Epic Simple Visit Coding: 7 Optimization Tips

February 22, 2022 |
Leigh Ann Braswell
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Meet Leigh Ann Braswell. She’s been in HIM for more than 25 years. She’s led high-functioning coding teams within enterprise-level health networks. She’s spearheaded a conversion to Epic’s EHR across 30 hospital sites—some at the same time! And she’s an absolute wizard at Simple Visit Coding, a feature already built into Epic that automates high-volume, low-risk accounts.

Leigh Ann also loves to help others. That’s why she recently shared her wisdom in a lively webinar, “Making the Most of Epic Simple Visit Coding.” It attracted quite a large crowd—and attendees had lots of compelling questions.

Lehigh Ann unpacked these 7 tips that HIM directors can use right away to maximize Epic Simple Visit Coding, overcome the nationwide shortage of medical coders, and kick their revenue cycle into high gear.

  1. Know the Epic Simple Visit Coding Criteria

Epic uses these four high-level Code Capture Rules you can implement for Simple Visit Coding:

  • Diagnosis coding
  • Pulling diagnosis from upstream sources. This can include provider orders, referrals, registration, charges, visit diagnoses, or previously coded accounts (recurring series) based on your compliance policies.
  • CPT/HCPCS pulled from charges/CDM upstream.
  • Accounts that fail coding validation errors will route to a work queue.

 

When building rules to process coding validation errors, Leigh Ann uses the provider order as a single source of truth. “If the order wasn’t directly entered into Epic itself, it’s definitely a training opportunity for frontline staff,” she says.

Another helpful tip: Make sure your most skilled human coders operate the error work queue. Doing so will boost coding accuracy. “Out of 30 hospitals, on a good day maybe we had 10 – 15 errors for all  Simple Visit Coding accounts,” she says. “That’s because the rules were built correctly.

  1. Use Simple Visit Coding on Day 1 of your Epic Go-Live

You can start Simple Visit Coding right away. However, many organizations want to see how it works before making a full commitment. No matter when you start, it’s wise to begin with specific accounts. The best early candidates are lab, outpatient therapies (physical, occupational, or speech therapy), lactation, massage therapy, and other accounts that don’t require an interpretive report.

  1. Identify the best candidates that can help you expand Simple Visit Coding.

Your list of accounts will depend on your health system, the type of services you offer, and your payer and state requirements. Common outpatient service lines to implement in addition to the early adapters listed above include

  • Cardiac rehab
  • Cash-flat services (massage therapy, calcium scoring, etc.)
  • Dietary or nutritional counseling
  • ED left-without-being-seen
  • Esophageal motility studies
  • Outpatient dialysis
  • Pulmonary function tests
  • Radiation oncology
  • Vaccine-only visits

 

For certain services, you may need to build rules. For example, screening mammography accounts include an interpretive report, but they don’t require an order. So, you can build rules in Epic that trigger a specific diagnosis for breast cancer screening account when a certain charge is present.

  1. Work closely with your IT team.

As you expand your Simple Visit Coding capabilities, your IT team will play a vital role. The ideal state: Ask them to build Simple Visit Coding in a support environment first so you can identify any errors. Also, conduct regular audits to make sure your system captures and codes everything correctly.

  1. Calculate your ROI.

Leigh Ann shares an example of a health system that moves 75,000 outpatient visits to Simple Visit Coding. That will create an estimated labor savings of more than $147,000, equivalent to 2.4 FTEs. “Imagine if you could train those coders on day surgery, inpatient coding, or move them to ProFee coding,” Leigh Ann says. “It’s a great opportunity to train your current staff, and most coders would love the chance to move up.”

  1. Seek a solution with robust analytics.

Healthcare organizations who choose to partner with DeliverHealth for Simple Visit Coding benefit from Power BI dashboards with in-depth analytics that go beyond what Epic provides. The DeliverHealth platform pulls in Epic data for outpatient claims, so you can track metrics like percentage of Simple Visit Coded cases, Simple Visit Coded denial rate vs. your overall denial rate, and how close you are to achieving an Epic Gold Star, an accomplishment that gives organizations a major marketing boost.

  1. Expand your horizons.

Once you optimize Simple Visit Coding, you’ve set the foundation for implementing additional efficiencies, including autonomous coding for radiology, which can deliver up to 95% accuracy.

Leigh Ann provided more informative tips, including how to handle combination code rules. You can catch all of her insights in the full webinar. Listen NowAnd if you want to get started with Simple Visit Coding using DeliverHealth’s innovative platform, contact us today.