Practice Brief
the start of their HIM education. Coding is an excellent example
of a career that requires dedication to life-long learning. Many
students are committed to advancing their HIM degree—
leading to an RHIT or RHIA. Institutions that build progression ladders into their offerings encourage students to come back to
school while they are employed. Students working in the field
are a good resource for instructors because they can bring real-life examples into the classroom during the transition.
Transfer Credits
Once the programs have fully transitioned to teaching ICD-10-
CM/PCS, credits for ICD-9-CM coding classes can no longer
be accepted as transfer credits since the content of the coding
classes are no longer equal. If a student requests transfer credits for coding classes, programs will need to review documentation (e.g. syllabi) carefully before granting the transfer. Some
programs will have increased the credits associated with coding classes, since credit hours for some coding classes may not
be equal to the current ones. Another consideration program
directors may need to address is whether or not a new course
needs to be developed with a different course number to reflect
that ICD-10-CM/PCS classes are significantly different from existing ICD-9-CM courses.
Program-Specific Challenges
Certificate Level
AHIMA is expected to begin offering ICD-10-CM/PCS-based
CCA, CCS, and CCS-P exams in March 2014. Coding certificate
students who graduate near or after that date should be fully
trained in ICD-10-CM/PCS. Preparing students for these exams
can present specific challenges since some of the programs offer
more comprehensive coding classes than others. All programs
should complete the conversion to ICD-10-CM/PCS by August
1, 2013 (year-round schools would need to do this earlier). Students with an expected completion date of January 2014 or later
will need to have completed coding courses where ICD-10-CM/
PCS is taught as the primary code set. Using the end date of January 2014 for coding graduates, plan accordingly for when each
coding course will need to be converted to ICD-10-CM/PCS as
primary. Faculty and students should also be familiar with the
new competency statements released by CCHIIM that will correspond with these coding certification exams.
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Associate Level
The length of associate degree programs is typically two full years,
with much pressure to not exceed that time frame. These pro
grams have articulation agreements with HIA/progression programs, so maintaining specific program length is critical to student success should they elect admission to a progression pro
gram. Associate-level programs are mostly offered by community colleges and may be expected to provide ICD-10-CM/PCS
education to their medical community. This anticipated need
may require additional resources, such as additional staffing,
currently beyond program limits.
Baccalaureate Level
The biggest challenges in the transition to the ICD-10-CM/PCS
system at the baccalaureate level is being experienced now for
students who are operating in the ICD-9-CM world but who will
most likely be tested on the RHIA examination based on ICD-
10-CM/PCS.
Students beginning a two-year HIM program will graduate
in May 2014 and will be eligible for early testing for the RHIA
in March 2014. So the need for them to know the new systems
is real. As they enter HIM practice, the entire healthcare world
will be in the final stages of preparation for the ICD-10-CM/PCS
system. There will be a critical need for professionals who are
proficient in the new system and can assist with the transition.
As a result, the current students must be taught dual systems
at the same time. A decision must be made regarding which system should be taught first. For example, the ICD-9-CM system
may be taught with side-by-side comparisons of how the ICD-
10-CM/PCS system differs. This works fairly well with the diagnosis coding system; however, with the variations in guidelines,
it can be challenging for students to become proficient in both.
The other option is for the ICD-10-CM/PCS system to be taught
as the primary system, with a look backwards at how the ICD-
9-CM system worked. There are challenges to this approach as
well. For instance, the timing of the publication of the ICD-10-
CM and ICD-10-PCS code manuals does not coincide with the
timing needs of the academic market, so the online versions of
the code sets must be used. Also, most textbooks include minimal information about ICD-10-CM/PCS but still cover ICD-9-
CM comprehensively.
Academic Challenges
Face-to-Face vs. Online
ICD-10-CM/PCS in distance education online programs will
need additional support (resources, both human and financial)
to rework these courses and to adopt application software that
can be used to assist with and assess the student’s grasp of the
materials.
Curriculum Development
Distance education (online) courses require faculty to rethink
the way face-to-face material is presented to students. The most
effective distance education courses are those that have been
redesigned to use technology and the Internet to promote learning. In an online environment, ICD-10-CM/PCS curriculum
must be presented in a manner that incorporates a multitude
of ICD-10-CM/PCS electronic resources and provides students
with the proper tools to translate theory into application and
proficiency. Thus, adequate time must be devoted to electronic
curriculum development for ICD-10-CM/PCS education.
Curriculum development for online courses generally requires 40 hours of preparation for every hour of online content.
Curriculum development workload should be calculated using
40 hours as the multiplier for the number of recommended instructional hours to yield the amount of time to be devoted to
