Simplify CPT and E/M Coding Processes with Computer-Assisted Coding Software

Digitaltransformationisubiquitousacrossbusinessesandindustries. However,differenttechnologieshavebeenfrontrunnersinthedigitalracefor eachfield.Forretail,it’schatbots.Formanufacturing,digitaltwins.Forhealth informationmanagement(HIM),thatroleundeniablybelongstocomputerassistedcoding(CAC)systems.Medicalcodingsoftwarehasprovided significantbenefitsforthevalue-basedhealthcareecosystem.AIand automationtechnologieshaveemergedaspivotalforcesoftransformation. TheglobalmarketforAIandautomationinhealthcareisprojectedtogrowat a46.2percentcompoundannualgrowthrate(CAGR)fromUSD6.9billionin 2021toUSD67.4billionin2027.Thisdemonstratesthesignificantbenefitsof utilizingAIforcoding,withAIandCACsolutionspavingthewayforamore automatedfuture.

Healthcareprovidersarebeginningtounderstandthepromiseandurgencyto integratetheseservicesintotheiroperations.Medicalcodingsoftware integrationhasyieldedsignificantbenefits.

Infact,codersusingCACsignificantlyoutperformthedecisionhealth benchmark.AGS’sCACsolution,forinstance,hashelpedproviders:

• Improveproductivitybyasmuchas50%

• Reducedenialsby20-30%

• Improveriskscorecaptureby20%

Executivesshouldconsidertheseoutcomeswhendiscussinghowtoenhance revenuecycleoperations.

OngoingchangestoCPTcodesreinforcetheimportanceandusefulnessofCAC insimplifyingcodinganddocumentationforoutpatientevaluationand management(E/M)services.Usingtechnologytoaugmentstaffoffers numerousbenefitswhichshouldnotbeignored.

How New CPT Guidelines Influence CAC Implementation

Astheimpactofmedicalcodingbecomesmorecloselytiedtorevenue outcomes,italsobecomesmoreintegratedintotheoverallbusiness infrastructureforproviders.UnderstandingCurrentProceduralTerminology (CPT)iscrucial.

TheCPTreferstocodes,descriptors,andguidelinesusedtodescribe proceduresandservicesperformedbyphysiciansandotherhealthcare providersduringthecaregivingprocess.Thesecodesserveasthefoundation forE/Mcoding,governedbyalong-standingsetofconstantlyevolving guidelines.

The2021CPTE/Mcodingguidelineswereintendedtoreduceadministrative pressureonphysicians.Toutedasoneofthe“firstmajoroverhaulsinmore than25years,”thehopewastostreamlinedocumentationrequirementsfor healthcareprofessionals.

Themajorquestionatthetimewas:Howdotheseguidelinechangesinfluence CACimplementation?

PoweredbyanamalgamationofAIandNLPtechnologies,CACSoftwarecan analyzeanduseunstructureddata,thusmakingiteasiertoassignaccurate E/Mcodesbasedonthedatagathered.Thissignificantlyreducesthetime spentmanuallyfilteringthroughdataandinputtingitintothesystem.

AsnewcodesandrevisionsareintroducedintheCPTcodeset,CACsystems canbetterclassifyoutpatientservicesandstructurethemanagementprocess. Inthepast,CACplayedacrucialroleinstrengtheninglegacyinfrastructure’s shortcomings,suchasitslackofeffectivecodingcapabilities.

CACimplementationcapabilitiescontinuetoimprove,ensuringitscontinued growthintheyearsahead.

However,therearepainpointstoconsiderwithCACimplementation,aswith anytechnology,including:

• Increasedhardwareandsoftwarecosts

• Improperlybuilttemplatesresultingininaccuratecodeselection

• Pooradherencetoindustrystandards

• Potentialcloningofcodes

Simplifying Your Medical Coding Needs – The AGS Way

WiththebenefitsanddrawbacksofCACsystemsunderstood,it’stimeto identifytherightsolution.

Therightpartnerwillhelpyouachieveyourhealthcareobjectivesby presentingaCACsolutionthataddressesyourspecificcodingneeds.Andthis iswhereAGScanhelp.

AGS’scomprehensiveCACsolutionstreamlinesandoptimizestheentire codingprocessbyassumingend-to-endownershipoftheimplementationand framework.PoweredbyacombinationofNLPandMLcapabilitieswithCPT

E/Mlogicalgorithms,ourCACsolutionautomatesE/Mcodingassignments by:

• IdentifyingeverypotentialICDcode–impliedorexplicitlymentioned–basedonavailabledata

• Capturingcodeacrossallcomponentsofdocumentation

• AutomaticallyselectingtheproperE/McodesbasedonthelatestCPT criteriausingeithertotaltimeorrelevantfactorstomaximizeoverall documentation

Thesecapabilitiescantakethecodingprocessevenfurther-suggestingcase historycodes,assigningexaminationtypes,andevenassessingthecomplexity levelsofvariousoutpatientcases.

AGS’CACsolutionaddressesmanyofthetypicalpainpointsassociatedwith CACimplementationby:

• Givingyoucontrolofyoursoftwareandhardwarecostsbasedonyour budget.

• Collatingandorganizingdatacomprehensivelyfromvarioussources, ensuringthattemplatesarecorrectlybuilt,preventinginaccuratecode selection.

• Offeringend-to-endsupportandimplementationcourtesyofour industryexpertsandproprietarytechnology,ensuringindustry standardsarefollowedeverystepoftheway.

• ProvidingaccurateE/McodeselectionandmanagementpoweredbyAI automationtopreventanypotentialcloningincodeandsubsequent errors.

Medicalcodinghasneverbeenmoreeffortless.WhenCACiscombinedwith ever-changingCPTE/Mcodingguidelines,itelevatestheabilitytomaximize reimbursements.Whentechnologysupplementsstaff,whocanthenvalidate coderecommendations,clientreimbursementsincrease,butittakestheright partnertomakeithappen.

IfyouarereadytobegindiscussionsabouthowAGS’CACsolutioncanbenefit yourorganization,weinviteyoutocontactustoday.

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