Computer Assisted Coding Is NOT A Quick-Fix Solution for ICD-10

By Erica Garvin for HIT Consultant

Dianne Haas of TrustHCS explains why computer assisted coding is not a quick-fix solution for ICD-10. The caveat is, like anything else, it has to be done right.

The year 2013 is upon us. It’s time to start some of those New Year’s resolutions. If transitioning to ICD-10 is high on your list, good for you. After all, the ICD-10 deadline (although pushed back to Oct. 2014) remains imminent. Right now you have the time, and Trust HCS’ Dianne Haas recommends you take it when tackling ICD-10—because there are no quick-fix solutions—including computer assisted coding (CAC).

“Don’t get me wrong, CAC certainly helps,” said Haas, executive director of the Springfield, MO-based ICD-10, CDI, and revenue-cycle company. “It will aid in areas of productivity and accuracy. It will assist you in getting your bills out the door. The caveat is, like anything else, it has to be done right. Even a robust CAC software system requires you to build your templates and ensure all of your interfaces and search engines are there to appropriately facilitate the process.”

Haas has stressed the importance of EMR/EHR template customization before, especially when it comes to gaining the greatest benefit from CDI programs. It’s an equally fundamental aspect to integrating CAC tools because, once again, technology alone can’t take on all the obstacles of transitioning to ICD-10.

According to a report released by research firm KLAS in April 2011, nearly half of healthcare providers surveyed have plans to purchase CAC products to tackle ICD-10 within the next two years. While CAC tools have proven to be more than useful, their recent gain in popularity doesn’t quite translate to seamless coding symmetry between ICD-9 and ICD-10. In fact, CAC tools will leave coding gaps that will require some much needed filling.

Haas explained: “Most records are coded in ICD-9 right now. In ICD-10, most particularly on the procedural side, the language has expanded while also becoming much more specific. So, the words that would be looked for in order to code some type of a surgical procedure, for example, may not even exist in current ICD-9 nomenclature.”

Some codes may also have a different or more delineated meaning under ICD-10, which could also lead to miscoding issues. The result of such coding gaps and gaffes could lead to a lot of important data getting lost in translation. But is there a solution for this? Actually, there just might be, according to Haas.

Right now, technology is being developed to isolate ICD-10 ontology to pinpoint those ICD-10 terms that won’t appear in records that reflect the current world of coding in ICD-9. This technology could help organizations identify where they may be at risk for encountering such coding snags, which could ultimately lead to better construction of EMRs and EHRs to sufficiently support ICD-10 language. Still, this technology is new, and not the only piece to figuring out the ICD-10 puzzle. For Haas, it all comes back to ensuring that your ICD-10 approach has the operational structure to support all of your technology solutions.

Extended deadline or not, time to tackle the ICD-10 is running out, and as organizations assess readiness for, plan their transition to, and educate their workforce regarding the change it’s going to take more than a single solution to put it into productive practice. “We’re talking about transitioning from a system of around 16,000 codes to more than 155,000 codes. That’s no small step. It’s more like a quantum leap,” Thus, she concludes, that a multifaceted approach, which might include CAC utilization, will facilitate have the structure, process, and tools in place for a successful ICD-10 go-live.