How computer assisted coding can help solve ICD-10 coding problems

Carl Natale
by Carl Natale
How computer assisted coding can help solve ICD-10 coding problems

We love problems that can be solved by throwing a lot of technology at it. The healthcare industry certainly is in love with technology.

For good reason. Technological breakthroughs have led to advances in diagnosis and treatments.

And technology is an asset to the business side of healthcare too. Software and equipment make it more efficient to manage clinical information and run the business of medicine.

But do medical coders rely too much on computer-assisted coding (CAC) applications?

CAC is supposed to make medical coding easier and boost medical coding productivity. If a healthcare provider has already started using a CAC system, it can raise productivity to a level that compensates for the drop caused by ICD-10 implementation.

CAC can do a lot for healthcare providers:

  • Increase medical coding productivity and efficiency
  • Increase medical coding consistency
  • Create a medical coding audit trail
  • Create data queries
  • Allow more comprehensive medical code assignment
  • Improve medical coding accuracy
  • Decrease medical coding costs
  • Use  free text for recording documentation
  •  Improve systems through feedback

But CAC doesn't do so much for medical coding accuracy and productivity. CAC can be an asset in the ICD-10 transition if:

  • 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.

And medical providers have to protect their CAC systems form infection by GIGO.

Garbage in. Garbage out.

The systems won't work when physicians don't enter the correct information to generate ICD-10 codes.

It's also worth noting that the Cleveland Clinic tested medical coders who used CAC to help assign medical codes to cases and compared their work against unassisted medical coders. The study found:

  • CAC helps medical coders process claims more quickly.
  • CAC did not increase errors in medical claims that were more quickly processed by medical coders.
  • If CAC were only used to process medical claims with medical coders, errors increased.
  • As CAC systems "learned," accuracy improved.

The Cleveland Clinic study reinforces the lesson that medical coders cannot rely on CAC systems. They need to verify the suggested codes even when clinical documentation is specific enough to support ICD-10 diagnoses.