Burning Water Skis and CAC

Don’t you hate those burns you get when your water skis catch on fire? Starting October 2014, no longer will your doctor have to enter in some ambiguous billing code to your insurance company when you’re treated for them. No, he/she will be able to enter in V91.07XA: “Burn due to water skis on fire.”  Or after your pet turtle channels its inner Teenage Mutant Ninja Turtle and decides to lash out, your doc can enter in W5922XA: “Struck by turtle, initial encounter.” 

Along with the much greater specificity (and hilarity) that the 140,000 ICD-10 codes will bring, hospitals are dreading the complexity and costs that come along with it. Frankly, it scares a lot of providers.  One said, “In our opinion, meaningful use is a cakewalk compared to ICD-10,” while another said, “I don’t think my clinicians will be aware enough to understand the differences between the new ICD-10 codes. We aren't even fully caught up with the education and the training for ICD-9.”

Provider interest in computer-assisted coding (CAC) has exploded as a way to alleviate ICD-10 productivity, complexity, and efficiency issues. While few providers are currently live on inpatient CAC, those KLAS spoke with have seen a reduction in FTEs and other ROI benefits. Nearly half of all other providers will be purchasing inpatient CAC in the next two years. 

With so much potential business, providers are going to see more and more inpatient CAC solutions popping up and competing for attention. In fact, we found that nine of the 13 CAC vendors that providers mentioned considering in our recent CAC report are currently signed up for a booth at AHIMA 2012. Not surprisingly, 3M owns so much of the current CAC mindshare because of their dominance in the encoder market. Impressively, OptumInsight, who has only 4% of the encoder market share, was considered by almost half of the providers we spoke with. Dolbey also emerged with just over one-quarter of provider considerations.

However, the inpatient CAC market is still so young that it’s hard to tell which solutions are developed. A number of providers have reported to us that their solution—along with nearly every other they’ve looked at—is not fully-baked. The ICD-10 delay gives providers the opportunity to do their due diligence in assessing which inpatient CAC solutions are established and live with the needed functionality for their organization. CAC is no silver bullet; outsourced coding, staff augmentation, and internal staff development and training are other strategies that progressive providers are marrying with CAC for their ICD-10 preparation.

So, as you prepare yourself to handle new codes like W22.02XD: “Walked into a lamppost, subsequent encounter” and the more granular billing information ICD-10 requires, it may be worth seriously looking at CAC technology. So far, the reviews are tentatively positive, but make sure to do your homework. While you’re doing that, I’ll be out water-skiing.