Patient Care with Effective MC & Reimbursement Solutions
Enhance patient care with a coding system that understands your patients’ condition.

Overview

MC and Reimbursement Solutions

3M™ Codefinder™ is a sophisticated, easy-to-learn tool for accurate, complete and compliant coding and grouping. 3M Codefinder is the only coding system in the world that provides over 100,000 logic pathways for coders connecting diagnoses with appropriate procedures. It has a knowledge base that insures comprehensive coding from a clinical point of view. It is much more than just a computerized ICD book. 3M Codefinder includes all the coding rules and regulations and it is updated on a regular basis. 3M Codefinder combines a broad vocabulary of clinical terms and concept hierarchies. The system understands entire context of patient’s condition and helps prevent the following types of common coding errors:

  • Incomplete coding
  • Inconsistent coding
  • Inaccurate coding
  • Invalid (non-terminal or nonexistent) codes
  • Nonspecific (NEC, NOS) codes
  • Excessive coding

Feature

3M Codefinder includes DRG grouper software that computes Diagnosis Related Group and the associated resource or cost weights. DRG cost weights are useful for understanding patient care resource requirements and for comparing patients with similar conditions.

3M™ CPTfinder Software ensures more accurate CPT codes and includes the entire CPT® nomenclature. CPT coding is optional but used widely in the US for outpatient coding and in Abu Dhabi for both inpatient and outpatient coding because of the greater specificity provided for physician billing.

3M™ Coding References are integrated into the Codefinder software and are right where coders need them to be to expedite the coding process. References include the ICD-9-CM and ICD-10 tabular manuals for both diagnoses and procedures, AHA’s Coding Clinic for ICD-9-CM and ICD-10-CM/PCS, AMA CPT Assistant, Dorland’s Medical Dictionary and Elsevier’s Anatomy Plates; Faye Brown’s ICD-9-CM Coding Handbook; ICD-10-CM and ICD-10-PCS Coding Handbook; The Merck Manual of Diagnosis and Therapy; Mosby’s Dictionary of Medical Abbreviations & Acronyms; and Mosby’s Manual of Diagnostic and Lab Tests.

How DRGs work

DRGs are based on a simple concept of averages. With DRGs, governments or insurance payers simply calculate the average cost of treating patients with similar characteristics (DRGs identify patients with similar clinical profiles and resource requirements for treatment) and pay the provider (the hospital in most cases) the average amount, regardless of what it costs to treat an individual patient. This payment method has proven effective for driving efficiency into inpatient healthcare delivery and has provided a mechanism whereby providers share some of the financial risk with the payers.
The US was the first to use DRGs for payment. When it introduced DRGs in 1983 as their way of reimbursing its Medicare (elderly) patients, they saw healthcare annual inflation drop from 14% to 3%, and the hospital length of stay drop by 20%. The number of annual hospital admissions decreased by 35 million and the US realized annual healthcare savings of $18 billion, according to a Rand Corporation study done in the 1980s.

Benefits

  • Accurate, consistent, and compliant coding, editing, and grouping
  • Increased coder productivity
  • Calculation of expected reimbursement for inpatient and outpatient claims
  • Fewer chart deficiencies and suspensions
  • Integration options with other third-party health information and clinical systems

Downloads

Medical Coding and Reimbursement Solutions



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