Issue link: https://viewer.e-digitaledition.com/i/142244
a Too l To e as e Th e Tr an siTi o n ? lAST yeAR, A survey of medical facilities conducted by healthcare research company KLaS revealed nearly half of the institutions planned to purchase a computer-assisted coding (CaC) system — a solution that automates coding based on clinical documentation — within the next two years to assist with inpatient coding during the transition to iCD-10. While CaC tools can be effective if used optimally, providers must carefully consider whether purchasing such a tool makes sense for them. according to Deepak Sadagopan, general Manager of Clinical Solutions and Provider Segment at edifecs, a Bellevue, Wash.based healthcare software solutions company, three trends are leading increasing numbers of hospitals to adopt CaC solutions: + greater code specificity due to iCD-10 and other regulations + Larger amounts of data entering the coding process with implementation of electronic health records (eHr) systems + Skyrocketing workloads for health information management (HiM) departments When used for what Sadagopan calls "routine, high-volume, low-complexity" procedures — mammography, for example — he contends CaC tools can be eminently useful and allow coders to focus on multifaceted cases that require a human touch. "Coders must take time to understand how their CaC tools work and the logic they employ to identify appropriate codes," says Sadagopan. "an important aspect to keep in mind regarding the accuracy of a CaC tool is the quality of + Implementing and auditing electronic clinical documentation to ensure it's specific enough to support ICD-10 use clinical documentation it uses to automate coding. if there isn't enough specificity in the clinical documentation, the quality and accuracy of code recommendations won't meet expectations." + Combining use of automated solutions (see "A Tool to Ease the Transition?") and coders elaine Lips, rHia, President and Ceo of eLiPSe, inc., a HiM and revenue cycle consultancy headquartered in Los angeles, notes CaC tools appear to be helpful in mitigating loss of + Coding using both ICD-9 and ICD-10 for selected diagnoses and procedures coder productivity due to iCD-10 but cautions that hospitals that purchase CaC systems often must reevaluate their coding workflows, especially if they use eHrs. + Working with payers to perform collaborative testing — "dress rehearsals" for ICD-10 — that can help both parties identify problem areas in the process "CaC vendors typically highly recommend using their own workflows to fully utilize the features and reap the benefits of their products," says Lips. "Hospitals that use eHrs often don't think about that because they have recently changed their work- "If providers make a concerted effort to test and explore their most often used codes and their ICD-10 equivalents well in advance of the transition deadline, coder productivity will be beneficially impacted," says Sadagopan. "By identifying the clinical coding areas and codes that are most likely to change, healthcare organizations can focus their coder and testing resources on high-risk code mapping areas and, in return, be left with useful clinical data." Lips' best advice comes down to a twist on a familiar phrase: Practice makes readiness. "Ensure your coders have enough time to be trained in — and practice — ICD-10 coding so they will be ready for the switch next fall, if not before," she says. "The investment will be well worth it." ■ flows to accommodate the new records system. i would advise providers to view a demo of how a CaC tool works with iCD-9 to get a sense of how it might perform with iCD-10. another item to consider is cost. if a provider group is small, the return on investment [roi] with a CaC tool might take longer to receive than for a large group. Hospitals will see roi faster compared to physician practices due to their higher patient volumes."