Autocoding Predictions

When possible, Claim Maker uses the extracted data from your files to make line item coding predictions. Predictions can include:

• CPT procedure codes: surgical, anesthesia (ASA), radiology, and interventional radiology
• ICD-10 diagnosis codes
• Modifiers
• E/M visit levels for office, hospital, and emergency department visits. The system selects each level with deterministic rules applied to evidence it cites from your documentation.
• Surgeon companion claim line items, for organizations that enable companion claims

Predictions appear at the top of the line item. The coder can apply a code individually by clicking on it, or select Apply All to apply all predicted codes.

Hover over a prediction, or over an applied predicted code, to see the context for why that code was chosen, together with a confidence score. High-confidence scores appear green. Lower scores appear yellow and should be reviewed. Your organization can customize these confidence thresholds. Contact [email protected] to learn more.

Autocoding predictions also provide the reference document the predicted code came from. A hyperlinked document appears in the predicted code pop-up. Click it to reveal the source document, then click the document to navigate there.

Inside the document, the Summary button generates a summary of the information used for a specific code.