# The Sad Truth of training



## vjst222

My employment just doesn't think ICD10 is all that important. Recetly, the physician coders have recently been put under the Hospital Coders. We are 2 diffferent worlds. With the combining of the 2 departments, the BUDGET has been cut. Now, my boss feels it is only necessary to send 1 coder to an seminar or conference. Although all coders need the training and the CEUS, my boss feels it is only important for one person to go and relay the news. I CAN'T STAND that reasoning. When I asked my boss about it and told her how important it was for me to be there and listen, she states, " There just isn't enough money in the budget," 

 Now, I just can't afford to pay to go to these seminars myself. I can hardly pay all my bills let alone send myself to a seminar.

 Is it me or is my organization just thinking... " Oh well they will figure it out. " We have done ABSOLUTELY no training for ICD10. YET, our hospital is getting ready to update our billing sofftware. They have spent over a year sending people out of state to get training on how to do this. They are spending 100,000 thousands of dollars on  " FIXING THE REVENUE CYCLE." yet they can't afford to send me to a $209.00 seminar. 

 I feel like maybe I should look for a new job, but yet I am not ready to leave here... I am stuck between a rock and a hard place.


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## btadlock1

Free Training from the people that wrote the book (There's a link if you scroll down):
http://www.who.int/classifications/icd/en/


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## vjst222

Thanks


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## btadlock1

Gabe26 said:


> Thanks



I know the feeling you have right now, but mine's almost the opposite of yours - I've been put in charge of ICD-10 implementation for our company, and I'm sure that my bosses would pay for me to go to classes if I found one in particular, but there are so many out there, I wouldn't know where to start to find a beneficial one. I just printed off the conventions and am going to see how much I can absorb from them. The free modules from the WHO seem really in-depth, though, so why pay to have someone teach you something, when you can get it from the source for free?


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## kevbshields

Now is not exactly the time to begin learning the details of technical coding in ICD-10.  Instead of going to conferences where the basics (structure, content and overview) will be covered (again!), coders should be working independently to assess their weaknesses and areas where development is needed.  For instance, coders who've not had anatomy, physiology, pathophysiology and similar clinical foundations in a number of years should be seeking how to fill those knowledge gaps.  You will NOT have time to develop these skills if you wait to address them.

Personally, I do not know that many speakers and consultants have any more insight into ICD-10 than we can gain by sitting down and developing our coding skills in that system now.  If you're confident in your clinical basics, look at some of the inexpensive ICD-10 basics workbooks.  Consider spending your money and time in locating the most recent version of ICD-10 and over the next year gaining some hands-on experience in ICD-10 coding.  

There really is no better lesson than sitting down, reading the guidelines, making notes in the manuals and getting your hands dirty coding in that system.

See what you can get for free and go from there.  Implementation will be challenging, but we'll all survive.


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## btadlock1

That makes me feel better...I think I'll understand it once I get all of the rules down. It may just be the size of the print, but it seems like there are a LOT more than in the ICD-9. The real challenge is going to be getting everyone else on the same page; how to teach it to people that are really experienced without drowning them in useless information, and also to the billing and reimbursement staff - many of whom have little to no coding experience and have no interest in learning about it...but I'll cross that bridge when I get there.


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## vjst222

Kev

 You know that is a great idea. Besides, if no one else will help you, YOU have to help yourself  Luckily I just had anatomy not too long ago.  BUT I will have to get my old anatomy book out and study up on it.

 Thanks for the ideas and suggestions

 Brandi

 I might have to come work for you  HAAHAA


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## xlbctso

Kevin -
Thank you for injecting realism into this touchy subject.  I work in the health payer system and I am not pleased with the way our I-10 project is moving.  I have finally spoken out about it and hopefully we'll have time to re-assess and get a grip. We don't even have a handle on our business requirements and we are chasing down tools and mapping exercises.  

L


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## vjst222

XLB

 I know what you mean my friend. I am just hoping and praying everything will transition smoothly.


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## mtonyahunterlewis

True the budgets have been cut everywhere. Everyone is gotta make a buck in training you to do what is required.  If you look hard enough, you will find "free" education out there. You just have to find it. You also must depend on that person who is going to those siminars to come back and share the information (that is if he or she understands it). Then some people are not into public speaking, so the person that is to go to the siminar can not be afraid to be the person afraid to get up and share the information in front of the group. It should be required he or she shares that information. Don't look for another job. Jobs are hard to find. That is just a small problem if that is the only problem. Some times we must find other methods to educate ourselves rather than look to others to educate us.


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## angelav@armedicalclaims.com

*Icd 10*

Thanks to Brandi for the link. Its better to get things from the source. At least I can start to look at it, see how the guidelines are set up, and go from there. I'm sure we'll all get through it. I think this will definately be a growing pain, but it will also showcase the value that coders bring to a practice/facility.


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## bfontaine

If you can't afford a class the very best thing you can do for yourself is to purchase a copy of the latest draft of ICD10 and read, read, read the introduction and the guidelines.  Get familiar with them and they won't be so scary.  I was lucky enough to go to a two day AAPC Boot Camp last year. One entire day was spent on planning for I-10 and setting up a committee for your location or company to get the buy-in we'll need from everyone.  They have suggested guidelines for who needs to be on the committee from the beginning, before you start training anyone including your doctors!  This isn't just coders who will be affected by the change, it's virtually EVERYONE in your office.  The coders will have it easier than we think, because at least we will know what is needed.  Think about your front desk people, the appointment people, the referral people, the nurses, MA's, PA's and doctors, and then the billers and A/R people on the back end.  There isn't ONE person who won't be touched in some way by this change.  Don't be scared for us.  We will take the time to learn it, and it's really not so different from what we have done all along, it's just all in one code!! 

Also, read your Coding Edge.  There should be an ICD10 article in every issue.  Ask your local chapter to put on some programs that relate to I-10.  There are people out there already who are willing to share their knowledge.  All you have to do is find them!!


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## swieranna@gmail.com

btadlock1 said:


> free training from the people that wrote the book (there's a link if you scroll down):
> http://www.who.int/classifications/icd/en/



great tool - thank you!


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## Aleifer

I believe the most difficult part of ICD-10 will be getting the physicians to document according to the level of specificity required, especially procedures.  We are all capable of learning ICD-10 but we will not be able to code if the documentation isn't there.


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## mitchellde

anna.s.o@sbcglobal.net said:


> great tool - thank you!



Yes this is a great link for ICD-10.  However the US will use ICD-10 CM and this is not the same.  This tool will not be of much help for us and can be very confusing when you compare the code sets and rules.


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## Pam Brooks

mitchellde said:


> Yes this is a great link for ICD-10. However the US will use ICD-10 CM and this is not the same. This tool will not be of much help for us and can be very confusing when you compare the code sets and rules.


 

Absolutely right Debra...and as we know.... other countries have a single-payer system, which we do not.  That's going to be one of our biggest challenges. 

I recommend just purchasing the ICD-10-CM draft, and reading the instructions, the code descriptions, and becoming very familiar with the methodology.  It's not all that different and confusing.


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## rthames052006

I totally agree with Kevin!  I for one am not afraid to admit that I need a serious brush up of A&P.  It's been years since I've taken a course and when you specialize I am a firm believer that you lose it, if not used on a regular/daily basis.  I see that AAPC has an A&P presentation that I'm considering....


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## dtricia

*ICD10 training*

Nancy Maguire's website Codapedia has free training modules, self paced.
She says she will have one a month till implementation.
Tricia


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## JG24

Regretfully I think this is the mindset of most physicians I come into contact with (especially smaller physician groups with 1 or 2 providers). Regardless of how hard we try to get them to understand that ICD-10 is coming, many of them still believe it will be postponed (again). Fortunately, we, as coders and billers who are part of AAPC, know different and it will be up to us to be as prepared as possible (even if we have to figure out ways to pay for our own training) so that when the time comes to do the "last minute scrabble" to try to get them up to date so they don't wind up closing their practices due to lack of income, we will be prepared.  As it has been said many times, learning the codes themselves is not a priority now but learning how to implement and what steps need to be taken are key now.  Also making sure that the doctors with work with now have their billing systems ready and that their documentation skills are up to par (start working them away from the "not elsewhere classified" and "not otherwise specified" codes).

In this particular case, I would suggest that you give as much information as you can to your managers (AAPC articles and the CMS website).  Looking for another job is not the solution to your problem, you will encounter the same thing throughout the medical field.  While AAPC has done an awesome job of preparing us, physician organizations (like the AMA) are failing to get the doctors to grasp just how drastic this transition will impact them and their pocketbooks.  Until the carriers stop paying them (or slows down) because they are not in compliance, they may not get the message regardless of how hard we try.

I would strongly encourage you (if you are not a local chapter officer) to consider running for an office. AAPC gives chapter officers discounts to national conventions and the next two conventions will be valuable in preparing for the transition.  Also some chapters do offer  "scholarships" to assist members in paying for conferences.  While they may not pay all of your expenses every little bit helps but you need to take the "bull by the horns" and use all of the resources available to you to gain the knowledge.

Boning up on your Anatomy now will go along way toward helping you be prepared.  If you have seen any of the ICD-10 drafts, specificity is going to be the key.  A lot of the regular book stores have some really good books out there that are fairly inexpensive.  While it may seem childish to some, the coloring books on Anatomy are amazing and you can learn a lot from them.


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## susiekay

I feel it's too early for coder training.  The electronic end is a whole different story.

I attended an ICD-10 class in Mpls last October just to get my feet "wet" and to get my hands on a draft of the ICD-10 book.  AAPC has advised that six months prior to the conversion is plenty of time for coder training.  Retaining the information is the key issue!!  Plus the ICD-10 will continually be updated until the final draft and printing.

My main concern is the using the I and O in the ICD-10 coding sequence, hopefully it won't be too confusing.  Oh I forgot the x place holders too.  It will be quite the learning experience!  At least we are all in the same boat!   

By the way, Brandi I really appreciate your input on this board.


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## peggy@pronetsystems.net

Now I am having the exact opposite problem.  My company is rolling out  hours of training - but you have to be on the work computers to use it!  How many of us have time during the work day to sit and study for hours?  I do not relish having to stay overtime to do my studying when having study guides I can use from home would be so much easier.
But the company thinks they are being very proactive by having all this training online for us! They are just not taking into account people's schedules or different learning styles.
Working for a large company that has to train a high number of employees will always be a conflict.


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