March 2, 2017

Online Versus On-site Coder Education: Seven Questions to Consider

By Barry Libman, MS, RHIA, CDIP, CCS, CCS-P, CIC and Lynn Kuehn, MS, RHIA, CCS-P
With more than a year of ICD-10-CM/PCS experience under their belts, coding managers have begun to turn their attention toward fine-tuning coder education. They’re using audit results to identify knowledge gaps and provide targeted training to enhance coding quality.

Basic refresher training as well as education about code updates are both in high demand. Another common area of focus is coding complex surgeries in ICD-10-PCS. Many managers are also interested in education targeting coding guideline changes that may have been largely overlooked during the rush to meet the Oct. 1, 2015 implementation deadline.

In addition, certain niche markets such as pediatric hospitals, long-term acute-care facilities, and critical access hospitals did not receive adequate setting-specific training, necessitating the need to revisit ICD-10-CM/PCS coding concepts and dive more deeply into coding challenges that are unique to these specialty settings.

Following are three benefits on on-site training for coding managers to consider:

1.   The ability to tailor content in real time. As questions arise, instructors can pause and elaborate on certain topics. They can also omit information that isn’t relevant to the organization or that’s too basic for the students, reserving time for more pertinent discussions. In addition, instructors can incorporate facility-specific audit results and case study examples, allowing them to focus on high-volume procedures, facility-specific documentation challenges, and other questions that may be unique to the organization.

2.   Instructors can turn questions into powerful teaching tools. When a student asks a question, everyone benefits from the answer. This includes students who may not feel comfortable asking questions out of fear of appearing ignorant. When students ask questions, especially follow-up questions for clarification, it also forces instructors to refine their explanations, ultimately yielding a more meaningful learning experience.

3.   It lets coders know they’re not alone. A group learning environment builds camaraderie. Something as simple as a head nod, for example, lets coders know that others share their frustrations and anxieties.

Benefits of online training include the following:

·  A flexible learning schedule. Coders can participate in online modules when it’s convenient for them. This includes remote coding staff who may not be able to travel onsite for training purposes.

·  Built-in proficiency assessments. Coding managers easily glean proficiency through test-your-knowledge questions built into the online modules.

·  Access to specialized topics. Organizations aren’t limited to courses available in their immediate geographic area. Coders can benefit from instructors nationwide who have developed top-notch online courses based on their areas of expertise.

 Consider these seven questions when determining whether on-site versus online training is the best option:

 1. How many coders work remotely? Although on-site training is convenient for a fully on-site staff, it does introduce complexities when some (or all) of your coders work remotely. For example, if you’re located in the northeast, and you know that training must take place in December, is it realistic to require all remote coders to travel on-site when weather conditions are unpredictable? You may not want to take the gamble, especially when the training is time-sensitive.

 Weather concerns aside, it’s certainly possible to train even a large remote staff on-site. If you usually require coders to come on-site once or twice a year, you could provide in-depth training at that time, followed up with subsequent online training. For example, some organizations opt to provide general ICD-10-CM/PCS update education on-site annually, with supplemental specialty-specific online training. This hybrid approach can be extremely cost-effective and efficient.

2. How will you maintain the discharged not final billed (DNFB) during education downtime? How much productive time will be lost when coders undergo the actual training itself, and are you able to outsource some or all of their work so the DNFB isn’t affected? This is less of an issue with online training because coders can complete modules during downtime and/or on their own time, though it’s still something to consider if you plan to build online training time into the workday.

3. What’s the topic of the training? Does it lend itself to a group learning environment in which coders can ask questions and problem-solve together, or is it better suited for individual learning? For example, if you want to train newer coders on how to code complex spinal surgeries, you might want to consider on-site training where students can discuss case studies and the instructor can read students’ body language and facial expressions to assess whether they truly understand the course material.

4. What’s your training budget? How do your online versus on-site options stack up against this allotted amount? When tallying up total amounts for on-site training, don’t forget to include costs associated with travel and lodging for any remote staff. This is especially important when training sessions are offered in succession rather than all at once (e.g., once per week for three weeks or once per month for three months), because it drives up the travel costs for remote staff.

5. What do your coders prefer? This is something to consider, given each coder’s individual learning style, but it certainly shouldn’t be the single deciding factor in your decision.

6. How many coders must be trained? This is important because it dictates the type of physical space required for on-site training. When training a large group of coders, for example, do you have access to enough computers? If not, can you rent space locally, and if so, what are the associated costs? Another option is to split the class size, although one disadvantage of this is that training sessions may be slightly different depending on real-time adjustments in the curriculum.

7. How soon must coders be trained? Even though the rush for basic ICD-10-CM/PCS education has passed, coding managers must continue to remain cognizant of the Oct. 1 deadline for ICD-10-CM updates and the Jan. 1 deadline for CPT updates. Instructor availability is also something to consider as these deadlines approach.

Regardless of the specifics, all coding managers must answer this important question for any coder training they intend to offer: Will coders use online modules, or will they undergo training on-site? Of course, there is no one-size-fits-all answer to this question, and both options have their merits.

About the Authors:
Barry Libman BW Barry Libman is recognized for his in-depth knowledge of coding and reimbursement. Barry is the president of Barry Libman Inc., and Libman Education, a leading provider of coder training.
lynn kuehn square Lynn Kuehn is a nationally recognized ICD-10 expert. Lynn is president of Kuehn Consulting, LLC, a consulting firm specializing in coding for all settings and physician practice management issues.

Contact the Authors: