When drawing up those ICD-10 strategies, healthcare organizations ought to be sure that “having enough coders” is on their priority list.

That's because ICD-10 threatens to simultaneously require more coders and make proficient folks even harder to come by. Given the current shortage of ICD-9 coders, one certainty is that providers will feel a productivity pinch as they transition to ICD-10. New technologies will help, and coders' roles will evolve, but providers will still rely on them for that most basic of business tasks, getting paid.

The new code sets for ICD-10 present a learning curve that, some experts say, will inspire older coders to opt-out, whether by retiring or simply finding a new line of work, while those who remain will find their jobs changing.

[Related: ICD-10 putting Americans back to work, part 3: Job security. Podcast: The upside of a sibling rivalry between HIPAA 5010 and ICD-10.]

“I have heard from a good number of coders that they will retire before ICD-10 is implemented but I hope they are not serious,” says Kathy DeVault, a professional practice manager at AHIMA. “When I have the opportunity to speak to coders and HIM professionals I encourage them not to retire but rather lend their expertise to the transition to ICD-10. I think experienced coders have much to offer to this transition.”

The newly-appointed president of the AAPC, Deborah Grider, agrees that veteran coders will be more important than ever for ICD-10. “The coders I talk to who are in their 50s, including me, will learn ICD-10 and help the new coders transition, because these coders are very used to rapid change in the industry,” Grider says. “I think the shortage will be widespread if we don't make sure we mentor new coders and welcome them into the industry.”

In addition to mentoring, outsourcing and coding tools will help providers deal with a shortage of coders for hire. Vickie Monteith, a director at Deloitte and Touche, said during a recent Webinar that, already “hospitals today are looking at outside contractors to help them get through ICD-10.”

Providers should also consider investing in tools that improve coder efficiency. AHIMA's DeVault says that “with the future use of computer-assisted coding, the role of coders may change.” Grider explains that “insurance carriers, including government payers, have said many times that there are problems with EMRs. This makes it even more important for coders to move to the next level and fill more of an auditing or reviewing role.”

Even changing roles and technology won't fix the shortage.

“I do believe that we will continue to see a coder shortage with the implementation of ICD-10, as we currently do now,” AHIMA DeVault says. But the need for coders “will never be eliminated.”