Care Providers — Hospitals
Intelligent Coding
McKesson Intelligent Coding™
Observation Module
Improve compliance and charge capture
for observation services
The pressure to limit cost and
admissions is driving hospitals to
focus on increasing their use of
observation services. Inpatientfocused nurses often provide these
services, making it difficult to collect
the data needed for outpatient
charge capture. Also, complex
coding rules must be applied when
patients move from the emergency
department (ED) to observation. As
a result, hospitals are losing revenue
for observation services provided.
leads the abstractor through
the clinician’s documentation,
translating it into the required
reportable units or hours delivered
(see figure 1).
The McKesson Intelligent Coding™
Observation module can help
improve your charge capture and
compliance.
When a patient receives infusions
and/or injections, multifaceted rules
must be applied, especially when the
patient receives these procedures in
both the ED and observation. The
abstractor simply enters key details
for each medication administration
into the Observation module. The
coding rules engine then takes the
entire patient visit into account
to produce all appropriate charge
codes.
Simplifying complexities
McKesson Intelligent Coding
applies complex outpatient coding
rules to an abstractor’s basic clicks,
providing a proven, repeatable
approach that helps produce
measurable financial results.
Similarly, the Observation module
Driving efficiencies
Whether the patient is directly
placed in observation services or
is transitioned there from the ED,
the Observation module supports
the workflow, making it easier
for the abstractor to focus on
accuracy. Leveraging a common
Our Observation module helps
organizations:
• Improve charge capture for
observation services patients
• Simplify the calculation of
observation hours, including
time deductions
• Automate coding on complex
visits where patients transition
between ED and observation care
settings
• Streamline the workflow for
observation coding to speed time
to bill
• Remove the difficulty of applying the infusion/injection
coding hierarchy
• Provides an audit trail for coding
and charges
Our Observation Module
includes:
• Effective interfacing with any ED
and hospital information system
• Calculation of observation hours,
including observation time
deductions
• Infusions and injections coding
• Chemotherapy coding
• Procedure coding
• Allocation of charges to multiple
nursing units
• Allocation of observation hours
over multiple days
• Assignment of modifiers to any
CPT code
• Detailed summary of observation
coding charges
• Consultative approach delivered
by nurses and certified coders
• Personalized account
management
McKesson Provider Technologies
5995 Windward Parkway
Alpharetta, GA 30005
www.mckesson.com
Copyright © 2013 McKesson Corporation and/or one of
its subsidiaries. All rights reserved. McKesson Intelligent
Coding is a trademark of McKesson Corporation and/or
one of its subsidiaries. CPT is a trademark of the American
Medical Association. All other product or company names
mentioned may be trademarks, service marks or registered
trademarks of their respective companies.
HSPM201-12/13
figure 1
The Observation module facilitates the calculation of observation units, procedure
codes and medication/infusion codes.
user experience between the ED
and observation services modules
helps to minimize the learning
curve and users process charges
faster.
Adapting to each environment
Most hospitals place observation
patients in the ED and various
nursing units. For each of these
areas to receive credit for the
services they provide, multiple
charge masters are utilized.
The Observation module is
implemented with this complexity
in mind. Optional service paths are
offered to accommodate various
charge master support needs.
Reconciling charge status of
each visit
Each visit populates the McKesson
Intelligent Coding software
through an ADT message. The
hospital can then track the coding
and charging process through
the active patient list. Detailed
information indicates the status
of key milestones, such as coding
status and export of charges.
Driving continued success
In our uniquely hands-on
implementation approach, a
dedicated project manager works
with you to design efficient coding
processes. After implementation,
this project manager continues to
provide advice on best practices.
Each year, the McKesson
Intelligent Coding team reviews
the new coding requirements
published by the Centers for
Medicare & Medicaid Services and
the CPT® rules published by the
American Medical Association.
At our annual user meeting,
customers contribute input regarding
best workflow, productivity and
compliance. New coding rules are
updated in the software and effective
on the day the rules take effect.
Contact us
For more information about
McKesson Intelligent Coding,
contact your account executive or
visit www.mckesson.com.