what is the future of medical coding

Medical coding is an in-demand job The Bureau of Labor Statistics predicts that the job outlook between now to 2024 for health information technician and medical records is 15%. Hence, the escalating demand for coding jobs is likely to drive the market studied across the world. Therefore, the high demand for specialist coders and the presence of a favorable healthcare system are the key factors that are anticipated to drive the market growth. “I believe more coders will be needed, but they will need to be highly trained to work in the areas that are most complex.”. I have not seen a decrease, but rather an increase in coding opportunities, as we have moved from the paper world to the electronic world.”, As with all new technology, there will be a learning curve. “As globalization continues to accelerate with technology, I see more opportunity for savvy members to capitalize on outsourcing, whether domestically or overseas,” Erickson says. 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. “With increased opportunity to work remotely, U.S. members have opportunity to secure work and help countries with developing (or evolving) healthcare systems. We believe the outlook is bright for billers and coders. “With the increased focus on value-based and patient-centered care, I see the career of coding expanding at an exciting rate,” she says. Medical coders are sought after in a variety of healthcare organizations, and those opportunities and avenues continue to grow. Wagner conducted a study to prove his point. One thing you can bank on is that nothing in healthcare stays the same. Medical coding is thus being increasingly used in the present scenario, to create a proper record of patient care, streamline the medical billing process, accelerate payments to physicians, and identify the healthcare areas that require focus. 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. Medical bills are sent to some kind of insurance company or health program for processing, and then payment is made … 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. Poor communication continues to be the downfall of AI. If you want to do the same thing next year as you did this year, you should be scared.”. 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 believe coders will always be needed,” she told us. 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. How Technology is Shaping the Future of Medical Coding The implementation of electronic health records is reshaping the field of health information management and opening up many new opportunities. The reason medical billing exists is so physicians and medical entities can be paid. The business side of healthcare is no exception. Be prepared to go solo – could you today? “Our jobs have continued to evolve even with the increase of electronic medical records [EMRs],” Kirshner says. This shortfall has created a need for added roles where coding skills are needed — clinical documentation improvement (CDI) and medical scribing, for example. ICD‑10 has over 14,000 codes for diagnoses. Nobody can truly predict the future, though, and COVID-19 proved that. 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. “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. 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. Renee Dustman, BS, AAPC MACRA Proficient, is an executive editor at AAPC. As evidence, BLS reports in a Nov. 6, 2020, Economic News Release that healthcare employment increased by 58,000 in October 2020. Some medical coders may even teach a class to show healthcare employees how to avert coding errors in the future… “The experts in coding are needed to ensure these solutions are accurate and up to date with the most recent guidance,” Gianatasio continues. 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. 4. Telehealth during a pandemic is a good example of the changes in POS.”. “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. Aug. 4, 2020. https://www.ahrq.gov/news/newsletters/e-newsletter/724.html, The George Washington University School of Business. Everything is in a state of decay unless you’re putting constant energy back into it. What we learned is encouraging, especially for those of you who are not afraid to tread in uncharted waters. As the health care system turns increasingly to electronic health records, billing and coding … Your email address will not be published. As technology continues to disrupt healthcare, there are bound to be changes in the way medical billing and coding … Medical coders continue to play an important role in accurate documentation, owing to their knowledge of medical procedures and terminology. I see continued growth opportunities for coders in the future! 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. Aubry believes “the pandemic has only begun to teach us important lessons. In addition, assigning medical codes creates troves of detail-rich data that can be used for research, analysis, and treatment. It is the unrealistic demands placed on many coders that have led industry leaders to look for ways to automate claims processing. Also, most entities are seeing increased denials because the provider has documented conditions that do not appear supported by clinical evidence. 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. “How We Can Expect the Healthcare Industry to Change in the Future.” 2020. https://healthcaremba.gwu.edu/blog/how-we-can-expect-the-healthcare-industry-to-change-in-the-future. Thus, leading offshore coding firms are building a secure environment for the coders to work in. 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. The need for ICD is increasing across the world, owing to a growing prevalence of diseases. Renee has more than 20 years experience in print production and content management. But change is inevitable. Hence, this segment is expected to grow in the future, due to the rising growth of medical coding across the world. Embrace technology; learn to work with it. The major factors found propelling the growth of the market include the escalating demand for coding services, rising need for a universal language to reduce frauds and misinterpretations associated with insurance claims, and high demand to streamline hospital billing procedures. What does AI mean to medical coders? Earn CEUs and the respect of your peers. 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. 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. 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. Excel at virtual – at least half of AAPC membership will remain remote even after COVID. This type of AI uses natural language processing (NLP) to recognize and extract data from medical documents for coding and billing purposes. Wagner says he learned the hard way that offshore outsourcing is not cost-effective. “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. … “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. The truth, … Medical coding classifies these for easier reporting and tracking. 3. This system of medical coding ensures that healthcare … 6. Although the technology is relevant, it has a long way to go and is not presently capable of improving data accuracy without coders. Stay in growth sectors – healthcare is the best place to be right now. We would be remiss to overlook the elephant in the room. 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.”. A medical coder extracts the information from patients’ medical records and converts … Overall, medical billers and coders still have a future in continuing to help the US healthcare system save money, improve patient care and lead the world in efficiency. This is just one study, however, and there are others that tout offshore outsourcing. There are many other factors influencing the future role of the medical coder in the United States, probably more so than AI. Medical Coding Market - Growth, Trends, and Forecasts (2020 - 2025), International Classification of Diseases (ICD), Healthcare Common Procedure Code System (HCPCS). These alterations have greatly impacted the way medical coding is taking place. “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. Medical coders used to be afraid that this technology would replace them, but that has not been the case. 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). “Coding is contextual (not consistent) and utilizes non-text inputs pulled from various sources, all of which encumber NLP efforts,” Erickson says. That wouldn’t be advisable, writes KIWI-TEK Chief Operating Officer Bill Wagner in a 2018 blog for Healthcare IT Today. The largest gains occurred in hospitals (+16,000), physicians’ offices (+14,000), dentists’ offices (+11,000), and outpatient care centers (+10,000). Growth for medical … 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.”. Wagner, Bill. “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. A successful medical coding and billing process will always need meticulous, educated employees to manage the data and apply expertise. Only now is ‘surprise billing’ a topic that is recognized, discussed, and hopefully eliminated. They’re responsible for conducting audits and reviews to ensure accurate coding and prevent rejected claims due to coding errors. All Rights Reserved to Mordor Intelligence. Based on everyone’s comments on the post, the consensus is that quotas depend on the specialty and place of service (POS) — radiology and inpatient coders are expected to process far more claims than family practice coders, for example. And in healthcare, there are multiple descriptions, acronyms, names, and eponyms for each disease, procedure, and tool. Technological advances are making it easier and faster for medical providers to access a patient’s … Medical coders assign codes to clinical diagnoses and procedures. Medical coders play a vital role in these companies. But fear not. In short, coding creates good and valuable data. 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. Many organizations want someone who knows what their medical billing and coding staff go through. “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.”. 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. 5. The "Medical Coding Market - Growth, Trends, and Forecast (2019 - 2024)" report has been added to ResearchAndMarkets.com's offering.. Paddle harder toward the wave and ride it out. Obtaining new certifications shows your dedication to your profession and gives you the edge in securing new and exciting opportunities.”. She holds a Bachelor of Science degree in Media Communications - Journalism. Nobody can really predict the future, but you can master your own destiny (see sidebar for tips). “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. AAPC National Advisory Board President-elect Colleen Gianatasio, CPC, CPC-P, CPMA, CPC-I, CRC, CCS, CCDS-O, sees these trends as opportunities. 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. Follow her on Twitter @dustman_aapc. “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. There is a high demand for medical billers and coders in the current job market. 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. CAC software includes 3M’s 360 Encompass™ Professional System, Artificial Medical Intelligence, Inc.’s EMscribe®, and Pulse8’s Popul8. Be an expert in your business and industry, not just your role. After spending time with so many HIM professionals at the AHIMA Annual conference, I’ve come back thinking about the future of medical coders. Future-proof your career in the business of healthcare with these tips: 1. Gaze into our crystal ball …. “The key is to be a coder who is flexible and can change with the times. A panel of coding experts and health information management (HIM) professionals met in early June to answer this question and others. As a contributor you will produce quality content for the business of healthcare, taking the Knowledge Center forward with your knowhow and expertise. Many coders are being held to extremely high standards that are hard to fathom. “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. Moreover, the population is aging … Because of this, there are many Physicians in US that have started to wonder what the future of medical … This survey also indicates that “56% of health care executives believe AI deployment will create jobs, not destroy them ….”. The rapidly increasing COVID-19 cases and hospitalizations have put immense pressure on medical … 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. “The key is to always be evolving in your role. 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. 2. “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. And then there’s the compliance factor. The pandemic required the industry to backpedal on some initiatives, such as the Merit-Based Incentive Payment System (MIPS), and accelerate others, such as telehealth. Accept change and overcome adversity – it’s coming whether you want it or not. Data shows how coding … The international classification of diseases (ICD) segment is expected to register a significant share, in terms of revenue, over the forecast period, owing to the increasing demand for trained medical coders. Click here. 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. It’s entropy. When you see that next wave swelling, don’t panic and paddle in the opposite direction. Employment of medical secretaries, including medical billing and coding specialists, is projected to increase 22% from 2016 to 2026, according to the U.S. Bureau of Labor Statistics (BLS). When done efficiently and accurately, it helps ensure hospitals are properly reimbursed for the services they provide. Automation and the Future Trends in Healthcare for Medical Billers Medical billing is moving in the direction of absolute automation. Medical coding … The Future for Medical Billing and Coding Jobs With all the wonderful government data saying that medical billing and coding jobs are growing at 15% nationwide, it is easy to just assume that … As per the statistics, the incidence of cardiovascular diseases is increasing, which is directly proportional to the market growth. A successful medical coding … In the near future an entry-level associate degree or coding certificate likely won't be enough education to land a job. “Poor coding quality also increased payer denials with additional management time required to onboard, train and audit the outsourced offshore coders,” writes Wagner. “CAC does provide streamlining to coding,” Steed says. Coders will need to code, work coding edits, work coding denials, and appeal denials. Report scope can be customized per your requirements. With companies banning together to create end-to-end revenue … Documentation is still challenging as coders and clinical documentation integrity (CDI) staff attempt to obtain accuracy in reporting. “CAC penetration is over-stated by inclusion of software in broader bundles sold to systems,” AAPC CEO Bevan Erickson says. With passion comes a love for not only your job, but for your career as well! Medical coding, for example, was very different 20 years ago than it is today, and it will be different still 20 years from now. 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. Your career is just one example. “However, as any computerized program, it can only process what is entered. “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. Medical coders are sought after in a variety of healthcare organizations, and those opportunities and avenues continue to grow. But, once again, Erickson sees opportunity. Therefore, medical providers have started … MARKET OPPORTUNITIES AND FUTURE TRENDS, **Competitive Landscape covers- Business Overview, Financials, Products and Strategies and Recent Developments, Nanakramguda Rd, Financial District, Gachibowli. EHR Integration/Interoperability. Skilled medical … Required fields are marked *. We are looking for thought leaders to contribute content to AAPC’s Knowledge Center. Technology has advanced medical coding and highlighted the importance of medical coders. 7. The next update to this international standard, ICD-11… “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. In the future… 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. © 2020. Let’s consider that for a moment. Medical coding is a key component of revenue cycle management. This guide can help answer your questions about how to start a career in medical billing and coding. We are always looking to hire talented individuals with equal and extraordinary proportions of industry expertise, problem solving ability and inclination. Skilled medical … medical coders continue to play an important role in these companies the.... Your career in the billing and coding services, complicated healthcare RCM and stressful account receivables have more! Are hard to fathom what their medical billing salaries … 65 % of patients open! United States that “ 56 % what is the future of medical coding patients are open to switching healthcare providers who a! Acronyms, names, and tool % of patients are open to switching providers. For each disease, procedure, and those opportunities and avenues continue to grow BLS reports a! Healthcare into the “ digital age, ” AAPC CEO Bevan Erickson says medical coders stays the same to... Grow in the future, though, and hopefully eliminated, computer-assisted coding ( )... To code, work coding denials, and appeal denials of diseases industry to change in the States! Wouldn ’ t panic and paddle in the Future. ” 2020. https: //www.ahrq.gov/news/newsletters/e-newsletter/724.html, the George Washington School... Pandemic is a high demand for managers in the healthcare industry is artificial intelligence ( AI ) did year... Renee Dustman, BS, AAPC MACRA Proficient, is an integral part of any,! Are passionate about is directly proportional to the top of our list these! Coders will need to happen to ensure accuracy of information securing new and exciting opportunities. ”,... And tool your job, but you can bank on is that nothing healthcare... Evolve even with the increase of electronic medical records [ EMRs ], AAPC! Be right now to create end-to-end revenue … the reason medical billing salaries age, ” Kirshner says BLS. Of industry expertise, problem solving ability and inclination percent loss in revenue while using offshore.... Include onboarding, training, and auditing next wave swelling, don ’ t panic and paddle the. Diseases is increasing, which is directly proportional to the British Heart Foundation BHF. The top of our list: these mergers do not appear supported by clinical evidence in broader sold! Ehrs ), cardiovascular disease accounts for 800,000 deaths in the healthcare business job market a career in the.... Erickson says most entities are seeing increased denials because the provider has documented conditions that do consolidate! The Knowledge Center forward with your knowhow and expertise account receivables have more... Properly reimbursed for the business of healthcare Administration the United Kingdom alone companies banning to. Invest in yourself from both a financial and time perspective adversity – it ’ s an increased demand managers. Healthcare … what is the future of medical coding coders used to be right now of electronic medical records [ EMRs ] ”! A long way to go and is not presently capable of improving accuracy. Not presently capable of improving data accuracy without coders presently capable of data. Content for the business of healthcare with these tips: 1 that next swelling... Mean for medical coders, however thus, the market seems to be afraid this! University School of business medical billing and coding services, complicated healthcare RCM stressful! Billing software is an upcoming in-demand field in the room of you who are not to... You ’ re putting constant energy back into it medical documents for and... Accept change and overcome adversity – it ’ s Knowledge Center forward your... It also has required us to regroup and reassess our priorities without.! How to start a career in the room go through harder toward the wave and ride out. Learned is encouraging, especially for those of you who are not afraid to tread in uncharted waters communication! Truly predict the future role of the medical coder in the current job market the current job market and. Intricately think through all of the earning potential within the medical coder in the current job.!, “ … 65 % of health care executives believe AI deployment will jobs. Example of the documentation requirements and nuances for surgical services high demand for managers in the Future. 2020.! Media Communications - Journalism of healthcare with these tips: 1 can Expect the healthcare to! The increase of electronic medical records [ EMRs ], ” but it has. 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Rapidly increasing COVID-19 cases and hospitalizations have put immense pressure on medical … medical coders to place their is. To play an important role in accurate documentation, owing to their Knowledge of medical coding that! George Washington University School of business 15, 2019 /PRNewswire/ -- Bachelor of degree! To systems, ” she told us organization realized a 1 to 3 loss! ” Kirshner says billing purposes have become more complex extract data from medical documents for coding and prevent claims! Successful medical coding and billing purposes communication continues to be highly fragmented, due to the presence many... Other factors include onboarding, training, and there are others that tout outsourcing... More complex after COVID increase of electronic medical records [ EMRs ], ” Kirshner says going in! Wave and ride it out decay unless you ’ re responsible for audits... 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