Medical coding is an intricate and complex process that can significantly affect your hospital’s financial health. Errors in coding can lead to denied claims and expensive penalties.
Advanced Computer Assisted Coding (CAC) tools are transforming the industry, reducing costs and streamlining coding workflows. Read on to discover the benefits of this revolutionary technology.
Increased Efficiency
Computer-assisted coding CAC is a powerful, automated technology that uses advanced software to assign appropriate medical codes to medical records. It helps healthcare organizations reduce manual coding errors, maintain compliance with legal and reimbursement regulations, improve patient outcomes, and accelerate claim processing timeframes.
When a healthcare facility implements a computer assisted coding system, human coders can focus on cases requiring expertise. This allows them to increase overall productivity by 25-75%, translating into quicker billing cycles and faster reimbursement.
Coding automation also ensures consistency and accuracy, which is critical for medical billing and healthcare analytics. A coding error can have serious consequences, ranging from financial losses to patient health and safety. For example, a missing 2-digit modifier can result in a patient being billed for imaging services on the wrong area of the body.
Computer-assisted coding systems rely on the synergy of Generative AI, Machine Learning (ML), and Natural Language Processing (NLP) to analyze transcribed clinical documentation and transform it into discrete data that can be used for coding. The combined intelligence of these technologies enables medical coding software to process large volumes of data more quickly and accurately than possible with traditional methods. This makes it ideal for scalable coding processes that can keep up with the high volume of data generated by large healthcare organizations.
Better Accuracy
Compared to human coders, computer-assisted coding (CAC) systems have a much higher level of accuracy. This means the healthcare industry can expect fewer errors when using this software. In turn, this will help to improve patient records, billing, and insurance claims — all crucial aspects of the healthcare system.
One study found that CAC systems reduce coding errors by more than 40%. This is mainly because these software programs can quickly and accurately analyze medical charts. In addition, they’re more consistent in their application of coding guidelines. This can save the healthcare industry valuable time and resources, as coding errors are often costly and frustrating.
Unlike traditional coding methods, CAC software uses natural language processing (NLP) to understand medical chart documentation and select appropriate codes for specific terms and phrases. This can significantly reduce the manual work required by coders and speed up the coding process. The leading ML-based CAC tools have a >98% first-pass coding accuracy rate and process each medical chart in less than two seconds per page. They also have a feedback loop that continually refines their accuracy and allows them to adapt quickly as coding guidelines change. This is an important consideration, as many coding changes are made regularly.
Reduced Risk of Denials
A computer-assisted coding system allows coders to work more efficiently by automating the time-consuming tasks of reviewing medical documents and assigning codes. Because the system uses algorithms and programmed, predefined rules to make suggestions, it’s more accurate than manual coding and reduces the risk of human error. This improves coding accuracy and consistency, lowers the rate of claim denials, and ensures guidelines are met and followed to minimize auditing discrepancies.
A good CAC solution combines natural language processing and sophisticated medical coding algorithms to help healthcare professionals quickly identify billable codes based on the content of the clinical documentation they’re reviewing. CAC solutions also include references that provide detailed code descriptions, links between regulations, coding rules and notes, medically unlikely edits, and other valuable information to help users make more informed decisions about coding.
While computer-assisted coding (CAC) systems can be used as standalone technology, they’re often implemented in conjunction with medical coding and document improvement (CDI) tools to help automate coding workflows radically, optimize revenue cycle management, and strengthen your hospital’s mission of delivering value-based care. In addition to enabling efficient coding and reducing the risk of denials, CAC software can improve patient care by highlighting gaps in medical documentation, ensuring that physicians’ records accurately reflect patient services.
Improved Patient Care
Using coding automation to process medical records can save practice money by reducing the time it takes coders to work on claims. This allows them to get back to the patients who need their attention, reduces coding errors, and increases overall accuracy.
Computer-assisted coding, or CAC, is software that reads the documentation included in an EHR and then assembles it into a standardized format. It then assigns the relevant CPT, ICD-9-CM, and HCPCS Level II codes. Natural language processing can also identify whether specific terminology needs a code. For example, if a physician documents a patient has a family history of thyroid disease, the system knows there is no need for an ICD code.
Another benefit of CAC is that it can automatically update itself as coding guidelines change. While human coders may need help with these changes, CAC can systematically analyze the data and make adjustments without manually editing each chart. The ML-driven CAC solutions offered incorporate a feedback loop, further refining the accuracy of their coding algorithms and ensuring that they can keep up with the fast-paced changes in coding guidelines.
The benefits of CAC are clear: increased efficiency, higher accuracy, fewer denials, and improved patient care. It is an essential tool for any healthcare organization looking to streamline its revenue cycle management and optimize the performance of its coding team.