the codes, coders use an application that displays the tient records that support the codes, or an audit trail of
clinical documentation side-by-side with the medical all changes made to the coding or demographics.
codes. Coders can review and modify the coding in the Compliance: Compliance supports a proactive and
application, and validate it against local and national auditable coding process, which strives to “get it right
coverage guidelines in real time. Coding managers and the fi rst time” and reduce additional work time and re-
administrators typically require separate training for the billing. Improvements in compliance are a result of more-
reporting and production-monitoring modules. accurate and consistent coding, as well as transparency
Today, CAC is most widely used in physician coding in the coding process. Together, these benefi ts reduce
for outpatient services. Some of the medical specialties the preparation work for audits, while simultaneously
that currently use CAC include radiology, emergency improving audit outcomes.
medicine, pathology and cardiology. Hospital coding
applications have also gained momentum during recent
Find a solution that fi ts into the coding work
CAC offers fi ve benefi ts
fl ow. CAC applications should integrate with
to those organizations that
other clinical and administrative applications
perform coding and billing
as seamlessly as possible.
tivity increases when the There are fi ve recommended strategies that can help
average amount of time to guide healthcare technology professionals in the planning,
code a case decreases. An evaluation and implementation of CAC solutions in their
increase in productivity re- coding environment.
sults due to the elimination 1. Find a solution that fi ts into the coding work fl ow.
or speeding up of particular CAC applications should integrate with other clini-
manual tasks within the cal and administrative applications as seamlessly as
coding process, such as possible.
document sorting, storage 2. Fully automate routine activities while assisting with
and retrieval, duplicate more complex activities. To deliver the benefi ts of
identifi cation, code lookup productivity, accuracy and consistency, CAC technol-
and selection, code order- ogy should be an intelligent assistant to the coder.
ing, or data entry. Automating simple coding scenarios; identifying am-
Accuracy: Accuracy im- biguous or contradictory documentation; suggesting
proves when the coding codes based on a thorough review of all documenta-
output better matches tion; eliminating repetitive data entry; and provid-
both offi cial guidelines and ing views across both structured and unstructured
payer reporting require- documentation will elevate the current coder role
ments. An improvement in toward one of auditor or reviewer.
accuracy can be observed through a decrease in denials, 3. Demonstrate benefi ts for the coder and the admin-
reduction in audit discrepancies, or fi nding lost charges istrator. To be accepted, all levels of the organization
that were previously under-coded. Increasing accuracy should realize the benefi ts and value of CAC. Coders
helps assure that an organization captures all of the should accept the application and be motivated to
charges that it is entitled to collect. implement changes in the coding process. Adminis-
Consistency: Consistency in the coding process en- trators need evidence that applications will deliver
sures that guidelines are applied similarly over time and quantifi able benefi ts and that these benefi ts will be
across multiple coding resources. A high level of consis- measurable and reportable to senior executives.
tency instills confi dence in the coding results, supporting 4. Supply data that is meaningful and complete. CAC
accurate clinical and fi nancial analysis. This is particularly technology can work without signifi cant changes to
important when employing coders with differing levels the clinician documentation work fl ow (for NLP),
2500 Tamiami Tr N
of skills and experience. or may be integrated into the clinical documentation
Nokomis, FL 34275
Transparency: Transparency and traceability enhance process (for structured input) or into a more near-
the manageability of the coding process by providing real-time coding process (for concurrent coding).
evidence of both the work fl ow and thought processes Regardless of the scenario, complete and timely
that went into the coding results. This may include links clinical documentation is a prerequisite for accurate
between the codes assigned and the portions of the pa- coding. CAC technology cannot make up for defi cient
www.healthmgttech.com HEALTH MANAGEMENT TECHNOLOGY February 2010 25
HHMT1002 Alife FINAL.indd 25MT1002 Alife FINAL.indd 25 11/25/2010 11:20:22 AM/25/2010 11:20:22 AM