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  ICD10 Watch
by Carl Natale

Why CAC can't solve all your ICD-10 problems

Americans like to cure things. We're always looking for a pill or procedure to fix what ails us.

photo credit: j.reed via photopin ccThat also applies to workplace problems. If something doesn't work right, fix the machine or get an app to do it.

Combine those two tendencies and you have a healthcare system that embraces computer assisted coding (CAC).

The technology has the potential to boost coding productivityto a level that compensates for the drop that's going to come when healthcare organizations transition to ICD-10 implementation. It's an idea that takes some of the bite out of the ICD-10 transition.

Cindy Doyon outlines the advantages of CAC:

  • Increased coding productivity and efficiency
  • Increase in coding consistency
  • Availability of coding audit trail
  • Data query ability
  • Potential for more comprehensive code assignment
  • Potential increase in coding accuracy
  • Potential decrease in coding costs
  • Use of free text for recording documentation
  •  System improvements through feedback

But CAC doesn't solve all the problems created by the ICD-10 transition, says Dianne Haas, executive director of TrustHCS. She tells Erica Garvin of (HIT Consultant that it can improve coding productivity and aid medical billing if done right. That means:

  • Templates and interfaces need to be built to do the job properly.
  • Electronic health records (EHR) templates need to be customized to maximize your clinical documentation improvement (CDI) initiative.

[See also: CAC & ICD-10: How to evaluate what CAC can do for healthcare providers]

Haas also points out that the ICD-10 code set doesn't just update the medical codes used. The language to describe diagnoses and procedures is more specific. Which can lead to a problem on the physician side says Paul Weygandt in a post that debunks ICD-10 implementation strategies.

He said the problem is that CAC systems won't work when physicians don't enter the correct information to generate ICD-10 codes. "There are some structurally obvious coding queries which could be generated by computer assisted coding," Weygandt wrote. "But the breakdown in the system will occur if the physicians are simply unaware of the content they need to provide for accurate coding."

Garbage in. Garbage out.

The key to making CAC work is CDI and physician education. ICD-10 implementation isn't just a technical challenge. It's a new information-gathering process.

photo credit: j.reed via photopin cc


Current days CAC is based on

Current days CAC is based on NLP . As all clinical documentation may not accurately define right ICD 10 code . There is always chance of getting wrong ICD 10 coding .

It’s even more complicated

It’s even more complicated than needing good documentation – although that is a key ingredient. How do you know the CAC system you are using is accurate? I am concerned with the influx of so many new companies into the eHealth space. How do you know you can trust the content that runs their engines?

I couldn't agree more. The

I couldn't agree more. The biggest challenge we have with coding in either ICD-9 or ICD-10 is the lack of adequate documentation to support the codes that best represent the patient's condition. Without better documentation CAC, including Natural language processers, vocabular engines or any number of sophisticated technologies will fail for lack of information to act on.

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