Computer-Assisted Coding Tools Make ICD-10 Easier

Facing an avalanche of new diagnostic codes in the transition from ICD-9 to ICD-10, the medical-coding community is increasingly looking to computer-assisted coding (CAC) tools to automatically generate medical codes for billing from clinical documentation in EHRs and transcription systems.

For medical facilities and practices, as well as for providers of online medical coding training courses, the delay in the implementation of ICD-10 gives additional time to transition to the new code set and to acquire tools such as CACs. Research firm KLAS reported recently that almost 50 percent of healthcare providers surveyed anticipated buying an inpatient CAC product in the next two years.

The current interest in CAC largely stems from worries over ICD-10 impacting staff productivity and efficiency. The transition from ICD-9 to ICD-10 equals a daunting leap from 13,000 to 68,000 diagnostic code, and from 11,000 to 87,000 inpatient procedure codes. The new codes enable coders to describe diagnoses in greater clinical detail and cover modern medical treatments and technologies, which is not possible with ICD-9’s limited and outmoded code set.

CAC tools allow medical professionals to easily review and quickly find codes and complicated code-related processes involved with billing and financial systems. The tools accommodate both structured text and unstructured text from EHRs, and if need be employs natural language processing with transcription systems to assemble the codes for billing and reporting purposes.

CAC significantly shortens and simplifies the process of assigning codes, said Graham Triggs, a senior research manager at KLAS.  Another tool addresses the financial and operational impacts of transitioning to ICD-10.

Jvion, a consultancy specializing in healthcare compliance technologies and services, has developed and recently launched a tool called RevCorea to enable administrators to better understand and deal with the revenue impacts of ICD-10.

Shantanu Nigam, the Jvion CEO, explained in a statement that RevCore, his company’s latest ICD-10-centric solution, takes advantage of Jvions’ existing icdcomplete software suite to extract ICD-10’s exact percentage impact on revenues. “The solution helps us quickly identify the highest risk DRG, MDC, and procedure codes. So, organizations can continue to give equal attention to every aspect within their testing, training, documentation, and IT efforts; or, they can choose to prioritize their attention on specific areas within these activities that pose the highest risk to their revenues. With RevCore, providers can focus their efforts to mitigate their financial risk with fewer resources and in a shorter timeline."

Jvion said that RevCore has already been successfully used in inpatient and outpatient settings. Besides insights into revenue impacts, the solution also provides a predictive modeler that identifies steps that can be taken while using ICD-9 to maximize existing revenues and, at the same time, address ICD-10 risks. Significantly, Shantanu claimed that RevCore can analyze 1,224 months of historical claims data in just a few weeks and can produce a full financial assessment in about 30 days.