The Coding Revolution Will Not Be (Completely) Computerized

Published on March 13, 2014

When it comes to HIMSS14 we can all expect exhibitors, presenters and attendees to have ICD-10 high on their list of topics to cover. As we march towards the impending deadline for transition, technology is going to play a huge role. This month’s gathering of the best in the industry will bring out many solutions and perspectives on how to handle the new and potentially very challenging workflow and resource needs created by moving to the ICD-10 standard.

Many vendors will promote a vision that is close to a health information manager’s dream: fully automated, Computer Assisted Coding (CAC). The computerized assistant that fully automates the labor intensive and complicated medical coding processes with near perfect accuracy and minimal physician input is an inspirational goal to strive towards. In principal, the promise of CAC will allow scarce coders to deliver more volume and prevent revenue leakage through improved coding accuracy.

The problem with the current state of technology automation is that the accuracy of the systems is not advanced enough to deliver significant ROI or provide an insurance policy for an ICD-10 strategy. For the immediate future the coding process will continue to have a very human influence. While the future of CAC is promising, a universally accepted best practice has not yet emerged. Many providers today plan to continue using second generation encoder and grouper software, and there are still several who rely on more primary tools that include reference manuals, heavy books and basic lookup software.

“Only through collaboration, teamwork and technology will our industry make it through this transition.”

While we have had more than ample time to prepare over these last 35 years since ICD-10 was introduced, and while technology has progressed exponentially since then to create more sophisticated clinical documentation, the ability to best manage the required level of expertise in coding has not scaled in sync. On October 1, our system will not suddenly have a glut of expert coders, ready to carry coding the final steps between software tools and CAC. Efficient workflow will still be reliant on those human coders, and it likely will be for some time.

To add to that complicated future, the problem with the forthcoming mandate to manage all these new codes is that there is a national shortage of quality coders. Most coders are in-house, but like transcription, more and more providers are looking outside their facilities to manage resources and ensure accurate clinical documentation. When you can’t find those coders, it’s an amazing challenge – no matter how good your technology may be in collecting and capturing data.

Only through collaboration, teamwork and technology will our industry make it through this transition. It is one of the things we will be engaging in many conversations about during HIMSS in Orlando, and we hope that this discussion grows loudly over the noise: the success of ICD-10 relies on us making sure that we keep coders engaged in the future of the technology debate.