Computer-Assisted Coding Features

Proprietary NLP technology
Optum™ Computer-Assisted Coding (CAC) is powered by Optum LifeCode®, a proprietary, patented natural language processing (NLP) engine which deciphers the meaning and context of words in clinical documentation and recommends relevant ICD-9 and CPT® codes. LifeCode doesn’t just search for word matches—it actually “understands” the meaning and context of the English language. This advanced technology results in a simpler, more efficient, and precise method for automated coding.

Extensive edits and resources in Optum Web.Strat
Using Optum Web.Strat in conjunction with Optum CAC boosts accuracy by giving coders access to better edits and resources to conduct additional research or to validate CAC-generated codes before completing a case. Web.Strat utilizes grouping and modeling to facilitate accurate DRG-APC assignment. In addition, Web.Strat gives coders the flexibility to use either a fully functioning book-based encoding tool to find medical codes, or a phrase-based logic encoding tool that provides code matches as they send a search term that was highlighted within Optum CAC or enter descriptions into a search field.

Enhance regulatory compliance and RAC readiness
LifeCode’s NLP technology automatically generates a set of ICD-9 and CPT® codes for review and validation based on text clinical documentation. By providing automatic audit trails and links to documentation for every code selected, it helps to support Recovery Audit Contractor (RAC) initiatives and other CMS programs. Web.Strat enhances regulatory compliance by increasing accurate, timely, and consistent coding practices within your organization and providing MS-DRG and RAC-focused edits to help minimize denials.

Ease transition to ICD-10
Due to ICD-10’s higher degree of specificity; LifeCode’s NLP technology can support accurate code selection. Its sophisticated engine will mine medical reports, assign codes, and present them to coders who then review and approve. This process also helps coders familiarize themselves with the vast amount of new data as they work. For example, ICD-10 includes more than 155,000 codes, in comparison, ICD-9 has 17,000.

Key benefits
Available for both inpatient and outpatient applications, this comprehensive solution helps organizations:

Increase productivity

• A decrease in coding time results in an eliminated or decreased coding backlog and a lower discharged not final billed (DNFB) rate

Improve accuracy

• Automatic edits boost coder accuracy and capture diagnosis and procedures including CCs and MCCs to reduce denials and rework and improve reimbursement. In addition, the improved accuracy leads to improved CMI

Increase revenue

• Drop bills faster for a shorter time to revenue and lower A/R days

Reduce expenses

• A decrease in coder overtime and the use of contract coders helps lower administrative costs

Improve compliance

• Links to documentation for every code selected result in an improved audit trail in support of the RAC program and other CMS audits

Transition to ICD-10

• Optum LifeCode understands the meaning and context of the English language to help coders transition more easily to ICD-10, a much larger and complex code set

CPT is a registered trademark of the American Medical Association.