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Computer Assisted Coding Fact or Fiction, A Case Study. Amy L. Wood, CPC Yale-New Haven Health System. Computer Assisted Coding. Magic Bullet or Marketing Hype? Selling the CAC concept to Administration Do the results change as coders become use to the technology?. Administrative “Buy In”. - PowerPoint PPT Presentation
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Computer Assisted Coding
Magic Bullet or Marketing Hype?
Selling the CAC concept to Administration
Do the results change as coders become use to the technology?
Administrative “Buy In”Highlight organization benefits
Increased compliance
Increased productivity
Potential for increase in revenues
Increased employee satisfaction
Decrease of the coding productivity gap during
ICD-10 transition
Selection Process for Product
Determine which service lines will be coded
Select visit types to be part of the process
1. Inpatient accounts Determine what documents to be included
Selection Process Continued
Outpatient Accounts to include:
Ambulatory SurgeryInterventional RadiologyHeart and Vascular Center
Selection Process Continued
Facility Infrastructure
Additional Equipment Needs
Cost of Implementation
Coder Staff Buy-In
Non-Threatening Introduction to Process
Calming Fears of Job Loss
Product only a Tool, NOT a Replacement
Stress “Assisted” in CAC Discussion
Coder Staff Buy-In
Outline ICD-10 Benefits
What is Involved in the Learning Process
Coder Reaction to Suggested Codes
Steps to Implementation
HIM must inventory sources of current medical record documentation
Information Technology Department (IT) heavily involved
Detailed mapping of document types to be part of the process
Additional Steps to Implementation
Work with IT to determine infrastructure of Facility
Involved testing and re-testing
Realistic expectations regarding implementation timeline
Post Implementation-Go Live
Monitor coder productivity
Measure and compare pre and post productivity values
After assessment, adjust productivity standards as necessary
Post Implementation Go Live con’t
Monitor impact on Accuracy
Are there additional benefits of CAC?
Can you compare ICD-9 to ICD-10 at this point?
CAC Phase 1 Go-Live Results
Outpatient Surgery implementation process January, 2012
Review conducted April, 2012
10% increase in coder productivity realized
CAC Phase 1 Go-Live Results
Inpatient implementation process December, 2011
Productivity measured over a three month period
Demonstrated 15% increase in coder productivity
Phase 2 Auto-suggested CodesIdentify all possible document typesBuild into test environmentIdentify potential obstacles Define what results wanted
Diagnosis codes onlyDiagnosis and CPT codesService areas or visit types
Phase 2 Auto-suggested CodesKeep a document type library
NLP engine needs to “learn” as product is used
Sample multiple scenarios to cover all visit types
Test and re-test results
Phase 2 Auto-suggested CodesDefine a reasonable timeline
Staff will need additional training
Select go-live date
Prepare for initial reduction in productivity during learning phase
Phase 2 resultsVery little reduction in productivity with go-
live
Staff has the option to use the product or to continue to code historical way
New productivity standards implemented 3months post go-live
Additional increase in productivity most notably in the surgical areasGI proceduresAmbulatory Surgery
ICD-10 Impact
Increased coding challenges
New coding guidelines/regulatory rules
Need for increased specificity of documentation
Lessons Learned from Implementation
Testing and Re-testing a must
Monitor coder use of CAC process
Does one visit type work better than the otherInpatient vs Outpatient
Additional Lessons Learned
All document types not always easily available for use.
Coder training time and resources neededExpectations of implementation timeline and
deadlinesInterface monitoring and EMR changes and
the effect on current system