There has been a lot of discussion in the healthcare business about how computer-assisted coding may lower coding expenses while enhancing coder efficiency. Many people have turned to CAC for assistance as a result of the ICD-10 rollout and its time-consuming commitment. Before the implementation of this new code set, coders had only 30 days to complete their tasks within the year. ICD-10 added another 90 days to that deadline.
One study conducted by the University of Chicago Medical Center found that billing for ICD-9 codes was more efficient than billing by medical record number. The study also showed that coding accuracy increased after the introduction of ICD-10 because incorrect codes were removed from the database. Coding accuracy is crucial to avoiding possible legal issues with insurance companies or other organizations who review medical bills.
ICD-10 created several new categories of diagnosis codes that require additional time and effort to enter into software programs. For example, a code for "acute bronchitis" requires a physician to submit not only the primary diagnosis but also any additional diagnoses that may apply. This increases the amount of work for physicians and coders but ensures that patients are only charged for the conditions they receive services for.
Computer-assisted coding tools can also increase the quality of care by preventing incomplete entries on medical charts.
ICD-10-CM/PCS and HCPCS are the current medical coding systems in use in the United States (Level I CPT codes and Level II National Codes). The Healthcare Common Procedure Coding System (HCPCS) is used to report outpatient hospital operations and physician services. It is maintained by the Center for Medicare & Medicaid Services (CMS). ICED-10-PCS is used to report inpatient hospital operations and physician services.
ICD-9-CM is the current medical coding system in use in the United States (Numeric CPT codes). The Healthcare Common Procedure Coding System (HCPCS) was developed to improve the accuracy of billing information submitted to health plans by providers and to help control costs by reducing unnecessary repetition of tests and procedures. The first set of HCPCS codes were released in 1993 and included all common procedures performed in outpatient hospitals. A second set of codes was released in 1997 that added codes for more specific procedures such as knee replacement surgery and carpal tunnel release. In 1998, a third set of codes was released that expanded on the original categories to include additional common procedures performed in outpatient hospitals. In 1999, a fourth set of codes was released that identified one million dollars in cost savings to hospitals that participated in the HCPCS program.
ICD-10-CA is the current coding system in use in Canada (CPT and ICNP codes).
As a medical coder, you'll encounter three types of codes on a regular basis.
Coding enables statistical study of illnesses and treatments, diagnosis-related group reimbursement, and more accurate observation and monitoring of epidemics or pandemic occurrences. It also aids in planning with the decision support systems of the medical organization. Medical coding is thus essential for improving health care management, policy making, and service provision.
Medical coding involves the classification and specification of medical terms found in patient records to identify what treatment was provided for which illness or injury. The coded information allows physicians, nurses, pharmacists, and other healthcare providers to analyze hospital data on patients' diagnoses and procedures to make better decisions about their care. It also helps researchers compare how people are treated at different hospitals or over time for the same condition.
Medical coders must be familiar with both the common and the unusual diseases or injuries patients may encounter. They must also know how to correctly code these conditions according to the guidelines set by their employer or research project. Finally, medical coders must have strong communication skills so they can explain medical terminology and coding processes to others.
The ability to read and understand medical records is critical for successful coding. These files contain all the information needed to diagnose an illness or determine that someone has recovered from one, as well as details on any tests done and treatments administered.