As the ICD-10 saga unfolds, providers and other stakeholders inevitably will find that the new codes are far more specific than ICD-9. And because of that specificity, simple mistakes could lead to reimbursement delays and claim denials. To get ahead of the game and prevent denials, you’ll need some type of quality control to keep those tiny—but potentially costly—errors from occurring. One way to do that? Hire an outside expert: an ICD-10-trained medical coder.

Defensible Documentation Toolkit - Regular BannerDefensible Documentation Toolkit - Small Banner

Decoding Coders

Coders fill many roles and can be a valuable asset to your clinic’s operations. According to American Academy of Professional Coders (AAPC), coders can do a great many things, including:

  • Auditing and appealing denied claims.
  • Educating providers, conduct chart audits, and recommend “appropriate application of federal mandates” and compliance regulations.
  • Acting as an “advocate for the provider and patient” regarding coverage and medical necessity issues.

Quality coders have gone through extensive education to navigate the ins and outs of medical coding, and they’re primed and ready to catch mistakes—before your claims get denied. A qualified coder can take into account your patients’ health stories (as told by your documentation) to ensure your diagnosis code is accurate and justifies reimbursement. Bottom line: A true pro will help you get paid.

Weighing Your Options

Maybe you don’t see “hiring a coder” written in your clinic’s stars—but according to this report, you might want to alter your vision of your clinic’s future: “It is predicted that denial rates will increase by 100 percent to 200 percent post-implementation, with a corresponding increase in accounts receivable days by 20 percent to 40 percent.” As you consider the cost of hiring a coder for quality control, keep those ominous denial and AR timeline predictions in mind.

Something else to consider as you weigh the pros and cons of hiring a coder is the fact that therapists will only use a subset of the full 68,000-code library. With some preparation, your clinic just might be ready all on its own. However, if you’re leaning toward hiring a coder but the cost is still weighing on you, there is another route you can take: An alternative—and less expensive—option is to outsource to a third-party coding service.

Training Your Staff

Whether or not you decide to hire a coder, it’s imperative that you and your staff thoroughly train and prepare for ICD-10. The ICD-10 code set is a whopping five times larger than the ICD-9 set you’re used to—which surely will be a big bite to swallow. Here are a few digestible resources to get you started in your educational efforts:


There’s a lot to mull over to determine whether adding to your staff is the right decision for your clinic. But if hiring a coder seems like the right answer for you, remember that professional ICD-10 coders are in high demand—so you’ll want to start your hiring hunt sooner rather than later.

Would you consider hiring a medical coder? Share your thoughts below.

  • ICD-10 Crash Course: Last-Minute Training for PTs, OTs, and SLPs Image

    webinarSep 2, 2015

    ICD-10 Crash Course: Last-Minute Training for PTs, OTs, and SLPs

    It’s officially here: the last month before all HIPAA-eligible professionals must switch to the ICD-10 code set. As the regret of procrastination washes over many of those professionals, they’re scrambling to ready themselves and their practices for the big switch. If you, like so many other rehab therapists, find yourself asking, “ICD-what?” then you’re in dire need of straightforward training—stat! Otherwise, you could leave your practice vulnerable to claim denials after October 1. Join us at 9:00 …

  • Will ICD-10 End the Paper Superbill? Image

    articleSep 8, 2015 | 2 min. read

    Will ICD-10 End the Paper Superbill?

    In a dark world filled with endless paperwork and thousands of billing codes, rehab therapy clinics need a hero. Many medical professionals would say their office hero is the paper superbill. It’s fast, convenient, and easy to use. But hold on to your spandex tights, because ICD-10 is coming—and it might just be the paper superbill’s kryptonite . Here’s why the ICD-10 paper superbill just doesn’t work: It’s longer. ICD-9 has around 13,000 codes, so your paper …

  • ICD-10 Open Forum Image

    webinarOct 5, 2015

    ICD-10 Open Forum

    On October 1, the US officially said RIP to ICD-9 and brought ICD-10 to life. For some of you, the transition might’ve been all sugar and spice—a real treat. But for many others, the switch to the new code set might’ve left you feeling overwhelmed, tricked, or even a bit scared. At the very least, you might be haunted by some lingering questions. That’s where we can help. We’ve brewed a cauldron filled to the brim with …

  • ICD-10 FAQ Part Three Image

    articleOct 20, 2015 | 16 min. read

    ICD-10 FAQ Part Three

    In the movie world, threequels have a reputation for failing to match the glory of their predecessors (The Hangover Part III, anyone?). It’s almost like the writers know they’re out of material, but instead of knowing when to fold ’em, they continue to hold ’em—right up until the inevitable flop. But with ICD-10, the questions just keep getting better—which means the third and latest installment of our ICD-10 FAQ is even juicier than the last. So, grab …

  • ICD-10 and Your Claims: 7 Essential Must-Knows Image

    articleSep 14, 2015 | 7 min. read

    ICD-10 and Your Claims: 7 Essential Must-Knows

    As we’ve suggested in previous posts , one of the best ways to ensure your practice covers all of its ICD-10 prep work bases is to audit your processes and workflows. By doing so, you’ll identify all the ways you and your staff currently use and interact with ICD-9 codes. If you’ve done that, you’ve no doubt pinpointed one of the largest—and most obvious—ICD-9 touchpoints: your claims. Then, you probably asked yourself (or the almighty Google), “How …

  • The Final 48: Your Guide to ICD-10 Transition Day Image

    articleAug 31, 2015 | 5 min. read

    The Final 48: Your Guide to ICD-10 Transition Day

    For law enforcement officials, the 48 hours immediately following a crime are the most crucial. Why? Because if they haven’t found any leads, identified any suspects, or made any arrests by the time the two-day clock expires, their chances of cracking the case—and, in some cases, saving lives—dwindle significantly. And while ICD-10 isn’t exactly a life-or-death situation, those HIPAA-covered providers making the switch will be up against a similar make-it-or-break-it timeframe. The only difference—besides the whole crime …

  • Founder Letter: It’s a Brave New ICD-10 World Image

    articleOct 7, 2015 | 4 min. read

    Founder Letter: It’s a Brave New ICD-10 World

    October 1—the day that marked the transition to ICD-10—is behind us; we made it. And so far, so good. According to this Modern Healthcare article : “One of the most maligned and feared events in healthcare history began with a whimper.” Although ICD-Day has come and gone, it’s prudent to remember that a “whimper” of an introduction doesn’t necessarily indicate what’s to come. That’s because many of ICD-10’s repercussions have yet to reveal themselves—especially when it comes …

  • The Complete PT Billing FAQ Image

    articleMay 24, 2016 | 25 min. read

    The Complete PT Billing FAQ

    Over the years, WebPT has a hosted a slew of billing webinars and published dozens of billing-related blog posts. And in that time, we’ve received our fair share of tricky questions. Now, in an effort to satisfy your curiosity, we’ve compiled all of our most common brain-busters into one epic FAQ. Don’t see your question? Ask it in the comments below. (And be sure to check out this separate PT billing FAQ we recently put together.) Questions …

  • Mythbusters: The ICD-10 Special Image

    articleAug 3, 2015 | 5 min. read

    Mythbusters: The ICD-10 Special

    Healthcare coding is having a bit of a cast change: ICD-9 is out and ICD-10 is taking over. By now, you’ve heard all about the new code set—but do you really have all the facts? In this special blog post, I’ll be busting some common ICD-10 misconceptions. (Sadly, my myth-busting measures don’t involve swimming in syrup, experimenting with explosives, or blowing up boats—we’ll leave that to the experts .) Let’s get to it! 1. The World Health …

Achieve greatness in practice with the ultimate EMR for PTs, OTs, and SLPs.