Computer assisted coding of
medical information uses natural language solutions to link the physician notes
in an electronic patient record to the codes used for billing Medicare,
Medicaid, and private insurance companies.
Natural language processing is
used determine the links to codes. 88%
of the coding can occur automatically without human review. Computer assisted coding is used in all parts
of the healthcare delivery system. The coding systems work well to implement
automated coding process.
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Physicians think about patient
conditions in terms of words. Software
is configured to achieve working with physicians who are more comfortable
describing a patient treatment in words than codes. The electronic patient record, created using
physician dictation, is used to form the base for the coding. Natural language solutions implement computer
coding to identify key words and patterns of language. The physician dictation can be done using
regular language that the software recognizes and translates into billing
codes.
Properly designed natural
language processing (NLP) solutions do not require physicians to change the way
they work. They can dictate in a
free-flowing fashion, consistent with the way they think, and are not limited
to structured inputs that may or may not fully capture the unique circumstances
of each patient encounter.
Matching codes generated from
physician notes to standard treatment protocols promises to improve health care
delivery. Accompanying that type of
physician patient management against best practice promises to revolutionize
health care delivery. The ability to
further check as to whether the recommendations for follow up made by
radiologists and matching the commendations with the actual follow up heralds’
significant promise of vastly improved health care delivery.
Computer assisted coding
applications depend on the development of production quality natural language
processing (NLP)-based computer assisted coding applications. This requires a process-driven approach to
software development and quality assurance.
A well-defined software
engineering process consists of requirements analysis, preliminary design,
detailed design, implementation, unit testing, system testing and
deployment. NLP complex technology
defines the key features of a computer assisted coding (CAC) application.
Automation of process will
revolutionize health care delivery. In
addition to automating the insurance, billing, and transaction systems,
streamlined care delivery is an added benefit.
The ability to look at workflow and compare actual care to best practice
is fundamental to automated business process.
The ability to link diagnostic
patient information to treatment regimes and drug prescriptions is central to
improving medical care delivery. Once a
physician can see what conditions need to be followed, and see that appropriate
care has been prescribed 100% of the time, care delivery improves
dramatically. Diagnosis of conditions
using radiology frequently results in detection of events that need follow-up.
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According to Susan Eustis, lead
author of the team that prepared the study, “Growing acceptance of computer
assisted coding for physician offices represents a shift to cloud computing and
billing by the procedure coded. Because
SaaS based CAC provides an improvement over current coding techniques the value
is being recognized. Administrators are
realizing the benefits to quality of care.
Patients feel better after robotic surgery and the surgeries are more
likely to be successful.”
The worldwide market for Computer
Assisted Coding is $2.8 billion in 2016, anticipated to reach $5.1 billion by
2023. The complete report provides a
comprehensive analysis of Computer Assisted Coding in different categories,
illustrating the diversity of software market segments. A complete procedure analysis is done,
looking at numbers of procedures and doing penetration analysis.
Major health plans report a
smooth transition to ICD-10. This is due
to rigorous testing for six years.
ICD-10 has had a positive impact on reimbursement. ICD-10 coding system requires use of 72,000
procedure codes and 68,000 CM codes, as opposed to the 4,000 and 14,000 in the
ICD-9 system. Managing high volume of
codes requires automation. Healthcare
providers and payers use complex coding systems, which drives demand for
technologically advanced CAC systems.
The market for computer-assisted
coding grows because it provides management of workflow process value by
encouraging increasing efficiency in care delivery. By making more granular demarcation of
diagnoses and care provided for each diagnosis, greater visibility into the
care delivery system is provided.
Greater visibility brings more ability to adapt the system to successful
treatments.
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