ICD-10 & Coding

For the Midwestern health system, the coding process change has gone beyond improving accuracy – it has strengthened how staff operate across the entire revenue cycle, from documentation through denial management.

Newly announced artificial intelligence applications highlight the shift toward domain-specific automation, where reasoning and native integration aim to improve efficacy and safety.

Several companies have released artificial intelligence enhancements for healthcare administration and operations, from billing and staffing to security and data management. Also, the VA will scale ambient scribing.

Artificial intelligence does not replace coder judgment – it instead acts as a consistent second set of eyes, flagging areas that may warrant attention and providing supporting evidence, says the CFO of the health system's human-in-the-loop process.

The center uses the claims submission technology to automatically turn its clinical information into data appropriate for HEDIS measures to maximize its pay-for-performance reimbursement. Services are accurately captured for reporting and reimbursement.

The results of using the technology have been transformative, the health system's associate chief medical officer says. Among other gains, the AI tool has generated $13K in annual revenue per clinician through enhanced HCC and greater E/M coding accuracy.

Contracted ASX-listed Beamtree to help find solutions to improve health data quality across 20 hospitals.

A principle-based approach to AI adoption emphasises risk management and privacy and security, among others, says the Health Information Management Association of Australia.

The Oregon health system's coder workload has been reduced by nearly 28%, while coding-related denials for autonomously coded radiology cases are now 70% lower than those managed manually. The automated denial rate is also substantially lower.

Northern Health in Melbourne has replaced its legacy system with AI-assisted coding.