Medical Transcription and the Transition to Coding
The medical transcription industry is currently seeking ways to rebrand itself. With the Association for Healthcare Documentation Integrity’s (AHDI) announcement of a name change for the profession to healthcare documentation specialist, the industry is making a shift to attempt to rebrand the skill set of the workers.
The move to the electronic health record is changing how healthcare documentation is done and processed. Meaningful use will require structured data, leading to less and less “traditional transcription” in the future. What we have known for years as the “narrative” in healthcare documentation will not meet the requirements for structured data, leaving the industry to deal with some major shifts in how things get done. At the same time, many medical transcriptionists are seeking new career paths where they can use the skills they have, add to them with additional education, and move into something new. Medical coding may be the answer for some.
Why Transcription and Coding Fit
When comparing the two professions, there are many similarities in the knowledge base required for medical transcription and medical coding. Both groups need to have a solid understanding of medical terminology, anatomy and physiology, pharmacology, and pathophysiology. While someone new to coding education has to learn all of those subjects, medical transcriptionists already have that knowledge. Coding requires an understanding of the healthcare documentation process; medical transcriptionists have that understanding. It also requires an ability to abstract patient information quickly and accurately, a skill that medical transcriptionists already possess and use in their day to day work. Research skills are also important in coding, yet another skill that medical transcriptionists have and use daily.
With the anticipated move to the ICD-10 coding system comes a requirement for increased specificity in documentation. This includes such things as acuity, anatomical detail, supporting lab values, and disease processes connected to common manifestations, to name a few. This is knowledge that medical transcriptionists already have or know where to find. In addition, the move to ICD-10 is expected to increase the need for coding personnel and without additional coders, may result in a deficit in the number of people required to complete the volume of work.
What Medical Transcriptionists Need
Not every medical transcriptionist will have the requisite skills to make the transition to coding, and even if they have the skills, some prefer not to consider this alternative. To assure maximum potential for success, one must have a solid command of medical language. Those who have come into the profession and managed to stay in it by simply “knowing how to spell words” aren’t likely to find this a viable option for a future career path.
A strong understanding of anatomy and physiology will be required for ICD-10 coding due to the increased specificity in assigning codes. Without that understanding, claims will be denied and payments will be delayed.
Potential for the Future
Medical transcriptionists who have been in the profession for a long time will share that their compensation for the same amount of work has continued to decrease over the years. The profession has not seen the increased compensation that has been seen in other sectors of the healthcare industry. Much of this may be related to it being one of the few places in health care where those who do the work are compensated in a piece-meal fashion, or paid on production. Yet, salary surveys done in past years both by AHIMA as well as AAPC have shown a consistent rise in compensation for coders. This should not be lost on those who might consider this change in career path.
It may also be that medical transcriptionists find coding a more rewarding profession in how it uses their skill set. Because of its very nature, coding requires one to use the knowledge base they have acquired to complete the work accurately. Many of the skills that drew one to the medical transcription profession are still used—that of solving puzzles and seeking answers–yet without the physical stress of pounding the keyboard all day.
If you attended the webinar we had during MT Week, you learned that we are developing a special coding course for MTs, a way to take that knowledge you have and use it to create a new opportunity for yourself. It’s a work in progress at this point, however, if you’d like to be informed as we make progress with it, you can sign up for our mailing list at the Online Coding Courses website.
How about you? Are you giving any thought into how you will rebrand yourself for the future? I’d love to hear your thoughts!
Tagged with: Coding Corner • continuing education • future of medical transcription
Filed under: Coding Corner • Continuing Education • Future of Medical Transcription
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A couple of years ago I completed a coding course and went on to become certified through the American Academy of Professional Coders (AAPC) as a CPC-A. I have since let my certification lapse with no intention of testing for it again.
Why? I found that while I was trained and certified, I would most certainly need to work on site as a new coder in order to gain the experience needed to then confidently work from home. That was not an option for me. Working from home as a new coder was not as accessible as it was when I started out as a new transcriptionist. When there is a coding question, it’s far more difficult to succinctly explain in a forum or email to another coder what the issue is and then get correct guidance because it requires the totality of the patient’s record to obtain the the correct codes. If you leave out anything, there is the potential for missed codes. Since other coders do not have access to the entire record to review you are pretty much on your own when it comes to complex issues. It’s far easier in transcription to provide a sentence with a blank and tell other MTs what it kind of sounds like or asking about an unfamiliar term or procedure name.
For those who can take the time to work on site for a time as a coder and then transition to home, I think it’s a great option. For those who are either unable to commit to working on site to gain experience from other seasoned coders or who simply prefer not to to work on site, it may not be a good option.
Dana Jasper
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Kathy Reply:
June 15th, 2012 at 3:01 pm
Dana, you make a good point that much of coding is now done in house. I see some of that changing. And yet, it’s just like many of us have often said about MTs. I always suggested that new MTs try to get an in house position for awhile before they tried to work at home. I imagine this is not much different. That said, I believe coding is a great opportunity and from the research we’ve done, the pay is certainly a better opportunity for MTs!
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I wish that I were as sanguine about coding being a good transition for MTs, but I’m afraid that I’m not. For older MTs close to retirement, it might be a good, lasting job, but for younger MTs, I doubt it.
Certainly, the increased use of EMR will allow coders to work from home, but any work that can be done by computer in Podunk can also be done by computer in Bombay, and it will be done cheaper in Bombay. Like it or not, cheap is a quality metric.
The increased availability of EMR will also allow the encoder, which we’ve used for years, to “talk” directly to the record without the intervention of a human which it currently cannot do with a paper chart. I can hear HAL’s voice, “What do you have in boxes 10, 51, 340 and 5432ZZ, EMR? Thank you. Coding now.” That’s the beauty of standardized language and structured data. With data mining techniques, even free-form boxes can be scanned for relevant, codeable words and phrases.
The coder who used to work with a paper chart, a code book and his/her brain and was valued and compensated accordingly, will become just a cleaner-upper after the machine (which is really what’s valuable) with lower pay to match until the powers that be decide that what the machine comes up with on its own is “good enough.” Remember, cheap (and fast) are quality metrics.
What amazes me is that MTs who have been through this once, don’t stop to consider that it’s quite likely to happen again. The only question is: How long will it take?
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