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February 2014

Resilient MTs Venture Into Coding
By Annie Macios
For The Record
Vol. 26 No. 2 P. 6

While “reduce, reuse, recycle” is a popular mantra among conservationists, it also may apply to medical transcriptionists (MTs). The spread of electronic environments has reshaped how transcription is performed, rendering traditional roles to relics of a bygone era. Sporting a diverse skill set while facing dwindling opportunities in their chosen profession, some MTs have taken steps to remedy what appears to be a dicey future by transitioning into the coding arena.

Although not for every MT, with the right training, attitude, and experience, it is possible to make a successful transition from transcription to coding. Kathy Martin, CEO of OAK Horizons, which specializes in medical transcription education, says those interested in making the switch must pursue training in a reputable program that covers CPT, ICD-9, and ICD-10 codes.

She notes that MTs already have many skills that translate well to coding, but they must master how to research codes, understand the basics, and practice relentlessly. “Their knowledge level is already wonderful; it is a matter of learning the art of coding,” she says. “A person with knowledge of the medical world can learn coding. If they love a medical atmosphere, they will do well.”

Barry Libman, RHIA, CDIP, CCS, CCS-P, president of Libman Education, says employers contemplating switching MTs into coding roles must be thorough when identifying potential candidates. “While MTs may have education and work experience relevant to coding, there are significant differences,” he notes. “Before investing in their retraining, an employer should evaluate whether the MTs are both willing and able to make the transition.”

Health care organizations that can transition MTs into other roles stand to gain, Libman says. “If retraining is an option, there is a lot of value in repurposing MTs from within one’s facility,” he says. “They already know the institution and its staff, and you know their strengths and education. MTs are fluent in medical terminology and the structure of health care and are already part of the HIM family. Retraining your existing staff gives them an advantage over other potential hires.”

Mary Beth York, CCS, CCS-P, a senior associate at Libman Education, says MTs looking to become coders must demonstrate knowledge of anatomy, physiology, and customized medical terminology, skills that many already possess.

Time Table
The amount of time needed to train MTs in coding depends largely on the candidates’ background, Martin says. “If they have been transcribing for 20 years for a one-doctor practice, they are better than someone coming into it with no experience,” she says. “A person who works for a transcription service who doesn’t know what type of report is coming next—who works with all types of notes—will have a better chance at being very good. If they are going to make a career out of coding, experience across the board, including inpatient, outpatient, and so on, gives them the best opportunity.”

OAK Horizons offers an online curriculum to train potential coders. “With little or no medical experience, someone can complete the full program in 10 or 11 months, but we’ve found that MTs take less time, so we created a fast-track program because we know they already have a strong medical foundation,” Martin says.

To qualify for expedited learning, candidates must pass a medical terminology entrance exam to ensure they have the level of competence that will enable them to flourish in the course.

Potential Roadblocks
Martin recommends candidates become credentialed. “Do they need a credential? Yes, if they want the best chance of getting a job,” she says, adding that a reputable program will help students prepare to sit for an AHIMA or an AAPC exam.

York agrees: “I think an MT really has a leg up by obtaining a credential. Is it essential? No. Is it tremendously beneficial? Yes. Employers look at a credential as evidence of commitment to the profession and to its body of knowledge.”

Joining the coding ranks can be more difficult for at-home MTs. Martin recommends they network locally and nationally, and “practice, practice, practice” just like when they began transcribing. “It might be out of their comfort zone, but you have to go out and meet people and network,” she says. “You are always a better coder if you can work on site first because you have access to other experienced coders who you can ask questions and learn from. But it can be a scary thing for those used to working from home.”

Despite the challenges, Martin has seen at-home MTs become successful coders. “The first one I knew did so long ago and made the transition easily, taking the credentialing exam and passing. She is a manager now,” she says. “More recently, a colleague saw the handwriting on the wall and went to a technical school to learn coding. She passed, worked for a local hospital, and after 18 months is now an auditor. This woman knew she had to put her effort into the process to see this kind of success.”

Opportunity Knocks
Martin believes ICD-10’s arrival makes this the perfect time for MTs to get into coding. “As new graduates coming out of a coding program, they will be on a level playing field with experienced coders because they will have in-depth training on ICD-10 if coming from reputable programs,” she says. “In our experience, those who complete the full program and take the exam do well because so much is covered in the coursework.”

There’s already a shortage of coders, and the ICD-10 implementation will only exacerbate the paucity and create more opportunities for enterprising MTs willing to do some legwork. “They must find the opportunities; they won’t just come to them,” Martin says.

Growing Your Own
Recently, Libman Education collaborated with Synernet, a provider of outsourced health care administrative services, to customize a program to educate Synernet’s MTs on coding’s finer points. “Knowing ICD-10 was coming and there would be a shortage of coders, we wondered how we were going to meet those needs,” says Pam Haney, MS, RHIA, CCS, CPC-H, Synernet’s director of coding services. “When our transcription manager began seeing transcription services leveling off, we thought of the idea to transition them to coders.”

The rigorous training program welcomes qualified MTs with medical terminology, disease process, anatomy and physiology, and pharmacology expertise. Personal interviews and careful screening of applicants’ knowledge of these four subjects yielded Synernet’s first class of eight, with four others from outside the organization also joining the class.

“We also wanted them to have ‘skin in the game’ to ensure they were committed and willing to invest the time and be successful, so they had to pay for the training up front and were offered tuition reimbursement once they passed the course and the AHIMA-level certification,” Haney says, adding that Synernet offered the MTs payroll deductions over nine months—the length of the program—to help participants budget the cost of the class.

The training, which used distance learning and a virtual classroom, featured four hours per week of live class work and four hours of recorded instruction available as additional support. “An instructor led the class with weekly sessions and also assigned eight to 10 hours of homework each week. It was a fairly demanding program but prepared them for the CCA [certified coding associate] credential,” York says, adding that eight of the participants currently are reviewing for the CCA.

Haney believes it was a win-win for everyone. “It keeps good folks working,” she says. “It was a financial risk for us to take on and was challenging for the students, but by growing our own, we feel we have found a way to meet the needs of the organization and fill the gap for the shortage of coders.”

— Annie Macios is a freelance writer based in Doylestown, Pennsylvania.