Top 10 Cringe-Worthy Things Wannabe Coders Say

My blog is over six years old!  Seriously, I just checked.  In the last six years as I've put myself out there as the Coder Coach, I've spoken either personally, over the phone, or via email to hundreds - okay, it's really probably dozens - of coders and tried to answer their questions about what it takes to be a coder.  I've been amazed at how those answers have changed since then, from the evolution of technology, which allows most coders to work remotely to finally seeing ICD-10 come to fruition. So I figure it's about time I published my top 10 list: the most cringe-worthy things people say when they tell me they want to be a coder.

Don't get me wrong.  My intent is not to put anyone off, but over the last six years, this coding thing has really caught on and I wouldn't want to steer anyone into a career that isn't right for them.  So take a moment to read through the list and decide if you're guilty of any of these. Since David Letterman's Late Show is no longer a thing, consider this my replacement Top Ten List.

And before you get upset, please read the sign: I'm not arguing, I'm just explaining why I'm right.  In other words, I'm being a coder (occupational hazard).

Number 10:Which type of coder pays the most?

Answer:  A really good one.  Focus your efforts on landing a job and then mastering it.  If you choose your work setting solely for making money, you may find yourself miserable and (maybe) sort of well off.  If you choose to follow your passion, the possibilities - and pay check - are pretty much endless.  Employers are willing to pay good money for really good coders who don't complain about how much they hate their jobs.  I don't actually do any hiring, but if I did, I would hire the hungry novice coder with a good attitude and a willingness to learn over the experienced grouchy coder who seems to hate her job.

Number 9: Should I be a hospital or physician coder?

Have you ever seen the movie City Slickers?  The answer is in that movie when Jack Palance says the meaning to life is "one thing."  Billy Crystal asks him, with great interest, what that one thing is.  The answer: that's what you've gotta figure out.  You and only you can decide which setting is right for you and there is no right or wrong answer.  I love getting an inpatient hospital chart and trying to figure out the latest surgical procedures and how to code them.  I would rather poke my eyes out with a dull pencil than assign an E/M level to a physician's chart.  I know other coders who love E/M coding.  It's like being a cat person or a dog person.  You will probably find that you like one more than the other and there is no wrong answer (unless you are not a cat person, and then we can't be friends anymore).

Number 8: No one will hire me with the coding credential I have; they all want something else

This is probably going to sting a bit, so brace yourself.  Why did you pay to get credential without first looking at local job postings and doing some research?  If you are reading this before going to school or getting certified, then do your homework before you pay any money to any educational institution.  All kinds of people will tell you anything to get your money.  Only local employers will be honest about what credentials they want.

Number 7: Where can I get free continuing education credits?

Free CEUs are out there, you just have to look for them.  Most AAPC local chapters offer free monthly educational sessions.  There are opportunities to summarize articles and get credit.  Coding Clinic offers a quarterly webinar that is free.  Other organizations offer free CEU credits.  Do an internet search and you may be surprised what you will find.  Did you do something, like attend grand rounds at a hospital, that you thought was very educational but you don't have a certificate?  Contact the certifying body and see if they will grant you CEUs for it.

Number 6: I can't afford to join AHIMA or AAPC

This one might sting too.  Find a way to make it happen.  As far as I'm concerned, when I hear this, it tells me you don't want it bad enough.  Granted, I started very young and was still living at home when I first joined AHIMA, but make no mistake, I worked hard to get where I am today. Find a way to afford that membership and show people you are serious about a coding career.  And if you have a credential through and let your membership lapse, you likely lose the credential.  You worked hard for that credential - don't let it go.

Number 5: This is my second (or third) career; I can't afford to start at the bottom

This is a great second or third career for people who discover they missed their passion until later in life.  But here's the reality: you still likely have to start at the bottom.  I've seen people find their way into coding by some very unusual means, but the ones who make it are the tenacious ones who won't take no for an answer.  Pretty much no one starts out in their dream coding job.  You will have to pay your dues.  And please don't think that means  I can't appreciate your experience in your previous profession.  There are definitely things you can bring to the table, but remember that in coding, you are a novice.  I'm a great coder, but I'm pretty sure if I decided to change careers tomorrow and become an aerospace engineer, there would be a bit of a learning curve. 

Number 4: Will you mentor me?

It's an innocent question and I'm flattered.  Really.  But I decided a long time ago that I would mentor from afar by penning this blog.  I don't have a consistent schedule to be able to spend a lot of quality one-on-one time mentoring.  But if you email me a specific question, I will do my best to answer it.  My advice is to find someone local to mentor you.  Ask them if they can meet you once a month for lunch and come prepared.  What are the questions you want answers to?  What challenges have they had in their career that they wish someone would have told them when they were getting started?  This is a great entry into your local coding network.

Number 3: I went to school for (fill in the blank) months/years and I'm certified; I'm qualified to be a coder anywhere

No.  You're really not.  I went to school too for two years and let me just tell you that even though I learned some good fundamentals, the real coding world is nothing like I thought it would be.  I learned everything I really needed to know about being a coder on the job, not in school.  I've now been coding for more than 20 years and I hold four different certifications and I have a news flash for you: I am not qualified to code anywhere.  I lack the practical experience of a physician office coder.  I find coding radiation oncology charts waaaaaayyyy outside my comfort zone.  And please don't ask me to fill out an IRF-PAI for inpatient rehabilitation.  In other words, after 20 years, I am not all that and a bag of chips, so please don't insult the world of experienced coders by thinking you have this all figured out.  I learn something new each. and. every. day.  Keep an open mind and be willing to learn - and admit when you're in over your head.  Natural curiosity and a willingness to learn is a good thing.  Acting too big for your britches is not.

Number 2: How can I get experience if no one will hire an inexperienced coder?

I would give anything if people would stop asking me this question.  Because honestly, I don't know the answer.  I don't know what your background is.  I don't know what your aptitude for coding is - and it is a skill that many people don't possess.  I don't know where you've applied or how hard you've tried to sell yourself.  And probably most importantly, I don't have a clue what it's like to try to get a job today because the atmosphere is so different from 20 years ago.  But this is what I do know.  Don't limit yourself to coding jobs.  Find a job - any job - that will require you to have coding knowledge.  When you do an online job search, search on the code sets (ICD-10 or CPT) and not the word coder.  There are so many jobs out there that revolve around coding that aren't traditional coding jobs.  Getting your foot in the door is one step closer to getting that traditional coding job - or something even better than you ever imagined.  And don't forget to network.  If you want to work with coders, surround yourself with coders.  Who you know may be your golden ticket.

And the Number 1 Cringe-Worthy Thing Wannabe Coders Say is: I want to be a coder because I want to work from home

AACK!!!!  Not a good lead in!  And if this is the first statement out of your mouth when you go into an interview, you probably won't get hired because here's a huge industry secret: hiring managers hate hearing that's why you're there.  It's like going on a first date with someone you just met and gushing about how badly you want to get married and have 6 kids. It's just not done.  If this is the real reason you want to be a coder, please re-evaluate.  Coding is a great career if you love it.  If you don't love it, you will be miserable for 8 hours every day.  And if you are miserable at home for 8 hours a day, that can be really depressing.  Also think about the child care aspect.  I often hear people say they want to work from home because they can't afford child care.  Many coding contracts require you to have child care in place.  Coding takes intense concentration and you can't babysit a kid at the same time.  Working from home is a great perk, I will admit, but it is not the reason I have the job I have.  I refer you back to Number 10 above: follow your passion.  If you're lucky, you can make some good money while you do what you love... from home... in your bathrobe.

Article Review: The Coder Coach Responds to "Industry Disconnect"

I'm afraid today's topic won't be quite the entertainment fodder that many of my readers have come to enjoy because this is a serious topic and one that I am very passionate about. And it deserves a serious blog posting!  Someone recently asked me on my Facebook page what I thought about a recent cover story published in For the Record Magazine.  "Industry Disconnect" by Selena Chavis is a great read for anyone who has been pounding the pavement looking for a coding job.  It is also a must read for any coding professional with hiring power.  In short, this article highlights the biggest threat to the future of the coding industry: the ability to hire, mentor, and train recent grads.

It's no secret how I feel about mentoring our future workforce.  My thoughts are well documented throughout the Coder Coach and my colleagues in the state of Colorado know how outspoken I am about the topic of mentoring coders.

So when I was asked, I thought, wow, what a great topic for my blog.  Here are my thoughts on the article: it illustrates an accurate, although bleak, outlook on the future.  But all is not hopeless.  This article has some great points, but it also brought to mind some myths about coding mentoring and training that I would like to address.

Myth 1: There is a disconnect between coding schools and employers and no one cares or is doing anything about it
Partially true.  In general there is a disconnect between schools and employers, as documented in the article.  It is not true that no one cares.  Hello!  Are you reading my blog?  I currently sit on Colorado Health Information Management's Student Alliance Task Force - a mouthful, I know!  This is an alliance made up of CHIMA members and directors from the local HIM schools and we spend our time trying to figure out how to get better and more meaningful internship experiences for students.  There are a ton of road blocks and we are trying to decide how to break them down.  More on that in a sec.

Myth 2: Hospitals will only hire people who can hit the ground running
I hate this myth.  Because, in my experience, there is no such thing as a coder who can hit the ground running.  Okay, that was deep.  Let me repeat with more emphasis,  there is no such thing as a coder who can hit the ground running.  It's true that new grads take more time and as the article mentioned, there is only so much you can teach in a 2-year program that will prepare people for a future in electronic medical records, privacy and security, coding, cancer registry, and the list goes on.  It is unrealistic to expect new coders to be able to hit the ground running and it's ridiculous to exclude new grads thinking they won't have anything to offer.  I have never hired a coder - novice or experienced - who didn't need on the job training.  It's true that you can teach an old dog new tricks, but it's equally true that old habits die hard.  A new coder may not have experience, but as Linda Donahue, RHIT, CCS, CCS-P, CPC mentioned in the article, it is easier to teach new habits than correct old ones.  If you can absorb information like a sponge, you may have a serious future in coding.

On a side note, I decided to test this no-such-thing-as-hit-the-ground-running theory, so I called up my friend and newest coworker, Sandy Giangreco, RHIT, CCS, RCC, CPC-I, PCS, COBGC, CPC, CPC-H and AHIMA-Approved ICD-10-CM/PCS Trainer (are you getting the impression that Sandy has a little experience?!).  I asked her if she felt like she'd hit the ground running and she said sort of.  Now keep in mind that Sandy has many years of excellent coding experience (and a couple certifications!) and was hired by Haugen Consulting Group as a Senior Consultant.  We don't have to teach her how to code.  But she is trying to get used to our way of doing things and our training materials so that she can further develop more materials and peer review other content.  She is not up to speed yet.  But it's only like her second week, so I'll cut her some slack!

Myth 3: If hospitals take the time to train people, they will just leave and take those skills elsewhere
Oh waaaa.  Oops, did I type that out loud?   This is something that industry leaders need to get over.  We no longer live in an era where people pledge allegiance to a certain company and stay there for 30 years and retire to a blissful lifestyle at the age of 62.  When I got my first coding job, my manager and mentor, Lila, told me she knew she wouldn't be able to keep me but she wanted to give me an opportunity.  And I am so thankful she did.  There are other Lila's out there who are willing to train you so they can have a hand in training the future workforce as a whole - not just at their own institution.  I think if more people adopted this mentality, the future of the coding field would be bright indeed.

Myth 4: No one is willing to train on the job
So it turns out Lila was right.  I worked for her for three years before taking a job as her peer coding supervisor at a sister hospital.  And then she moved on for another career opportunity outside our hospital system.  That was 15 years ago.  Recently our paths crossed again when Lila took a management position with one of my clients.  Last fall I got to travel with her during a training trip and it was so much fun to be back in the company of that person who first gave me a start.  And I was dying to ask her: if you could do it all over again, in today's climate of EMRs and code-based reimbursement, would you hire a green coder like I was back in the day?  And she said yes.  Here it is almost 20 years since she gave me a chance and so much has changed with coding and HIM and she still feels the same way about training and mentoring.  God bless Lila and every coding manager like her.  We also have a hospital system in Colorado that recently opened their own coding school in preparation for ICD-10 and they are accepting people with baseline coding class experience and placing them into coding positions at the end.  People are willing to train, you just have to find them.

Myth 5: Experienced coders know more
Okay, so this may be where I lose some loyal blog readers and for that I apologize.  I will start by saying that I know some really smart, terrific coders who can code like nobody's business.  And as a coding trainer, I also know a lot of "experienced" coders who don't know as much as they think they do.  At Haugen Consulting Group, we actually have a training program for experienced coders about coding basics or fundamentals where we get them back to the coding guidelines.  Because they forget.  They get so caught up in the details that they can't see the forest between the trees.  And it's not really their fault.  My point is, new coders may have an advantage here - we are trying to get coders back to the guidelines and most students know nothing but those guidelines.  They are also "closer to the books" when it comes to things like anatomy and physiology.  And I cannot stress enough How.  Very.  Important. This. Will.  Be. For. ICD-10.  No coder knows everything - it's impossible.  I learn more about coding every day and I teach the darn stuff.  That's actually what I love about it.

Myth 6: Coding students can't get hands-on experience because of EMRs
There is some truth to this.  I hate that word "can't," though.  When I did my internship I reported to the hospital every day for 3 weeks like it was my job.  There was a coding unit and all the coders sat together.  I understand that that hospital no longer has a coding unit.  The coders all work from home by accessing the electronic medical record (EMR).  And that's how most hospitals are these days.  It's not impossible for students to get hands on experience, but it is challenging.  The main road block here is HIPAA.  The Health Insurance Portability and Accountability Act of 1996 allows for electronic submission of health information and as HIM professionals, we understand the confidentiality and security issues surrounding protected health information (PHI).  As HIM professionals, we have a duty to keep this data confidential but we also have the duty to train new professionals.  We are trying to find ways to bust this excuse, but our first commitment is to the patient and protecting their data.  That's just something to think about when you complain about the background check you need to go through to get access to a system as a student.  How would you feel if it was your medical record?

Myth 7: There are not enough coding jobs for students
Bologna.  I've said it before and I'll say it again.  There may not be a bunch of jobs for "coder," but there are tons of jobs that are coding related.  Stop searching for coding positions in HIM departments and ending your search there.  Start looking for jobs that have ICD-9-CM and CPT embedded in their job descriptions.  You will learn more than you think just by being around codes.  Plus, if you can get a job in billing, this is a great place to see coding reimbursement in action.

Wow, this is already way longer than I intended, so I will leave you with this.  I love that Ms. Chavis's article was the cover story.  I think this is the most critical issue facing our industry today (even more so that ICD-10!). But I don't want you to walk away from this article thinking that a future in coding is futile.  Get out there and network!  People give jobs to people they know, so go out there and get known!

If you haven't found a job in coding, ask yourself if you've exhausted every option.  I meet all kinds of people who want to be coders for all kinds of different reasons.  If you want to be a coder only because you want to work from home, stop now.  You won't be successful.  But if you want to be a coder because you love the detective work you have to do to pull documentation together to get those codes, then there should be nothing on this earth that will stop you.  I see a lot of people making excuses about why they aren't getting coding jobs, but I firmly believe that if you want it badly enough, you will get there.  I'm no stranger to excuses myself - mostly when it comes to living a healthy lifestyle.  So lately, I've been carrying around this quote as a reminder any time I catch myself making an excuse and falling into the role of victim:

"Ninety-nine percent of the failures come from people who have the habit of making excuses."
-George Washington Carver

I am willing to work with my colleagues to remove the excuses about why we can't train and mentor.  Are you willing remove excuses for any of your own roadblocks that you've put up?

I Bet You're Wondering What I've Been Up To...

Oh wow, has this been a crazy fall! Up until this year, "Rocktober" was a term we used in Colorado whenever our beloved Colorado Rockies made it to the playoffs. This year Rocktober took on a whole new meaning for me. And while it was a great month, I am so happy to say it's over and now I can concentrate on the less busy holiday season. Yes, October was that busy!

As you saw from some of my blog postings, I kicked off October in true coder fashion by attending the AHIMA Convention and Exhibit in Salt Lake City. What a great opportunity to learn the newest, latest, and greatest from some of the nation's best HIM and coding minds and get in some serious networking as well. This year was particularly busy at convention as I was honored with an AHIMA Triumph Award for mentoring, mainly due to my efforts with the Coder Coach blog and some of the networking and educational events I've hosted over the last couple of years. It was an incredible honor and to help commemorate the occasion, I took my personal and professional mentor - my mom (pictured here with me) - along with me. It's hard to tell who was more excited about my award!

This was also the first year that I was chosen to speak at the national level. I presented an outpatient track at the coding meeting on the overlap between coding and charging in the cardiac cath lab. As if that wasn't enough, I just couldn't say no when another Triumph Award recipient and fellow Coloradan, Dee Johnson, asked me to be a part of the Student Academy. Dee is a student at Arapahoe Community College, my alma mater here in Colorado, and was a key planner in this year's Student Academy. The academy is a free event for students in AHIMA programs at the convention each year. I was a part of the mentor lightning rounds where several established professionals spent a few minutes with each group of students to share our experience and answer questions. All of that and Apolo Anton Ohno too! The Olympic athlete and Dancing with the Stars champion was our closing keynote speaker and he had an inspiring message about giving it your all.

Once I was back at home, there was no rest for the weary as I delved into not one, not two, but FIVE client trainings. For those who aren't aware, training sessions take about 4-5 times as long to prepare as they do to present but the work is always well worth it when I get to training. That is my favorite part of my job because it combines two of my great talents: coding and talking! My last week of training involved three training sessions, work-related road travel, a snow storm, and, of course, that inevitable sinus infection as a result of a crazy month. I would love to tell you that following that last training on October 28 I headed out for happy hour with my friends, but truth be told, I had a nice evening vegging out on the sofa and catching up on all my DVR'd shows!

So here we are in November and I'm trying to wrap a few things up before the holidays. Last weekend I met with a fantastic group of super coder geeks (birds of a feather!) who were so amazing to not only spend their own time coding some records in ICD-10, but to also give up a Saturday to come together and talk about the results. This is a project that the Colorado Health Information Management Association's (CHIMA) ICD-10 Task Force has undertaken to assess documentation readiness for ICD-10. I have had a great year chairing this task force and working with an enthusiastic group who is making great strides as a clearinghouse for ICD-10 information in the state of Colorado.

Last week I was interviewed by ICD-10 Watch, a terrific resource for anyone interested in ICD-10. We specifically chatted about the fantastic opportunities that await coders as we transition to ICD-10. The interview is recounted in the blog posting How ICD-10 can create opportunities for medical coders.

Whew, I think I need to take a nap now that I've recounted the previous month's events! I plan to get back to the ICD-10-PCS series in another week or two, but bear with me - November's calendar is starting to fill up, so it might be 2012 before I can give the series the attention it deserves. In the meantime, I hope everyone has a terrific holiday season.

Evolution of the Coder Coach

I recently looked over my past blog postings to see what material I haven't covered. Well, there's a lot. And I realize my last few posts have been very heavy on ICD-10 - mainly because that's what I'm working on most of the time. It got me thinking, though - have I strayed from the initial intent of this blog? Who is my audience - current coders or future coders?

I have a friend and avid blogger (who's blog I am sorely behind in reading!) whom I consulted before I started the Coder Coach blog and I asked her, "What do I blog about?" She said, "Whatever you want!" Perfect! Because if I can't write about something I truly want to write about, what's the point of having a blog?! And today it really hit home - my audience has expanded.

I started the Coder Coach group and blog about 2 years ago because I identified an alarming trend. Schools are turning out coding professionals by the dozens and many of them are becoming certified. They spend a lot of time, money, and effort to get the training they will need to land them in a lucrative career only to have the doors of employers slammed in their faces because they lack experience. I've talked to my peers and we're all under regulatory pressures that make it difficult for us to train new employees. But can we ever really expect to hire someone who can truly hit the ground running without any training?

The Coder Coach isn't just this blog, it's also a Facebook group (where I post links to this blog and others) and it's a group of curious individuals in the Denver area who get together every couple of months to learn something about coding from a pro (not always me!) that goes above and beyond classroom learning. In my mind, the Coder Coach is helping to fill that big gap between school and experience.

But as I mentioned, my audience is growing. The unknown isn't just limited to coding students and new grads right now. The coding field is about to undergo a monster transition and at the same time, health information management (HIM) professionals are struggling with implementation of electronic health records (EHRs), health information exchanges (HIEs), and meaningful use standards. As an HIM professional and coder, I see and talk to many people who are paving the way for the future of these professions. My mother is a retired RHIT who was before her time - she retired about 10 years ago and before her retirement was really excited about the future of EHRs. When I tell her about what's going on in the field right now, she is in awe - we are just starting to realize what she had a vision for 15 years ago.

And as I've toured the state of Colorado, conducting outreach through our ICD-10 Task Force, I've had many HIM practitioners asking me questions that coding students ask me. Should they consider a change from the operational side of HIM to coding and what's the best way to do it? So I will try to give a good balance in my blog postings of basic things I think anyone interested in a coding career should know now along with what everyone seems to need - a little insight into what it will be like as an ICD-10 coder.

Happy evolving to all of us!

Opportunity Happens: ICD-10 is Mine

To quote my recent Facebook posting, "Ever notice that amazing opportunities are followed by boatloads of work?" That's my excuse for where I've been: opportunities and their resulting heavy workload. For me, opportunity is cleverly disguised as ICD-10. What is your opportunity?

Just to catch you up, I recently accepted a senior consulting position with a new consulting firm. Haugen Consulting Group is based locally in Denver and while I will be pretty much doing what I've been doing - coding consulting and education - I will also be working with a team of amazing consultants as we lead our clients through the ICD-10 implementation.

I am also chairing the Colorado Health Information Management Association's ICD-10 Task Force, which is gaining momentum each month. For the last month I've visited two of Colorado's three regional HIM associations and also had the opportunity to speak on ICD-10 and HIPAA 5010 implementation last month in Montana and do an audio conference on the new leg revascularization CPT codes for HCPro. Later this month I will present at CHIMA's spring meeting on the importance of mentoring our future workforce (I'm going to bat for all of you!) and will also moderate an ICD-10 panel. These speaking engagements lead to more speaking engagements, which is what I love to do. And sometimes the speaking engagements lead to contracts, writing opportunities, and other networking opportunities.

While I've been working on some exciting prospects of my own, some of the people I've been mentoring have also received some opportunities. I recently got a call from a recruiter asking about one such candidate and another recent grad got a part-time position in an HIM department based on her work there as a volunteer. And my advice to them now that they have their feet in the door is to work hard to keep those opportunities coming.

So if you've completed a coding or HIM program and are having trouble finding work, here's a reminder of some of the things I recommend for getting your start:

• Network! I've received jobs from 4 people I knew or worked with in the past. And I've hired people I've worked with in volunteer organizations. Who you know matters!
• View everything as a learning experience. Work is work, no matter how much you enjoy what you do. There are days when you won't like the tasks that have been assigned, but there may come a day when you need to tap into that experience.
• Find a workplace mentor. Once you get your foot in the door, find someone you can go to with questions. This doesn't have to be a manager - it can be a lead, a person who has worked there "forever" or even a team of people.
  
• Keep a positive attitude. No one wants to work with someone who is negative and miserable. A positive attitude goes a long way in any industry.
• Don't give up - because opportunity happens!
  

What Are You Going to do About It?

I will be the first one to admit when I’m bad at something (like math), but as far as joke-telling goes, I think I’m actually quite good. It’s the remembering part that’s tricky. But I do have a few favorite jokes in my arsenal – a blonde joke or two (it’s okay, I’m blonde!), a couple of jokes that are only truly appreciated by kids under the age of 8, and one joke that teaches a lesson. I am going to share the latter with you now.

A damn broke uphill from a town and the entire town had to be evacuated before the eventual flooding and devastation that was going to occur. One man began to pray and asked that God protect him from the flood. The police came to his door and told him to evacuate and he said, “No thank you. I believe and have faith that the Lord will provide.” The police left. Soon the flood waters were starting to make their way into the town and the man was forced to move to the second story of his home. He prayed again and asked God to protect him. A motor boat with rescuers came by offering to take the man to safety but again he said, “No thank you. I believe and have faith that the Lord will provide.” The rescuers sighed and shook their heads and moved on. Soon after that, the flood waters were so high the man had to take refuge on his roof. He maintained his prayer for safety. In one final attempt to clear the town, rescuers came by in a helicopter but the man refused to get on board. He said, “No thank you. I believe and have faith that the Lord will provide.” Soon there was no place left to climb and the unfortunate man drowned. When he got to heaven and spoke to God he said, “Lord, I believed in you and had faith that you would save me. Why did you let me drown?” And God said to him, “I provided you with the police, a motor boat, and a helicopter. What else was I supposed to do?!”

I’ve heard the joke many times – sometimes as part of a sermon, sometimes as an anecdote to get people to realize they have more control over their lives than they think. I receive many phone calls and emails from students and novice coders who are frustrated with the hiring process. And since I’ve committed to mentoring, I try to find time to respond to each of those emails. I am always happy to give a little pep talk or give a little advice that may guide them in the right direction. But occasionally, I get an email that is a series of complaints and blame games and all I can think is: what are you going to do about it?

Don’t get me wrong. No one loves a good venting session more than me. I even have friends that I can email and rant to and they won’t take it personally. I can type a 2 page email and usually get the response, “Feel better now?” and usually I do. I am all for venting frustration. But at some point, you have to make a decision to do something about the problem or change course. Otherwise you’ll go crazy. Think of Einstein’s famous quote about the definition of insanity: “doing the same thing over and over again and expecting different results.” So if you’re stuck in venting mode or you haven’t tried a different attempt at getting what you want, it’s time to break the monotony and move on.

I recently started reading The Last Lecture by Randy Pausch with Jeffrey Zaslow. I don’t get a lot of time to read and I am by no means a speed reader, so it will probably take me at least a week to get through this “quick read.” The story, if you are unfamiliar, chronicles the last lecture given by Randy Pausch, a professor at Carnegie Mellon University before he succumbed to pancreatic cancer. He was 47-years-old and left a wife and three young children behind. His lecture entitled “Really Achieving Your Childhood Dreams” was really directed at his children (the lecture was recorded) and is so inspiring, it yielded a spotlight on a national TV news program, the book, and countless videos on YouTube.

In the book, Pausch dedicates an entire chapter to his parents and their parenting skills. One of the things his parents did for him was to encourage him to find answers to the unknown. This is something I felt I had in common with him – my parents were always telling me to “look it up” if I didn’t know an answer. In fact, my mother always told me, “Knowledge isn’t what you know; it’s whether or not you know where to find the answer.” And as much as I hated the look-it-up-response (I actually thought they were lazy), I appreciate it now because now I don’t rely on someone else to figure everything out for me.

I am at a point in my life where I am probably the happiest I’ve ever been. And I’ve noticed that as a happy person, the last people I want to be around are unhappy people. Unfortunately, I have a few in my life – friends, acquaintances – who every time I talk to them dump every last problem on me and then wait for me to speak. Sometimes I mess up and give them advice. What I’ve found to be more effective is to ask them what they plan to do about it. If all they want to do is complain about their situation and aren’t willing to do anything about it, there’s really not much else I can do other than listen and wait it out until they’re done. But every once in awhile, I see something flicker in their eyes and I can tell they haven’t really thought what they would do about it. And I sometimes suspect they’re waiting for someone to tell them what to do. My hope is that my question is a virtual slap-in-the-face to get them past the complaining stage and onto the fixing stage.

Are you one of these people? Are you waiting for the magic opportunity that will get you into the coding profession? Have you really tried everything to get into the industry? I defer again to Randy Pausch, who created a list of childhood dreams. On that list was “being in zero gravity.” His students won a contest that enabled them to experience NASA’s plane “The Weightless Wonder,” which helps astronauts get used to a zero gravity environment. Unfortunately for Pausch, no faculty was allowed. So he found a loophole and withdrew his application as faculty and resubmitted it as press (for which he had to do some additional work to get the story into the media). It worked and Pausch was able to cross one thing off his childhood to do list. So I ask you again, if you’ve tried to get a job and have failed, what are you going to do about it?

Now Blogging in Two Places!

If you haven't had the chance to check out AHIMA's HI Careers website yet, you definitely should. Besides all the great information for HIM and coding job seekers, they've recently added a series of blogs from industry pros - including yours truly. I will continue with my Coder Coach blog as well - now you just get to read me in two places! Plus, you get the added benefit of hearing from others as we tackle some FAQs about getting hired in HIM.

AHIMA's HI Careers website

How the Coder Coach Spends Her Time

You’ve read the blog postings before – I am very passionate about helping folks break into the industry. And as I step on my soap box to tell novice coders to be persistent and network, someone inevitably asks me if I hire new coders. The honest answer is no, but it’s not because I wouldn’t if I had the opportunity. The truth is, as a consultant, I am working with clients who expect - and pay a premium for - experienced coding knowledge. And because I am not in a position to hire new coders, I write this blog, present monthly Coder Coach events, and tweet relevant articles I come across. When I give that answer, the next inevitable question is, “What do you do as a consultant?” So I thought I would take a moment to tell you what I’ve been up to lately – in my day job.

Because I work for a small company, we get a wide array of requests, so to many, my job may seem like a crazy schizophrenic mess. I can’t possibly put down everything I do without writing a small book! So I decided I would take the last couple of weeks and give you the rundown.

I’ve been working with a client for about a year to improve their coding and charging accuracy in the cardiac cath lab. While that may seem simple and straightforward, the client is a large teaching hospital and training the coders isn’t enough – we also need to talk to the nurses, techs, and doctors about documentation. Last week I traveled to the client and presented seven identical training sessions to the nurses and radiology techs in the cath lab on how to improve their documentation. Each presentation was two hours. And that two hour presentation took about a week to prepare for. In between training sessions, there were meetings with cath lab and HIM management and time spent one-on-one with one of the coders who had questions on some cases. I had an extra treat last week when we were invited into the cath lab to see some procedures being performed.

During the evenings last week I put the final touches on two presentations I needed to submit for this week’s AAPC chapter meeting and also met with my boss about a potential new contract that would significantly impact my summer work deadlines. After traveling home, I attended my first board meeting as a director for the Colorado Health Information Management Association where we planned our strategic initiatives for the coming year and I took a few moments to stress the importance of hiring new pros and expressing a need to get more employers on board (I just want you to know that I’m also preaching to my peers!).

This week my time was split between clients as I prepare for training a client next week on injections and infusion coding and follow-up with my cath lab client on the issues from last week and plan the next round of training. I spent several hours analyzing client data and doing a couple of chart audits. Last night I spoke at the AAPC chapter meeting and networked with some folks a bit. Today I will be pulling together the handouts for the next Coder Coach event and again preparing for next week’s training.

Over the coming weeks and months, I have several training sessions to prepare for with clients, client reports that need to be written, and client meetings that need to take place. I am also working on our company’s plan for ICD-10 training, writing white papers on ICD-10 implementation and training and presentations for two AAPC chapter meetings next month. We don't want to think about it, but fall is right around the corner and it's the busy season for consultants as we study the code changes and read the Federal Register for changes to code-based reimbursement for next year. Amid all of these tasks are a myriad of other little “to dos” and more than one project I’m not yet aware of. In my spare time (?!), I blog, network, and do other miscellaneous things for the Coder Coach group and soon will also be blogging for AHIMA's new HI Careers website.

So if you ever ask me what I do and I pause and say, “Um,” it’s because I’m trying to remember exactly what it was I did that day!

Tribute to a Mentor

I’ve been meaning to start a blog for novice coders and wanna-be coders for quite some time, but that initial blog topic has been elusive – at least until this week when I received the sad news that Deane Poore, RHIT, one of my coding mentors, recently passed away. And as I congregated with former coworkers to pay respects to our esteemed colleague, I found myself reminiscing about my career beginnings and all the people who had a hand in my development as a coding professional. There was my mother, Nancy Stanton, RHIT, who encouraged me to get an associate’s degree in health information management (HIM); there was Lila Mayer, RHIA, who gave me a chance as an outpatient coder after graduation even though I had no experience except for the limited coding I did under her supervision as an intern; Layne Poseley, RHIA, who checked all of my work for the first year of my employment and answered countless “why’s” and “how’s”; and there was Deane, a former teacher turned coder, whom Lila brought out of retirement to teach me inpatient coding. And those are just a few of the people who got me on the right track within my first few years in the industry. From there, I have been unknowingly passed from one mentor to another, never truly realizing that the time they spent with me was one of the greatest gifts I could ever receive.

Now, after working in the HIM and coding field for almost 15 years, I have come to appreciate the fact that the way I was trained in my first coding position is not the norm. Most hospitals do not have the time or resources to take a novice and groom him or her into a quality coder. Since I started coding in 1995, the world of hospital coding has seen a complete facelift with the introduction of a new and overhaul of an existing code-based reimbursement methodology, increased coding regulation, and more focus on coding compliance. There is also the added challenge of learning to use electronic medical records (EMRs) and ensure that HIPAA guidelines are being followed. Changes to the coding industry are happening at such a rapid rate these days that employers are finding it more and more difficult to train and mentor new coders.

Nationwide Coder Shortage

The problem is the industry needs more coders. There is a nationwide coding shortage and industry experts expect this demand to increase as the nation marches toward the October 1, 2013 deadline to implement ICD-10-CM/ICD-10-PCS. To existing coders, implementation of the new system is the equivalent of telling everyone in America that starting in 2013, we will no longer speak English and that Chinese will be the new language. Many current coders are threatening to retire or change careers rather than learn the new system. That means it is the prime time for new coders to enter the field and for once, the playing field will be level – new and experienced coders alike will need to learn the new coding system.

So now is a great time to become a coder, but what do you need to know? Which healthcare setting is the right one for you (doctor’s office, hospital, rehabilitation, etc.)? Which certifications are most widely recognized? Do you have to join an association to get a job? How much money will you make? Can you work from home? These are all questions I hear from wanna-be coders on a regular basis and I would like to help answer some of them and maybe point you in the right direction.

If you have specific questions about becoming a coder, let me know and be sure to check out my Coder Coach Facebook page for updates about upcoming networking and mentoring sessions: http://www.facebook.com/groups.php?ref=sb.