Three True Realities of CAC

Posted in Gebbs Healthcare

Computer-assisted coding (CAC) has been around since before ICD-10 was introduced – and was developed approximately 15 years ago as a tool to enhance manual coding processes with many promises of grandeur. Today, it’s a growing and emerging market – estimated to reach $4.1 billion globally by 2025, but the realities of what CAC can and should do have changed significantly since its inception.

Initially, many experts promoted CAC’s ability to help ease the transition to the complex ICD-10 classification system, which in some cases it did relatively well. What CAC has not done is replaced the expertise needed to operate an effective HIM team – even though some preliminary marketing tactics promised its ability to help save healthcare organizations loads of money by reducing resources.

Today’s iteration of CAC is a much more realistic view of how we can use the technology to complement manual efforts in the world of medical coding. Here’s our take on today’s true value and reality of CAC and how it’s impacting the coding profession.

CAC will never make coders obsolete. In fact, some may argue that the introduction of CAC has elevated the profile of medical coders by allowing them to focus on higher-level functions such as CDI, auditing and oversight/management of technology. Given the complexities of the medical coding field, it should come as no surprise that a study conducted by the Cleveland Clinic indicated that CAC without an expert coder is actually less precise than manual coding. Where it becomes more valuable is when expert coders work with CAC and natural language processing (NLP) technologies by helping “tune” it over time to improve efficiencies. The technology is smart, but it requires experienced coders to help usher it along. Because CAC can’t differentiate between principal diagnoses and procedures, can’t make decisions and can’t apply regulatory guidelines, there will always be a role for highly-trained coders.

Without Buy-in From HIM Teams, CAC is Sure to Fail. When adopting any technology solution that’s going to impact your teams’ daily workflow and responsibilities, it’s critical to get the staff involved in the process. If they understand the purpose of adopting a CAC technology platform, they’re much more likely to support it. Even more importantly, they should be part of the evaluation and decision-making process when selecting a product or vendor. Expert coders will bring a unique perspective to the table – they’ll know the best questions to ask, scenarios to consider and are most likely to help decide which solution is most likely to match your organization’s needs and solve the unique problems you’re facing.

With CAC Must Come a Dedicated Focus on Improving Provider Documentation There is no CAC solution that can “fix” incomplete or inaccurate provider documentation. What it will do is help to highlight and amplify the common problems and issues your organization has when it comes to clinical documentation. Having a highly-skilled team of coders in place that can monitor these opportunities, work with physicians to educate and train them on the impact of their errors as well as the solution will make CAC a far better investment. It’s likely to improve efficiency, decrease denials, and enhance your overall revenue cycle.

Today’s CAC market is growing steadily and with good reason – with organizations using CAC seeing enhanced workflow queues and workforce management capabilities. With the right expert coding team on your side, advanced coding technologies such as CAC, NLP and AI can help improve your team’s productivity, accuracy, consistency, transparency and compliance.

GeBBS Healthcare Solutions offers CAC, with our customers seeing anywhere from 25-75% gains in productivity. To learn more about GeBBS’ technology enabled solutions, click here, or Request a Consultation.