Is your organization ready for autonomous coding?

Most chief financial officers and revenue cycle leaders would agree that a solution is needed to contain costs around coding support, whether using internal full-time employees or an outsourced coding partner. We are in a time where there is a high volume health information management (HIM) staff hitting retirement age, and there is difficulty finding and hiring skilled staff. Outsourced services can be pricey and sometimes difficult to manage. If autonomous coding can help with these challenges, CFO and revenue cycle leaders are likely interested in exploring options. But, they need to ask an important question first: Is our organization ready to adopt an autonomous coding solution?

Autonomous coding solutions focus on automating the core coding functions of ICD-10 diagnosis coding, CPT® and Healthcare Common Procedure Coding System (HCPCS) and, in some cases, modifiers. Are your coders spending time on other functions outside of this? It’s important to understand the workflow and coding habits of your team, assess whether change management is needed and if your organization is willing to support that change process.

When I think of functions like chargemaster code changes, Centers for Medicare & Medicaid Services (CMS) place of service changes, non-claims information or internal tracking information like financial departments and billing area, these items are all outside of scope for successful automation. Facility coding usually has fewer of these items to address, but on the professional coding side of the house, where coding is highly driven by charge workflows, I see coders handling these items more often.

Electronic health records (EHRs), in some cases, have made it easy for these functions to fall into a coders lap to address. Most of these registration and billing type items should be addressed upstream in the revenue cycle, but when not done appropriately, will require touches by coders or others to update.

You’re ready to start exploring autonomous coding. Now what? Start by assessing your workflows and address any potential failure points prior to adopting an autonomous solution. Take these more basic tasks out of the hands of the coders so they can focus primarily on successfully rolling out and encouraging adoption of the technology.  

The benefits of automating your coding can far outweigh the change management in the long run. It’s better to identify areas of potential challenges and opportunities prior to implementation, when you have time to create and work through corrective action. If changing processes upstream is not possible, it may be beneficial to look at a post-coding workflow that would still allow you to benefit from coding automation. Either way, you want to prepare so that you can adopt the new technology and see success immediately.   

In part two of this series, we will discuss compliance considerations when transitioning to autonomous coding.

Amanda Hudson is a business manager at Solventum.