Some propose artificial intelligence as a solution. AI could aid computer-based medical coding systems, identifying errors, enhancing patient care, and optimizing revenue cycles, among other benefits. Today, we’re highlighting some of the ways in which artificial intelligence could change medical coding in the future.
Artificial intelligence has solved countless human challenges – and medical coding might be next.As organizations prepare for ICD-11, medical coding is about to become more complicated. Healthcare organizations in the United States already manage 140,000+ codes in ICD-10. With ICD-11, that number will rise.
It’s impossible for humans to memorize the 140,000+ codes in ICD-10. With ICD-11, we’ll see more codes, making things even more complicated.The coding of medical diagnosis and treatment has never been easy. In fact, it’s one area where many organizations struggle. Poor coding can lead to missed revenue opportunities. It can impact patient safety, increase insurance denials, and harm reputation.Could artificial intelligence solve these problems? According to a report from Forbes, medical coding with artificial intelligence is closer than you think – and AI is already solving medical coding challenges for organizations around the world.
First, it helps to understand what ICD-11 is and why it’s important.International medical organizations currently use the ICD-10 medical coding standard. It’s the tenth version of the International Classification of Disease codes. ICD-10 was created by the World Health Organization (WHO) and has 10,000+ codes available for diagnosis and treatment.The next version of ICD has already been approved for implementation. WHO member states voted to implement ICD-11 in May 2019, and implementation will begin in WHO member states – including the United States – in January 2022.ICD-11 is a significant change from ICD-10. It contains four times more diagnostic codes: instead of the 10,000+ codes in ICD-10, healthcare organizations will have 55,000 diagnostic codes from which to choose.In America, medical coding is even more complicated. There is an enhanced version of ICD-10 specific to the United States. This version has over 140,000 classification codes, including roughly 70,000 codes for diagnosis and 70,000 codes for treatment. It’s possible the American version of ICD-11 could have several times that number.
Could Artificial Intelligence Help?It’s already impossible for a human being to memorize the 140,000 codes in America’s ICD-10 medical coding system. In fact, it’s impossible for someone to memorize the 10,000 codes in the international version of ICD-10.That’s why medical coders rely on code books. They thumb through a book or scan a database of codes to find the most appropriate code for the services performed.Complicating things further is the fact that the same medical service can qualify for multiple codes. Depending on interpretation, there may be multiple ways to code a service.Some suggest using artificial intelligence to help. As AI becomes smarter and more powerful, many healthcare organizations are turning to artificial intelligence.Over the past 20 years, healthcare organizations have increasingly adopted computer-assisted coding systems. These systems recommend codes and identify coding errors.By enhancing these systems with artificial intelligence, organizations can optimize revenue cycle management, avoid coding errors, and enhance patient care.Artificial intelligence could:• Identify inconsistent code usage within an organization• Spot coding errors• Identify the use of a rare or unique code• Automatically recommend codes based on the services performed• Provide actionable data on code usage, patient activity, and medical services performed• Track codes within a patient’s history to avoid manual code entry with every visitOverall, artificial intelligence could perform a role similar to contract medical coding specialists, helping healthcare organizations identify missed opportunities.
How Contract Medical Coding Specialists HelpArtificial intelligence will aid medical coding in the future. Today, however, healthcare organizations rely on medical coding specialists to help.Contract medical coding specialists can implement better systems for inpatient, outpatient, same-day surgeries, ancillary departments, and physician E/M.Unfortunately, not all medical coding services are alike. Some medical coding specialists have just a few months of training. Others have years or decades of experience.By hiring the right medical coding specialist, healthcare organizations can optimize revenue cycle management, avoid coding issues, and enhance patient care.
Like it or not, medical coding is becoming increasingly complex. With the launch of ICD-11, things could become more complex in the near future.To help your organization prepare for future medical coding challenges, contact our medical coding specialists at HMI, LLC today. With decades of experience optimizing medical coding, HMI, LLC helps healthcare organizations capture missed revenue opportunities and avoid coding errors.
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