Productivity Tips: A Guide for Medical New Coders

A Guide to Improving New Medical Coders’ Performance

The medical coding industry is currently in a boom, and the projections show no sign of slowing down. However, with this boom, the market, its conditions, and coding tools are also changing very fast. To be honest, every day, we can see new coding software on the market, or we can even get a change in regulations.

This creates a lot of problems for medical coders, and it becomes very difficult for them to cope with the rapid changes. This is especially true for new coders and billers who enter the market. Additionally, studies reveal that coding accuracy rates need to exceed 95% to minimize claim denials and ensure financial health, which clearly shows the pressure that coders face.

To counter this situation, healthcare providers should focus on their employee training and the overall structure of the billing department. And that’s what this blog is about. The blog will provide you with a detailed guide based on AHIMA guidelines on how to maintain the productivity of new medical coders. So, let’s start.

What Do Medical Coders Do?

Now, before we go into the details of how to maintain and increase the coder productivity, it is important to understand what medical coders actually do. This will give us a foundation to work on. By knowing this, you will have a good idea about which job responsibilities you need to improve.

So, what do medical coders do? Well, they are responsible for translating patient care records into universally recognized alphanumeric codes, ensuring the accuracy and efficiency of the billing and reimbursement process. These codes are the industry standard so that all state coders can follow the same structure. The standard codes include the International Classification of Diseases (ICD-10), Current Procedural Terminology (CPT), and Healthcare Common Procedure Coding System (HCPCS) to categorize medical diagnoses, procedures, and services.

All coders have the following job responsibilities:

• Reviewing medical records and assigning accurate codes.
• Ensuring compliance with regulations and payer requirements.
• Supporting revenue cycle management by facilitating correct claim submissions.
• Collaborating with billing teams to address claim denials.
• Staying updated on coding guidelines and healthcare regulations.
• Validating charges
• Sending charge corrections
• Querying providers
• Responding to emails
• Attending staff meetings

Medical Coding Productivity Standards

Defining Productivity in Medical Billing

Well, there is no simple way to define productivity. Since it is a subjective matter, every healthcare provider and every coder will have their own definition of coding productivity. However, we can set some benchmarks that will help us evaluate efficiency metrics.

In the entire industry, productivity in medical coding is typically measured by the number of records coded, the accuracy of coding, and the time taken to complete tasks. To help us better gauge the productivity of our coders, DecisionHealth has given us the following criteria:

• Charts reviewed daily (all coders’ average): 78
• Claims coded daily: 89
• Claims submitted daily: 79

If a coder fulfills the above criteria, then he can be considered good at his job.

Factors that Influence Productivity

If we look at the data, we can deduce that four factors have more impact on coder productivity than anything else. Let’s briefly discuss each of these factors:

Experience Level: On average, new coders write fewer code than coders with experience. However, experience after a specific limit reduces the performance. Here’s a table summarizing the coder productivity stats based on the years of experience:

Years of Experience in Medical Administration	Charts Reviewed	Claims Coded	Claims Submitted	Denials Appealed
Less than 1 year	68	56	36	3
1 to 5 years	90	137	116	2
6 to 10 years	108	115	129	11
11 to 20 years	83	92	65	6
More than 20 years	64	74	36	3

Based on this data, we suggest hiring medical coders with experience between 6 to 10 years.

Specialty: The medical field or specialty a coder is working in can also have a massive effect on their performance. For instance, coders in fields like orthopedics and pain management are more productive (coding 94 and 93 claims daily, respectively) than those in urology or otolaryngology.

Work Environment: The work environment is probably the biggest outlier of all. It’s also very obvious and makes sense. A coder in a hospital will almost always code more than a coder in a small clinic. According to the data, hospital coders handle 60-80 cases daily, while clinic coders manage 30-50.

Technology Utilization: Tech has changed medical coding considerably. That is also true for how coders do their jobs. During research, we found that hospitals that use tools like Computer-Assisted Coding (CAC) and Electronic Health Records (EHR) can significantly enhance productivity. In fact, Xtelligent Healthcare Media conducted a study and found that the adoption of CAC can improve the efficiency of your coders by up to 68%.

Why Is Accuracy Important For Medical Coders?

Speed is essential, but accuracy is even more critical in medical billing and coding. Therefore, healthcare providers should frequently audit their coders so that the accuracy of their employees can be increased. Otherwise, what good is it to code 100 codes a day if 20 or 30 of them are rejected?

AHIMA Tips for Maintaining the Productivity of New Medical Coders​

Now that we completely understand the factors that affect the coder efficiency and established productivity benchmarks, let’s discuss how we can improve upon these set standards. Most of the tips that we are going to share now are factually based on the American Health Information Management Association (AHIMA) guidelines.

Provide Comprehensive Training

The first step is to train your new coders. Training your employees continuously will enable them to stay up-to-date with the ever-changing technology and regulations. AHIMA’s resources emphasize the importance of:

• CMS Guidelines: Training coders on the latest Medicare & Medicaid Services (CMS) coding rules to minimize claim denials.
• Certifications:  Invest in your employees and help them get the latest coding certifications like CPC or CCS-P. These certifications aren’t just a piece of paper; they improve your coder’s productivity. To give you an idea of this boost, data suggests that certified coders review 29 more charts and code nearly twice the claims of non-certified coders.

Set Realistic Productivity Goals

Setting medical coder productivity standards is essential to gauge the skills of your new coding team. However, this is easier said than done. Because the learning curve is different for each employee. New coders often struggle to meet industry benchmarks due to limited experience. We can name at least seven strategies to tackle this issue. However, AHIMA suggests starting by setting incremental goals based on metrics such as:

• Average coding time per record.
• Case Mix Index (CMI) to measure coding complexity.
• DecisionHealth’s benchmarks (the standards that we shared earlier) for daily productivity.

Leverage Technology

Manual coding is outdated now and is also prone to various errors not to mention the apparent inefficiency. That’s why hospitals should employ tools that can automate repetitive tasks.

Automating repetitive tasks using CAC tools can help coders focus on complex cases. For example, coders using CAC can code up to 4.5 times more cases daily.

If you are utilizing the right technology and your employees are well-trained, then every coder should be coding at least 120-200 cases daily.

Foster Collaboration

As the saying goes, “Teamwork makes the Dream Come True,” we suggest promoting collaboration between your coders. An interesting way to do this is by pairing new coders with experienced ones. This way, newbies will get continuous mentorship and real-time feedback.

Create a Distraction-Free Environment

Distractions during work are also a big obstacle for coders in achieving their benchmarks. This is true for all employees, not just medical coders. A recent research paper claimed it takes over 20 minutes to regain focus after being distracted during work.

So, it’s imperative to create an environment where coders can work without any interference. Such implementations can include:

• Limit Non-Coding Tasks
• Provide a Quiet Workspace
• Implement Productivity Tool
• Establish Clear Communication Protocols
• Offer Flexible Work Hours

Hire More Medical Coders

A team’s productivity is also based on the number of members. Based on the data provided by DecisionHealth, departments with 11 to 25 coders and 51 to 99 coders were the most efficient, coding an average of 70 and 69 claims per day, respectively.

So, you should structure your medical coding department based on these statistics. This isn’t an obligation but rather just a suggestion based on statistics. Here’s a more detailed look at the team size and productivity:

Coders/Billers in Coding/Billing Dept.	Charts Reviewed	Claims Coded	Claims Submitted	Denials Appealed
10 or fewer	51	55	59	4
11 to 25	34	70	54	4
26 to 50	54	46	44	5
51 to 99	67	69	128	1
100 or more	75	53	53	1

Outsource Medical Coding Services

Now, if you have gone through all the tips we shared in this blog, you should have a good starting framework for maintaining productivity with new medical coders. At this stage, you have two choices i.e.: You can either try to implement all this yourself and, in case of failure, lose a lot of money and resources, or you can simply outsource all of your medical coding operations to specialized medical coding companies like NeuraBill.

For healthcare organizations struggling with coder shortages or productivity gaps, outsourcing medical coding can be a practical solution. Outsourcing will provide you with: consistency, scalability and expertise across specialties