasingly challenging and down-coding these claims. Nobody can truly predict the future, though, and COVID-19 proved that. See what actually is going on in the healthcare business job market. Medical coding for social determinants has the benefit of systematically documenting the external factors that may impact a patient’s health and create challenges in their interactions with the health care system or barriers to obtaining recommended treatments. Click here. Reserve a block of time each week to read up on changes and updates in your field. COVID-19 has certainly fast-tracked healthcare into the “digital age,” but it also has required us to regroup and reassess our priorities. Nobody can really predict the future, but you can master your own destiny (see sidebar for tips). Wagner, Bill. All Rights Reserved to Mordor Intelligence. The future is getting brighter for the field of medical coding with the use of electronic medical records. "(Coding) is changing and it is going to change fast, and are students getting the kind of skills, competencies, or exposure to these concepts that will allow them to understand that coding … Because of this, there are many Physicians in US that have started to wonder what the future of medical … 6. As technology continues to disrupt healthcare, there are bound to be changes in the way medical billing and coding … I believe coders will need to be more informed about these areas and query for clarification to protect revenue.”, Barbara Aubry, RN, CPC, CPMA, CHCQM, FABQAURP, AAPC Fellow, a senior regulatory analyst for 3M Health Information Systems, agrees that AI has some growing up to do. Telehealth during a pandemic is a good example of the changes in POS.”. “Coding Accuracy: Study Reveals Differences Between Domestic and Offshore Coding.” 2018. https://www.healthcareittoday.com/2018/03/23/coding-accuracy-study-reveals-differences-between-domestic-and-offshore-coding-him-scene/#google_vignette, Wagner, Bill. “The final results showed that, despite what seems to be a much lower hourly rate for offshore coders, the total cost is much higher when all factors are taken into consideration.”. In addition, assigning medical codes creates troves of detail-rich data that can be used for research, analysis, and treatment. EMRs will not be able to interpret a provider’s thought process for medical decision making or work with them to do a better job at documenting it.”. Medical coding … The Centers for Medicare & Medicaid Services (CMS) will continue to add and revise these programs, such as the Quality Payment Program, based on usage patterns, according to Aubry. A successful medical coding … If you were to ask your parents or anyone born in the baby boomer era, they would probably tell you that your medical billing and coding training will involve a lot of paperwork. “The key is to always be evolving in your role. Good companies should welcome that communication and be willing to work to meet that challenge.”, Melissa Kirshner, MPH, CPC, CDEO, CRC, CPC-I, Approved Instructor, AAPC Fellow, sees EHRs limitations daily. In the future… And then there’s the compliance factor. Medical coders used to be afraid that this technology would replace them, but that has not been the case. CPT 2021 Update: New Lab, Category III Codes, Major Stimulus Bill Pumps Funds Into Healthcare, COVID-19: Be Informed, Take Precautions, Stay Calm, and Carry On, Telemedicine Takes Healthcare Into the 21st Century, Don’t Let Telehealth Claims Derail Your Accuracy Rates, 40 percent – monitoring data from Internet of Things devices, such as wearable technology, 37 percent – accelerating research for new therapeutic or clinical discoveries, 37 percent – assigning codes for accurate diagnosis and reimbursement. I see continued growth opportunities for coders in the future! Renee has more than 20 years experience in print production and content management. And that’s a good thing! “The experts in coding are needed to ensure these solutions are accurate and up to date with the most recent guidance,” Gianatasio continues. 3. “Is Offshore Coding Really Saving You Money?” White Paper.https://kiwi-tek.com/whats-trending/domestic-vs-offshore, https://www.imagineteam.com/blog/the-future-of-medical-billing-in-2019-5-trends-you-should-consider-now, https://www.hfma.org/content/dam/hfma/document/article/PDF/54648.pdf, https://www.healthleadersmedia.com/revenue-cycle/3-elements-needed-revenue-cycle-future, Healthcare Tech Outlook, “Artificial Intelligence Meets Medical Coding,” Aug. 10, 2020, https://www.healthcaretechoutlook.com/news/artificial-intelligence-meets-medical-coding-nid-1895.html, https://www.healthleadersmedia.com/revenue-cycle/how-covid-19-kicked-open-digital-front-door-memorial-health-system, BLS, Employment Projections 2019-2029,https://www.bls.gov/news.release/pdf/ecopro.pdf, BLS, Economic News Release Employment Situation Summary Nov. 6, 2020,https://www.bls.gov/news.release/empsit.nr0.htm, BLS, Occupational Outlook Handbook, https://www.bls.gov/ooh/healthcare/medical-records-and-health-information-technicians.htm, https://www.optum.com/content/dam/optum3/optum/en/resources/ebooks/3rd-annual-ai-survey.pdf, DiMarco, Michael. 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