While ICD-10 implementation is a major change for medical coders, it's not the only one.

There are three significant forces converging on medical coding:

1. Electronic health records (EHR)
2. Computer-assisted coding (CAC)
3. (last but not least...) ICD-10

"Taken together these changes will profoundly alter how coding is performed, managed, and integrated into the healthcare delivery system," wrote Wendy Coplan-Gould, RHIA; Katie Carolan; and Beth Friedman, RHIT; in "Re-engineering the Coding Workflow: Assessing Today with an Eye toward Tomorrow" in the July Journal of AHIMA.

Kind of makes you wonder why anyone would want to be a medical coder. kForce Healthcare Group President Peggy Pricher told SearchHealthIT.com the disruption isn't a perk of the job. "It's a combination of technology, ICD-10 and the complexity around it, and the complexity of the rules and regulations," she gave as reasons why medical coders are planning to leave their jobs and many their replacements are having second thoughts.

[ICD10Watch.com Poll: Are you planning to quit the medical coding field?]

But the good news is the complexity and exodus will create more demand for the coders who stick it out.

And there's help coming.

"IT staff can help ease the burden on coders -- and keep them around longer -- with thorough EHR training that puts an emphasis on detailed data capture by health care practitioners, Pricher said. When doctors and nurses understand the system's features in depth, and become comfortable using many of them in their daily workflow, documentation benefits. Starting now on a slow ramping-up, they said, will ease the 2013 transition to ICD-10 codes, making it less of a big-bang event and more of a smooth process."

And it's not just tech - EHRs and CAC. A lot can be gained by re-engineering the medical coding workflow - as discussed in the Journal of AHIMA article. It's a five-step process:

1. Assess current workflow: map the process
2. Outline the future state: who, what, and where
3. Define the gaps and identify solutions
4. Set realistic expectations and timelines
5. Re-engineer the process (and celebrate success)

So medical coding won't be just a 9 to 5 job. Medical coders need to work with IT staff to make sure they can take advantage of the all the changes. It also will help if coders develop some analytical skills. Someone trained in ICD-10 and revenue cycles can help healthcare providers identify where they are making or losing money.

Medical coders will be at the center of a lot of disruption, but those who stick it out or come in new will reap the benefits.