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Re-envisioning the Role of Medical Coding in a Value-Driven Healthcare Landscape

January 26, 2024Hamid TabatabaieManaged Healthcare ExecutivePayers, Plans, & Claims,Clinical Documentation, Coding

While medical coding may not be at the forefront of innovation priorities for some healthcare systems, there is real opportunity for care delivery improvement and systemic cost savings. Instead of perceiving coding solely as a necessary mechanism for fee-for-service reimbursement, progressive healthcare leaders are viewing coding as a catalyst for advancement in population health, value-based care and research.

Diagnosis (ICD-10) and procedure (CPT) code sets offer substantive data insights to support the patient journey and experience. Clearly, tracking patients’ activities over time is an imperative for clinical decision-making, and clinically specific codes can be an accurate and efficient tool for care providers to summarize relevant and critical information in each patient’s chart.

Codes as numeric signals offer a wealth of information that can enable predictive insights into future health incidents, while satisfying reimbursement requirements with higher quality and reliability.

For progressive health systems that want to leverage tech to improve population health, there are two realizations that are important to consider.

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