AI-assisted coding in medical practices: 5 reasons to use it and 3 reasons to think twice

Automated coding tools, often called computer-assisted coding (CAC) or artificial intelligence (AI)-assisted coding, are showing up on more practice wish lists as administrators juggle staffing gaps, payer edits and documentation burden. In most settings, the software scans clinical documentation and structured electronic health record (EHR) data and then suggests International Classification of Diseases, Tenth Revision, Clinical Modification and Current Procedural Terminology/Healthcare Common Procedure Coding System codes for a human to validate, a workflow outlined in AHIMA’s Computer-Assisted Coding Toolkit.

Used well, CAC can help practices submit cleaner claims and focus human expertise where it matters most. Used poorly, it can scale compliance risk fast, which is why the HHS Office of Inspector General stresses fundamentals such as accountability, monitoring and auditing in its General Compliance Program Guidance.