Will Computer-Assisted Coding Make Coders Obsolete?

Will Computer-Assisted Coding Make Coders Obsolete?

I was recently asked by a medical coder if I thought our professional services would soon become obsolete as more and more computer-assisted coding (CAC) applications are developed. I did not have to think about this for very long because CAC increasingly has been brought on line in many specialties over the past 10-15 years.

What I have seen is that the need for coders has not diminished, but the demand for more experienced coders has increased.

For example:

  • Organizations need coders who can teach the computers when they are unable to code from a note.
  • Organizations need coders who can teach providers how to improve their documentation, so that the note will lead the CAC system to the most appropriate codes.
  • Organizations need auditors to audit the CAC coding, to feed into compliance programs, the accuracy of the documentation and coding as determined by the CAC systems. Computerized systems cannot work unchecked. CAC system performance needs to be audited to make sure the programming is determining the proper coding.

CAC Not Always Right

I recently received an Explanation of Benefits for an adjacent tissue transfer of a defect that was created on the tip of my nose from Mohs surgery. The reconstruction was coded 14061 Adjacent tissue transfer or rearrangement, eyelids, nose, ears and/or lips; defect 10. 1 sq cm to 30.0 sq cm.

There was no way the secondary defect and the primary defect on the tip of my nose could add up to more than 10 square centimeters. When calling the surgeon’s office, the response I received from the nurse was that the “computer coded the procedure.”

We had a CAC scenario.

My question to the nurse was, “How does the computer get the dimensions of the secondary and primary defect?” Her answer was that the computer got the information from the physician’s documentation.

My response was that the physician’s documentation was inaccurate, and I could send her pictures of the defect and the final reconstructed defect. I explained to her that there was no way the primary and secondary defects could exceed 10 square centimeters.

The computer is only as accurate as the input into the algorithms, and in our case, that is the documentation. That is why the coding and documentation must be audited.

What Does CAC Mean for coders?

As we move into a more artificial intelligence environment, higher level coding skills will be needed, such as clinical documentation improvement, auditing and education. And those who are developing and maintaining CAC systems will always need coders to continually improve and challenge the system. I do not think that CAC will be taking our jobs, but it will be causing us to step up our skill set.

Barbara Cobuzzi

Barbara Cobuzzi

Barbara J. Cobuzzi, MBA, CPC, CENTC, COC, CPC-P, CPC-I, CPCO, AAPC Fellow, is a consultant with CRN Healthcare Solutions in Tinton Falls, N.J. She is consulting editor for Otolaryngology Coding Alert and has spoken, taught, and consulted widely on coding, reimbursement, compliance, and healthcare-related topics nationally. Barbara also provides litigation support as an expert witness for providers and payers.Cobuzzi is a member of the Monmouth, N.J., AAPC local chapter.
Barbara Cobuzzi

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About Has 90 Posts

Barbara J. Cobuzzi, MBA, CPC, CENTC, COC, CPC-P, CPC-I, CPCO, AAPC Fellow, is a consultant with CRN Healthcare Solutions in Tinton Falls, N.J. She is consulting editor for Otolaryngology Coding Alert and has spoken, taught, and consulted widely on coding, reimbursement, compliance, and healthcare-related topics nationally. Barbara also provides litigation support as an expert witness for providers and payers. Cobuzzi is a member of the Monmouth, N.J., AAPC local chapter.

4 Responses to “Will Computer-Assisted Coding Make Coders Obsolete?”

  1. EBY MATHEW says:

    I was not sure if computers would take over the coding profession but after reading this article am hopeful that professional coders will still be needed. Thank you for addressing this topic.

  2. Brad Ericson says:

    Hi Eby,

    Check out the March issue of Healthcare Business Monthly, which should arrive soon and is already on-line. I wrote an article about that very topic.

  3. CloudCareBridge says:

    I do think CAC (along with AI) will have an large impact as providers look to reign in costs, increase revenue in light of lower reimbursements and deal with onerous “paperwork” requirements. The next 5 years look to be a pivotal time in the direction of healthcare services – how they’re delivered, how they’re accounted for and how their paid for.

  4. AJ says:

    Was hoping this write up would include more information but it barely scratched the surface of the issue. Yes, CAC (driven by Artificial Intelligence) will be putting lower level coders out of work. It already is. How do I know? Well, I’m living through it on the payer side. It will eventually trickle over to the physician/facility side as the technology is refined and becomes cheaper and more widely available. Automation initiatives are at the forefront of most ‘big players’ in the health insurance game. As the article highlights, all coders will need to amp up their skills in order to have a chance of surviving in the medical reimbursement realm. Technology is improving on a very rapid scale. The AI computers are very ‘smart’ and they are being programmed by smart people who already know and understand these complex reimbursement methodologies. We have to accept this and adapt, or become obsolete.

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