Systems and methods for real-time group coding

Abstract

A computer-implemented method for real-time coding of medical group codes such as diagnosis and procedure related groups is described. In one embodiment, one or more initial medical group codes may be assigned to a patient record based on a first set of inputs. Upon assigning the one or more initial medical group codes, a coding summary of the one or more assigned medical group codes may be displayed. While displaying the coding summary, at least one input from a subsequent set of inputs may be received and updating one or more medical group codes in the patient record.

What is claimed is: 
     
         1 . A computer-implemented method for improving medical coding efficiency of a patient record, the method comprising:
 assigning one or more initial medical group codes to the patient record based on a first set of inputs, wherein the initial medical group code is a procedure related group code;   upon assigning the one or more initial medical group codes, displaying a coding summary of the one or more assigned medical group codes; and   while displaying the coding summary, receiving at least one input from a subsequent set of inputs and updating one or more medical group codes in the patient record.   
     
     
         2 . The method of  claim 1 , further comprising:
 upon receiving an input from the subsequent set of inputs, determining whether the input from the subsequent set of inputs affects an aspect of the coding summary.   
     
     
         3 . The method of  claim 2 , further comprising:
 upon determining the input from the subsequent set of inputs causes an aspect of the coding summary to be affected, updating the affected aspect of the coding summary in real-time; and   displaying the updated aspect of the coding summary and updating the one or more medical group codes.   
     
     
         4 . The method of  claim 2 , wherein the affected aspect of the coding summary comprises a reimbursement amount computed in association with the one or more initial medical group codes. 
     
     
         5 . The method of  claim 2 , wherein the affected aspect of the coding summary comprises a medical group code weight associated with the one or more initial medical group codes. 
     
     
         6 . The method of  claim 2 , wherein the subsequent set of inputs is based partially on clinical documentation obtained from the patient record. 
     
     
         7 . The method of  claim 1 , further comprising:
 upon receiving a request for a patient report, displaying the requested patient report prior to updating the one or more medical group codes.   
     
     
         8 . The method of  claim 1 , further comprising:
 assigning the one or more initial medical group codes to the patient record under a first health care classification system; and   determining, prior to updating the one or more medical group codes, at least one alternative medical group code under a second health care classification system as an alternative to at least one of the initial medical group codes.   
     
     
         9 . The method of  claim 8 , further comprising:
 displaying, in the coding summary, prior to updating the one or more medical group codes, information related to the alternative medical group codes adjacent to information related to the one or more initial medical group codes.   
     
     
         10 . The method of  claim 8 , wherein the first health care classification system comprises a first international classification of diseases (ICD) revision and the second health care classification system comprises a second ICD revision different from the first ICD. 
     
     
         11 . The method of  claim 1 , wherein the procedure related group code is selected from the group consisting of Ambulatory Payment Classification (APC) groups and Outpatient Prospective Payment Systems (OPPS), Ambulatory Payment Groups (APGs) and Ambulatory Surgical Centers (ASCs). 
     
     
         12 . A computing system configured to improve medical coding efficiency of a patient record, comprising:
 a processor;   memory in electronic communication with the processor;   instructions stored in the memory, the instructions being executable by the processor to:
 assign one or more initial medical group codes to the patient record based on a first set of inputs, wherein the initial medical group code is a procedure related group code; 
 upon assigning the one or more initial medical group codes, display a coding summary of one or more assigned medical group codes; and 
 while displaying the coding summary:
 receive at least one input from a subsequent set of inputs and updating one or more medical group codes in the patient record; 
 upon receiving an input from the subsequent set of inputs, determine whether the input from the subsequent set of inputs affects an aspect of the coding summary. 
 
   
     
     
         13 . The computing system of  claim 12 , wherein the subsequent set of inputs is obtained from clinical documentation obtained from the patient record. 
     
     
         14 . The computing system of  claim 12 , wherein the instructions are executable by the processor to:
 upon determining the input from the subsequent set of inputs causes an aspect of the coding summary to be affected, update the affected aspect of the coding summary in real-time; and   display the updated aspect of the coding summary and updating the one or more medical group codes.   
     
     
         15 . The computing system of  claim 12 , wherein the affected aspect of the coding summary comprises a reimbursement amount computed in association with the one or more initial medical group codes. 
     
     
         16 . The computing system of  claim 12 , wherein the affected aspect of the coding summary comprises a medical group code weight associated with the one or more initial medical group codes. 
     
     
         17 . The computing system of  claim 12 , wherein the instructions are executable by the processor to:
 upon receiving a request for a patient report, display the requested patient report prior to updating the one or more medical group codes.   
     
     
         18 . The computing system of  claim 12 , wherein the instructions are executable by the processor to:
 assign the one or more initial medical group codes to the patient record under a first health care classification system; and   determine, prior to updating the one or more medical group codes, at least one alternative medical group code under a second health care classification system as an alternative to at least one of the initial medical group codes.   
     
     
         19 . The computing system of  claim 18 , wherein the instructions are executable by the processor to:
 display, in the coding summary, prior to updating the one or more medical group codes, information related to the alternative medical group codes adjacent to information related to the one or more initial medical group codes.   
     
     
         20 . The computing system of  claim 12 , wherein the procedure related group code is selected from the group consisting of Ambulatory Payment Classification (APC) groups and Outpatient Prospective Payment Systems (OPPS), Ambulatory Payment Groups (APGs) and Ambulatory Surgical Centers (ASCs).