BC Advantage asked the new President/CEO of The Academy of Professional Coders (AAPC) about her thoughts on the current state of the industry, what industry professionals should be looking to achieve in the future and more...

BC Advantage (BCA): The economy had played an effect on all industries including the healthcare industry. What steps do you think coding professionals and new industry members need to take to ensure longevity within this industry?

Deborah Grider (DG): As far as our members I recommend that each member extend his/her knowledge base, update and brush up on current skills and develop new skills, going  beyond coding and obtaining either the auditing credential or the compliance credential to make themselves more valuable to the healthcare industry.

BCA: Apart from the obvious ICD-10 changes coming in 2013, what other areas of the industry should coders and healthcare professionals consider learning more about?

DG: With the advent of health care reform everyone in the health care industry should learn about meaningful use, the Electronic Health Record and the stimulus monies along with how the RACS, MICs, ZPICs and others impact every health care organization.

BCA: You have been in the industry for just over 30 years, what are the major changes you have seen that have made an effect on the average everyday coder/biller?

DG: I entered the industry when we recorded medical records on 4 x 6 cards, (if anyone remembers that!)  We took cash or check, not even credit cards in those days, and very few health plans or payers accepted the codes. In those days we had a modified version of the HCFA 1500 forms and we wrote on the claim what was performed in narrative and handed it to the patient as they paid and walked out the door.  In the mid-80's things began to change and many health plans began accepting the codes and we began using CPT and ICD-9 more frequently.  We did not really need to know how to code; there were no regulations, or rules to follow in most cases.  Then the medical policies emerged, HHS and CMS got more involved and started denying claims, can you imagine that?  We were shocked but had to conform.  Then came electronic claims and I remember the old Annson System the BCBS developed to submit Medicare and Medicaid Claims.  Boy did I think I was in heaven.  All other payers we submitted claims for were on paper, but with the advent of the simple MS DOS based systems, more sophisticated systems emerged as well as more federal regulations.  In the early 90's no one even heard of an audit or E/M leveling.  But in 1995 things again began to change with even more regulations, HIPAA, the Federal False Claims ACT and from 1996 to today the regulations have been getting more complex. Now the Electronic Health Record, Meaningful Use, ICD-10 and whatever else comes next will challenge and stretch us beyond our limits I am certain.  One thing I can say though, I remember in the early 80's a Practice Management system vendor told me electronic claims, health records and the innovations within the business of medicine would lighten our load and free us to do other things.  I don't think that really happened; the more sophisticated technology we have, the more complex our lives have become.

BCA: It must be exciting yet overwhelming to be the head of the largest coding association with over 100,000 members. What new features do you hope to implement while at the AAPC for all members?

DG: We are not just about coding anymore.  We launched the Certified Professional Medical Auditor (CPMA) credential in 2010 and launched one CPCO (Certified Professional Compliance Officer) credential in January of 2011.  We will launch a Practice Management credential by the end of 2011.  Our focus is now credentialing the business side of medicine.

We plan on providing more benefits and services in the upcoming years.  We are launching our virtual office so our members will be provided with additional training and CEU opportunities.

BCA: With ICD-10 already being used in many countries around the world for the past 6 or more years. What are your thoughts on the delay and late implementation of ICD-10 in the USA?

DG: We have delayed implementation too long.  We are far behind other countries and are the only major country left to implement ICD-10.  I don't think the industry, especially physicians are taking the deadline date of 10/1/13 as seriously as they should.  There should be preparations going on now, but many are waiting and hoping for future delay of which HHS and CMS have assured us will not happen. 

BCA: As the first Certified Coder leading the AAPC, your skills and industry knowledge will be able to provide a strong direction for new industry professionals. What are the main areas that you plan to focus on?

DG: Right now we are focusing on ICD-10 implementation guidance and training and development of curriculum for our coders.  We are also getting more involved with legislative issues and have become part of the ICD-10 Stakeholders that meet in Washington each quarter.  We are also focusing on the "Business Side of Medicine" creating the Certified Professional Compliance Credential of which was launched January 2011 and the Practice Management Credential which will be launched later this year.  We want to give our membership opportunities to increase their skill and knowledge which will bring more value to them and the industry and help those who desire more of the career ladder.

BCA: What challenges do you foresee facing as the head of the AAPC to ensure quality for your 100,000 members?

DG: Our members are what make this organization. We plan to support our local chapters, providing more opportunities for our coding community, assist with providing high quality education and training, and to continue to support our coders during the challenging times ahead. 

We are striving to stay on top of changes as they occur, and AAPC has a lobbyist in DC who is our advocate in Washington to help us achieve this.

BCA: Many coders believe they only need to stay informed about their specific specialty or current job position. What would you say to these professionals in regards to further education and career diversity?

DG: I learned many years ago with the constant changes in health care that it is important to evolve and grow you must reach out of your comfort zone and learn a new specialty or skill.  I think that a coder who focuses in only one specialty might limit themselves in the industry if they want to move up or move to a different specialty.  I encourage growth and furthering education especially with all the changes and challenges we face today.

BCA: You have written several publications for the AMA, how do you prepare for the magnitude of information needed to complete such a project? And do you have any other publications in the works?

DG: It takes months and months of research and writing to produce the many publications I have written for the AMA.  All of the topics I write on are areas of expertise for me and since I love to write, quite enjoyable. However one example is the "Coding with Modifiers" publication of which I am in the middle of writing the 4th edition.  I research CMS, individual carrier, and payer policies regarding each modifier if a policy exists before writing the material.  I actually have several publications in the works right now.  They are:  Principles of ICD-10-CM 1st edition; Principles of ICD-10-CM Worktext 1st edition", and Coding with Modifiers 4th edition.

BCA: As a conference speaker and one who still presents to live attendees, what are the main issues that these attendees are having, now and in the future?

DG: ICD-10-CM is the hottest topic, E/M is always a favorite, actual hands-on sessions are very popular and they give the attendee the opportunity to learn by doing which is my favorite way to learn.  Chart auditing is very important right now with the regulatory issues we all face with auditing and compliance, and many of the compliance sessions are very beneficial for not just coders, but everyone in the health care industry.

BCA: What points would you tell these people who are looking for work or perhaps seeking a new position and having an issue finding the right position within this industry?

DG: Continue to expand your knowledge.  The more knowledge and skill you have the more valuable you are to the industry.  For our new coders, it is somewhat difficult as you might imagine.  Most medical practices and hospitals want experienced coders and are not really giving our new coders a chance.  My fear as I have always said is that if we don't mentor our new coders and help them succeed, what happens to our physicians and other providers when there is no one to take our place?  I encourage administrators, managers, and physicians to give the new coder's a chance.

What I tell new coders is that if you really want the job, dress for the job you would like to have not the one you are applying for and "suit up".  Present yourself in a positive light.  Also it might be helpful to offer to prove yourself.  Offer to work for the provider as an "intern" so to speak for 30 days as a learning experience; meaning you don't get paid.  This will give you insight into the practice and to prove your strengths and skill.  Also get involved in the AAPC local chapters, find a mentor; someone to talk to and help you either with contacts, listening to your concerns, maybe reaching out and recommending you to a provider or health care facility, etc.  I have had a few really good mentors in my career that I would not be where I am today without them.  I owe them so much.

BCA: BC Advantage is an advocate for further education and certifications. If someone was already working within the industry but not certified, what would you say to them on why they should become certified with a professional association?

DG: I think a professional association becomes your advocate.  The AAPC is a good way to meet others in the industry and we have members who are coders, consultants, managers, physicians, attorneys etc.  It is also a good way to network and be a part of an organization who supports them in every way we can.  I became a member of AAPC in 1996 and have made such wonderful contacts, friends, and colleagues and the AAPC has helped me grow and strive to become the best I can be.

I think becoming certified if not required by an employer further validates to the coder their expertise and skills in the industry.

BCA: What should new and existing AAPC members look forward to in 2011 onwards?

DG: The AAPC will certainly be there for our members.  We will continue to work to ensure our members are represented well in the industry and that our profession evolves and grows with all the challenges.  We will continue to strengthen our education and training. We have kept our membership, examination costs and services reasonably priced as we are cognizant of the downturn in the economy and will continue to do so.   Our National Conference in 2011 will have an extensive variety of educational topics in tracks from coding to compliance to auditing to practice management.  We have a great Regional Conference coming up in Nashville, Tennessee in September with more networking and education opportunities.  AAPC will begin to partner with more organizations to provider ICD-10 training opportunities.  We plan on holding a Code-A-Thon in the late spring in which anyone in the health care industry can ask an ICD-10 question.  We plan to continue this every quarter for a more limited period to help answer questions and ease concerns about ICD-10.  We are working hard in providing low cost and no cost continuing education options for our members.

We have had feedback that some industry professionals are considering exiting the industry before ICD-10 is implemented. What words of encouragement do you have for these people and others who are nervous about the upcoming changes?

Yes, it will be a challenge for everyone in the industry, but it also an opportunity for us to expand our horizon's, learn a new system and help our medical practices move forward so we are in line with most major countries.  If you think about it, the health care industry will need coders more than ever to assist providers and hospitals and coders would be more highly valued in the industry.

Visit http://www.aapc.com for more information.