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Claims & Coding


Computer-assisted coding:

the secret weapon

CAC does not eliminate the need for medical-coding professionals to be

involved in the coding process, but it can make them more productive and accurate.
By Mark Morsch
echnology has fi nally arrived that is radically
changing the process of medical coding in
health-information management. Computer-
assisted coding (CAC) automatically generates
medical codes directly from clinical documentation. With
CAC technology, healthcare organizations can streamline
their revenue-cycle processes while becoming more com-
pliant with the increasingly complex payer and quality
reporting requirements.
Electronic health records (EHR) produce a rich source
of electronic documentation; however, these systems can
be diffi cult to integrate into the coding process. CAC
technology provides a bridge between the documenta-
tion in EHR and transcription systems and healthcare
fi nancial systems.
CAC natural-language processing (NLP) applica-
tions scrutinize and interpret unstructured clinicians’

notes using specialized linguistic algorithms, extracting
the clinical facts that support the assignment of codes.

Structured input applications integrate the coding into
the clinical documentation process, producing clinical

SHOWLINE documents with embedded codes. NLP applications
typically can work with current clinical-documentation

practices that produce unstructured text, such as dicta- the coded data into the organization’s billing system.

tion, speech recognition and transcription. Standard interface formats such as HL7 or XML can be
CAC is frequently de- used to export the clinical documents. With NLP-based
Mark Morsch serves as
ployed using the software- systems, however, virtually any document format can
vice president of natural-
as-a-service (SaaS) model be used.
language processing and new but also can be handled as
Web services are also an option for some environ-
technology at A-Life Medical,
a conventional client-server ments, particularly if an existing programming interface
San Diego.
software installation. With is available. The output of the CAC work fl ow is coded
For more information on
Nelson Publishing
A-Life Medical solutions:
SaaS deployment, local in- records, including the CPT and ICD-9 coding and other
stallation requirements are information needed to fi le a complete claim, such as
2500 Tamiami Tr N
minimal. CAC products modifi ers, units, code linkage, patient demographics and
Nokomis, FL 34275
often include a number of different modules to provide payer demographics. For optimum work fl ow that does
a complete coding work-fl ow solution, including coding not require data entry, the coded data transfers directly
review, production monitoring, management reporting, from the CAC system into the billing system.
coding automation and auditing. CAC does not eliminate the need for medical-coding
Data interfaces are required to feed the clinical professionals to be involved in the coding process. It can
documentation into the CAC application and accept make them more productive and accurate. To review
HHMT1002 Alife FINAL.indd 24MT1002 Alife FINAL.indd 24 11/25/2010 11:20:06 AM/25/2010 11:20:06 AM
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