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  ICD10 Watch
by Carl Natale

Optum releases comprehensive CAC system

Optum released a new medical coding system last week for hospitals.

Optum Enterprise CAC is designed to:

  • Scan health records and assign ICD-10 codes for all inpatient and outpatient encounters
  • Apply medical codes to medical claims
  • Manage clinical documentation improvement (CDI)
  • Use Optum's "cloud infrastructure"

Those functions should simplify the medical coding workflow and boost productivity, according to an Optum news release.

The Optum CDI Module can scan documentation to make sure it is complete and accurate enough to assign ICD-10 codes to the encounter. This module is the result of collaborating with the University of Pittsburgh Medical Center (UPMC):

"Two years after implementing Optum’s CAC technology, UPMC increased inpatient coding productivity 21 percent, saving approximately $200,000 annually through reduction in overtime. In that same period, UPMC improved its case mix index (CMI), a critical measure for ensuring accurate Medicare and Medicaid reimbursements, by 8 percent, resulting in a $22 million improvement in revenues."

Optum is an information and technology-enabled health services business that comprises three companies – OptumHealth, OptumInsight and OptumRx – and has more than 35,000 employees worldwide.


Optum CAC is based on NLP

Optum CAC is based on NLP (Natural Language Processor ) which is based on token analyzer . It will be intersting to see its working on ICD 10 coding. as there will be different code for very small differences in Clinical documentation

Whatever solution for ICD 10

Whatever solution for ICD 10 has been provided will work only if it is tested rigrously. Does Optum had done testing with payer and provider

It is interesting to note

It is interesting to note that UPMC achieved these results under ICD-9. So, we can encourage providers to improve their documentation and coding today with expected ROI. Results of the product under ICD-10 are, of course, unknown at this time.

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