How to Train Coders for Real World Compliance
Article Reference Code: NAMAS.01.30.2026
Written by: Beth Schleeper, Owner & Instructor, Advanced Coding Services
Training new medical coders in 2026 is a whole new ball of wax. Between evolving payer policies, tighter compliance oversight, and technology, new coders can either become confident professionals, or expensive mistakes, quickly!
The difference? How we train them. If you’re teaching new coders today, your job isn’t just explaining ICD-10-CM and CPT. It’s teaching them how to think, how to research, and how to defend their decisions. Let’s look at some of the training priorities that matter most.
Start with the rules: ICD-10-CM and CPT are the foundations. Every coder needs a solid grasp of ICD-10-CM and CPT guidelines. That part hasn’t changed. What has changed is the expectation that coders understand these guidelines as minimum standards, not absolute authority. New coders should be taught early that guidelines must be followed before individual codes, your parenthetical notes, instructional notes, and exclusions matter, the CPT guidance explains how a service is reported, not whether it’s paid. Avoid allowing the coders to believe “the book says I can code it” or “there’s a code for it so it must be billable and reimbursable”. That thought process will get them in trouble EVERY TIME! Just because there is a code, does NOT mean it is billable! Code selection must be defendable with the documentation of the service rendered.
Teach coders to know their resources and how to actually use them. One of the biggest gaps in new coder training is resources. Coders don’t fail because the answer doesn’t exist, they fail because they don’t know where to look. Or that they need to look! Every new coder should be trained to routinely use CMS and MLN publications for Medicare guidance, their state specific Medicare Administrative Contractor (MAC) for LCDs, articles, and billing rules, The Federal Register to understand why rules change (and when they apply), and The OIG, specifically the Compliance program guidance and the Work Plan.
Anatomy still matters. A coder who doesn’t understand anatomy will always struggle, no matter how good their code book is. Dr. Google is your friend, for anatomy refreshers, clinical visuals, and terminology. Teach coders how to use it responsibly, not secretly. Take a course at a local college. Find a coding school that offers anatomy and terminology for coders and take the class! (Advanced Coding Services is offering a class soon!)
Know your payers, they make the rules, at least for their subscribers. Payer policies trump AMA guidance and CPT descriptors. Coders need to know and remember this. If a payer says a service is bundled, non-covered, or requires specific documentation, that’s the rule—regardless of what CPT allows. Coders need to know how to locate payer medical policies, how to read coverage criteria, and how to apply payer-specific rules without overcoding or undercoding. Coders should understand that coding and reimbursement (billing) are related, but not identical. Teaching this upfront prevents frustration and denial rework later.
Code only confirmed diagnoses and only diagnoses actively being treated. This is where many new coders stumble, especially outside the inpatient setting. Training must reinforce two critical principles:
- Code only confirmed diagnoses (no “rule out,” “probable,” or “suspected” unless guidelines explicitly allow it)
- Code only diagnoses that are evaluated, treated, or directly impact care
Historical conditions, problem list carryovers, and copy-paste diagnoses are not automatically reportable. If it’s not addressed, assessed, or relevant to treatment—it’s not code-able for today’s visit.
Teach coders to use professional, reliable sources. New coders shouldn’t feel like they must figure everything out in isolation.
Strong training programs encourage the use of professional organizations, including:
NAMAS, AHiMA, AAPC
These aren’t just credentialing bodies—they’re ongoing education lifelines.
Better yet, teach coders to network. Encourage them to join NAMAS’ membership platform, attend the NAMAS conference, attend meetings at the local coding chapter, participate in online forums, ask questions and here’s a big one… Build professional relationships!
The reality is, no textbook teaches everything or every scenario, every coder gets stuck. The successful ones know who to ask. Train coders to think, not just code. Emphasize resources over shortcuts. Teach payer rules alongside coding rules, normalize research and questions, build confidence through knowledge, not speed. When you train coders to understand why they’re coding something (and how to back it up) you don’t just create better coders, you create confident professionals.
And honestly? That’s the goal. Right?
Contact Beth on LinkedIn by Clicking her Name Below:
Beth Schleeper, Owner & Instructor, Advanced Coding Services
Medical Billing Coding Expert, featured on multi-media professional panels to support proper medical administration procedures, A demonstrated history of working in the hospital & health care industry. Skilled in Healthcare Consulting, Medicaid, Billing Services, Physician Relations, and Conference Speaking. Strong entrepreneurship professional with a COC, CPC, CDEO, CRC, CPB, CPCO, CPMA, CPPM, CPC-I, CANPC, CEMC, CEMA, CMRS, and CMCS focused in Medical Insurance Coding Specialist/Coder from the AAPC, NAMAS, and AMBA
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