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3,451 followers

3mo

Missed our webinar about the hype surrounding AI and outpatient infusion coding? Watch this snippet from the event to see how having an automated solution can simplify your coding so that you aren't leaving revenue on the table.

Transcript

So before we jump into the Q&A, I do want to at least show you one example of a of a autonomous coding system that we have here, adapters and it's really the only one that we have for autonomous coding. And it's very, very specific to a outpatient infusion administration, which is a notoriously difficult coding process. There's, it's all time and duration based, but there's a specific hierarchy of. Things that have to be followed in terms of the of the CPT codes that are required to be built. There's overlapping and concurrency rules that are constantly changing. You have intramuscular in sub Q injections which also typically occur in these infusion departments or even other departments that are not necessarily oncology or specific to infusion. Things like D and Obs in emergency departments for instance. At least 30% of all emergency department patients typically refuse typically are infused with some sort of. Drug Administration. And those have to be billed exactly the same way because again, it's an outpatient infusion service. So complex infusions can have many, many, many, many events in terms of start and stopped, rate change, paused, restarted, which all have to be taken into account. But the the good news about it is that if all that information is documented, it's very logical and mathematical and based on one transaction, there's only one. Or one service, I'm sorry, there's only one set of compliant billing codes that have to that that can be derived from any of the events that are that are performed in the service. And just to give you an idea of how complex some of this information can be what you're looking at here, I don't intend you to be able to read each one of these, but each one of these line items is a specific combination of either order ID, drug and event. And the events you can see often the right they'll say things like new bag, paused, stopped, given whatever that. Those might be and each one of these, like I said, events have to be considered before you can come up with complete and compliant and billable codes. So to have a, to have a coder to be able to pull up all this information and any HR and be able to do kind of this map in their heads, good coders are are really good at this and they can do that. The problem that you have then is if you have a, if you have an infusion center that does 150,000 infusions a year, you need about 30 coders. Because they can do about, you know, four or five of these per hour. Good ones, maybe 10. You need a large number of coders specifically for this service in order to produce complete and compliant billable code. Umm. So. Looking at this slide set of data, once those items have been documented though, it's again a fairly simple mathematical calculation to be able to pull all this information, all these start and stop times and event times and translate that according to CMS rules and regulation regulations into specific billable code. And the end result is something like this that you would see, yes, there is a chemotherapy drug that was delivered for the first hour and then you had, you know. Additional hours 1 to 8 and there's one unit of the first code, 2 units of the second. You have your another chemotherapy drug, a separate drug, which is delivered for 30 minutes. So there's one billable unit that and you have a a Med drug that was infused as well Med I mean a therapeutic drug that was infused non chemotherapy drug. And then you had a hydration, the patient was hydrated for 55 minutes, right, Actually for a lot longer than that, but due to currency rules and regulations, you can only build for 55. It's of it so. The the end result, these specific codes that you see here, these specific units that have been calculated out and charge for a specific client. This is the only possible outcome you can have based on all that data. And to be able to pull that data out of the HR via an interface, run it through the system, calculate it, send it back to their billing system as complete compliant data is an exceptional time saver and increases. Our code is efficiency by upwards of 80 to 90%. Now, there's always going to be exceptions to things like this and and and again, you're going to want to keep your coders because they can always be redirected to somewhere else. So if you're thinking about, you know, becoming efficient in more areas, something like this would would be very useful in that regard.

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