Home Health ICD-9/ICD-10 Alert

Understand your options before beginning your search.

Is it better to hire new coders from outside or to promote from within? This question baffles many agencies - but these inside tips will help you make the right choice for you.

Home health agencies face a special challenge when looking for coders: Home health coding is so different from other disciplines that you really need someone with special skills, experts agree.

Option #1: Appoint someone from within your agency to handle coding.

"When it comes to either hiring or 'growing' coders, I vote for 'growing' them," says senior consultant Karen Vance, OTR, with BKD in Springfield, MO. Finding a coder with home health experience can make a huge difference, she insists.
"It's hard to train people to have the clinical reasoning to identify the primary diagnosis," she points out.

Look for: If an employee inside your agency has shown dedication and dependability, and you have the ability to train that person as needed, then you should go ahead and make him a coder, agrees consultant Phyllis Yingling with Apple A Day in Hilton Head, SC.

"If you have a good employee, that's half the battle," Yingling says. If someone in your agency has shown herself to be meticulous and dedicated, "you're far better off using that person and helping [her] get certified," she says.

Otherwise, you could pay "big bucks" to train a new employee without knowing if she's really worth the investment, Yingling notes.

In addition to general dedication and dependability, Vance advises agencies to look for the following qualities in a coder:

strong assessment skills,

willingness to learn,

attention to detail, and

patience.

 The difference between expert coders and those that "bungle through" is willingness to stick with a problem, Vance says. You need someone who enjoys the "puzzle" aspect of coding.

Option #2: Hire a coder from outside.

Sometimes finding a coder from within your agency simply isn't an option. Because nurses in home care haven't historically had coding responsibilities, many aren't "quite as astute" as dedicated coders can be, points out Karen Upton, RN, regional nurse coordinator for NHC HomeCare in Murfreesboro, TN.

When faced with a choice between a professional coder without home care experience and a nurse without coding experience, Upton is inclined to go for the professional coder, she says. Of course, finding someone experienced in both is ideal.

If you do hire an outside coder without home care experience, be prepared to devote a significant amount of time and money to training that person, experts agree.

Look for Someone Who Can Easily Adapt to Home Care

There's a lot to learn in home care that your average professional coder won't have experienced in other settings, reminds Margaret Rush, RHIA, HCS-D, OASIS and Coding Coordinator for Alacare Home Health & Hospice in Birmingham, AL.

Key skill set: If you're looking for a coder from outside of home care, try to find someone with experience working with multiple disciplines, counsels Upton. This experience will allow the coder to adapt more quickly to the home care setting.