Hospitals rely on elective surgeries as a source of up to 50% of all revenue, allowing them to take losses on a range of high-cost service lines to remain profitable. The COVID-19 pandemic laid bare the impact of reduced surgery volume, with hospitals suffering immediate revenue loss and negative profit margins.
As surgical service lines return to pre-pandemic volumes, it’s imperative for hospitals to have the right technology tools and best practices in place to maintain safe, accurate, and efficient surgery workflows. Not only does better efficiency lead to increased revenue; it also improves the experience for both healthcare professionals and patients by lowering risks, complications, and delays.
Two tools, in particular, can play a pivotal role in streamlining the surgery scheduling process: Shared terminology and automated Current Procedural Terminology (CPT) coding. These tools may be overlooked, but successful implementation and use of shared terminology and automated coding can have several key downstream impacts before, during, and after an elective procedure.
The Importance – and Challenge – of Streamlined Surgery Scheduling
According to a report from Strata Decision Technology, hospitals lost an average of $3 million per month when elective procedures were canceled to treat the initial surge of COVID-19 patients. Given healthcare’s low margins, that’s a difficult loss to take.
Want to publish your own articles on DistilINFO Publications?
Send us an email, we will get in touch with you.
Streamlining the scheduling process offers hospitals a clear opportunity to recover needed revenue. Facilities can complete more efficiently with less waste and time spend while still meeting staffing, safety, and quality requirements.
For many hospitals, though, this process is easier said than done. Many factors contribute to running a successful OR, from coordinating surgeons’ schedules to tracking surgical equipment to providing enough time to clean and restock supplies. It’s also important to consider the needs of the patient – both before the surgery – to ensure that appropriate pre-operative procedures have been completed, and after, to prevent patients from waiting for a vacant recovery room.
Many areas of hospital operations are involved in surgery scheduling, and getting everyone on the same page can be a tall order. One of the easiest ways to streamline is to get everyone to speak the same language. That’s where shared terminology and accurate mapping to CPT codes come into play.
The Role of Shared Terminology and Coding
Clinical terminology is constantly changing. In 2020, healthcare saw nearly 400,000 unique updates to terminology across a range of conditions and procedures. Some updates were planned, but others were not – including rapidly implemented ICD-10, SNOMED, CPT, and LOINC codes for COVID-19.
The right codes are critical for accurate diagnosis, treatment, billing, analysis, and clinical research. Vagueness in terminology and coding inconsistencies can lead to operational and clinical issues such as inadequate prior authorization submissions, incorrect room set-up, and preferred supplies at the ready, as well as charge capture setbacks such as delayed payments or denied claims altogether.
With so much at stake, hospitals shouldn’t leave the task of managing clinical terminology and CPT coding to home-grown solutions that require significant resources and regulatory oversight, all of which can disrupt clinical and billing workflows. In many cases, this is extremely difficult for internal teams to manage as many CPT code descriptions are very broad and do not exactly line up with the clinically stated procedure name. Unless the facility has strict policies in place, coding these individual procedures becomes very subjective.
Source: Hitconsultant
