Thursday, January 12, 2012

Thoughts on Recruiting ICD-10 Resources

I recently read a post on a LinkedIn forum from a person wanting to interview people who specialize in recruiting ICD-10 resources.  It got me thinking about my experiences on ICD-10 projects, the people I’ve worked with over the past several years and various ICD-10 resources I’ve seen come and go.  Here are some of my thoughts about recruiting resources for your ICD-10 project.
1.   ICD-10 resources are generally not  interchangeable

There’s really a large difference between the knowledge needed for provider-side vs. payer-side ICD-10 projects.  Payers utilize many applications that providers do not and vice versa. I’m largely a payer-side resource and I think it’s clear from my C.V. that this is the case; yet I continue to get inquiries from recruiters looking for someone to help with ICD-10 record coding, practice management assessments and patient financial accounting functions.  I suggest recruiters understand this difference and consider the knowledge and skills of the person they are considering before they approach that resource.

2.  Two levels of ICD-10 knowledge that I consider important

A.  Level 1: general knowledge about the differences between ICD-9 and ICD-10 and how these differences impact software applications and business processes.  For instance, how things like “V” codes, “E” codes, combination codes, etc. have changed in ICD-10. How other codes like DRG’s, HCC’s and MDC’s are impacted by ICD-10. This level of knowledge should be expected of the analysts, developers and testers charged with assessing and remediating applications and processes impacted by ICD-10 – particularly in the payer space.

B.  Level 2: detailed knowledge about how to code diagnoses in ICD-10; essentially a certification in ICD-10 coding.  This knowledge is critical for those working for providers and those immersed in the clinical aspects of healthcare delivery.  I sense this type of knowledge is what most training programs currently address and which gets the most attention from recruiters.

Knowing ICD-10 coding is one thing.  Understanding how ICD-10 functions like Medicare risk assignment, provider payment methodologies, HEDIS reporting and other business processes is a totally different thing. 

3.  Heads down analytical work vs. socializing knowledge to a broader audience

For resources who will be sharing their knowledge with more than a few others, I’d suggest that recruiters spend extra time ensuring their target resource has the capabilities, desire and personality to socialize their knowledge across a range of other resources.   I’ve worked with a few very knowledgeable resources that couldn’t or wouldn’t share their knowledge on a broad base.  They were generally placed on heads-down analytical tasks.  I’ve also worked with people who love to generate, curate and share information.  These people should be leveraged to the greatest extent possible.

4.  “We do things a little different in these here parts Ma’am”

There’s a large difference between how ICD-9 and ICD-10 are used in the U.S. healthcare system vs. other countries. I know of an ICD-10 resource from Canada who was highly touted yet had no clue about how ICD codes were used for payment and analytical purposes in the U.S.

5.  Build vs. buy vs. contract your ICD-10 resources

Clearly there will be a large demand for people who can interpret clinical documentation and code medical records and claim forms using ICD-10.  I suspect these types of resources would typically be hired or contracted on a long-term basis.  Internal resources knowledgeable in ICD-9 could be trained in ICD-10 and advances in computer assisted coding technologies may eventually supplant these resources.

And there will also be a short-term, transitory need for resources who understand ICD-10’s impact across the various software platforms and business processes used by payers and providers; especially the actuarial, financial modeling, provider contracting, benefit design and business intelligence/analytics areas.  It may be more cost-effective and efficient to use 3rd party resources for these tasks. 

I hope this post is helpful to those charged with identifying and placing ICD-10 resources for their own organization or on behalf of another organization.

3 comments:

  1. There are currently no certifications for ICD-10-CM/PCS. AHIMA offers training and those individuals that completed the required training and assessments will then be designated as an AHIMA approved trainer. AAPC requires their members to take a proficiency assessment but it is not a certification. You need to make sure your readers understand that when they are looking for qualified experts this is what they need to look for.

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  2. Yes...thanks for the clarification.

    I understand there are not any official "certification" programs - that's why I said "DETAILED KNOWLEDGE about how to code diagnoses in ICD-10" and "ESSENTIALLY a certification in ICD-10 coding."

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  3. What do you mean Steve?
    These are current changing which are being done in module 10?
    One of my friend has told me that it is gonna be very tough to pass even after having experience in medical field.
    cpc-exam-help is also guiding through experience based strategies. I am really shocked to see this, please clear it further.....

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