Computer-assisted coding software uses Generative AI, Machine Learning, and Natural Language Processing technologies to interpret clinical documentation and convert it into medical codes. This enables healthcare organizations to maximize their revenue and comply with regulatory standards. Hospitals expect a loss of productivity due to the ICD-10 switchover, but CAC software can mitigate this.
Medical coding has a steep learning curve; even experienced coders can lose productivity when faced with new procedures and diagnoses. Computer-assisted coding software (CAC) is valuable to healthcare organizations. CAC software uses natural language processing technology to analyze medical records and automatically suggest the correct code for each patient visit. This process can save healthcare organizations significant time and money while improving coding accuracy. Moreover, CAC can help healthcare organizations reduce claim denials and accelerate revenue by identifying errors that may result in denied or rejected claims.
In addition, the software can identify patterns of coding that might indicate fraudulent billing practices and alert staff to potential issues. This can help healthcare organizations improve coding compliance and avoid penalties. With the rise of ICD-10 complexities, many hospital officials are turning to CAC solutions to maximize coding accuracy and reduce coding error rates. However, hospitals should look for a solution to support their existing systems and integrate them into other HIM applications, including EHR/EMRs, transcription software, CDI, and voice/text/speech recognition.
Additionally, they should choose a solution that provides flexibility to meet the unique needs of their physicians, facilities, and coders. The system can adjust to evolving processes without requiring additional customizations. The right CAC solution will allow them to streamline their coding workflows and optimize their revenue cycle.
Medical coding is extremely complex, with multiple touchpoints creating a high error margin. Computer assisted coding system reduces the need for human intervention and increases productivity by automating the process of assigning medical codes to clinical documentation. It uses natural language processing, or NLP, to identify key terms and phrases in medical transcription. It then interprets these elements and assembles them into SNOMED CT codified concepts.
Next, it assigns CPT (Current Procedural Terminology), ICD-9-CM, or ICD-10-CM medical code sets. It also gives HCPCS Level II codes, if needed. These medical codes are then incorporated into the claim for reimbursement purposes. The software helps ensure that the coded claims match the payer’s official guidelines and reporting requirements, which can lead to fewer denials for the healthcare facility.
As a result, NLP-based CAC improves the quality of the submitted claims to payers and reduces the need for rework or discharged not final billed (DNFB) claims. This can help healthcare facilities increase their bottom line and avoid costly penalties from payers. Healthcare organizations are increasingly using NLP-based CAC to improve coding accuracy and efficiency. According to a recent report, deep adopters of CAC technology—fully leveraging the software’s capabilities—experienced better financial outcomes, coding productivity and workflow, and coder accuracy.
Computer-assisted coding software, or CAC, improves workflow operations and streamlines revenue cycle management. It enables healthcare organizations to maximize the money they receive for each medical procedure or diagnosis. The technology helps hospitals meet compliance and coding accuracy standards. It also allows them to cut coding backlogs and reduce costs by improving coder productivity. The technology uses natural language processing (NLP) to analyze physician notes and automatically suggest the right code.
This makes it easier for coders to complete their coding tasks and ensures they use the correct codes. It also helps them save valuable coding time and resources that could be used on more complex cases. In addition, the software is highly scalable and can be implemented in any size hospital. It can be integrated with EHR/EMR, encoder systems, voice/text/speech recognition software, CDI, transcription systems, and other HIM applications. The technology uses NLP, a combination of AI, linguistics, and computer science, enabling computers to understand human writing and solve different problems.
Computer-assisted coding software allows for faster processing of medical documents. This helps reduce coder error and increases productivity while improving overall data quality. In addition, it reduces the amount of time that medical coding professionals spend reading discharge summaries and progress notes, allowing them to focus on more complex coding.
Coding software utilizes natural language processing to read and interpret clinical text and convert it into structured data. This translates into medical codes used to determine patient eligibility for reimbursement. Using CAC software enables healthcare organizations to make accurate and complete claims compliant with regulatory guidelines and payment methodologies. A recent survey indicated that 94 percent of hospitals and health systems that use computer-assisted coding software are satisfied with their results.
The automated process produces cleaner, more reliable codes and can be used for billing, analysis, and statistical reporting. The future of coding technology is even more promising. Emerging artificial intelligence (AI) can take automation to the next level, utilizing machine learning algorithms to assign codes without human intervention autonomously. AI can also analyze vast amounts of data, identifying patterns and trends in medical documentation to improve coding accuracy. While skilled human professional coders will still be required to oversee coding workflows and handle complex cases, emerging coding technology can assist and support them in the long run.