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Lifepoint Informatics has created an API toolbox, a suite of Application Programming Interfaces, which will help customers take the necessary steps to ensure compliance with health plan requirements and government regulations. The API toolbox now includes both a solution for a medical necessity validation and a successful ICD-9 to ICD-10 crosswalk. These comprehensive tools and services can help healthcare organizations identify areas of risk, improve documentation, increase coding efficiency, translate codes, map and convert existing information systems, and educate staff. Lifepoint Informatics encourages customers and prospects to test out free versions of both tools available on their website at http://www.lifepoint.com/api-toolbox.html. A more comprehensive and customized version of each API tool is available for a fee. Integrating with these API tools is straight-forward for both "on-premises" client server applications and browser-based systems.
"The ICD-10 Crosswalk and Medical Necessity Validator are just the beginning," William Seay, Chief Executive Officer said. "We plan on adding additional solutions to our API toolbox, to help our customers stay ahead of compliance demands and simplify the implementation process so they can focus on fulfilling the clinical and diagnostic needs of their patients."
Validate Conversion of ICD-9 to ICD-10 Codes with Lifepoint's Crosswalk Tool
Lifepoint's crosswalk is a data map that helps to translate between ICD-9 and ICD-10 codes and is intended to be used primarily for large datasets. Organizations can test out a free version of the ICD-10 crosswalk tool available on the Lifepoint Informatics website, and they can also have the crosswalk embedded into their own health information systems to translate ICD-9 codes into the correct ICD-10 code.
Validate Medical Necessity of Diagnostic Tests with Lifepoint's New Validator Tool
Healthcare organizations need to ask themselves, "How well do you track medical necessity?" Does the provider experience write-offs, compliance penalties, denied claims, fee schedule paperwork and patient dissatisfaction due to billing surprises? Not tracking if a procedure is payer approved before delivering care can be costly and time consuming. Determining medical necessity at the point of scheduling can help hospitals, labs, anatomic pathology and diagnostic imaging centers comply with CMS mandates and health plan policies.
The Lifepoint medical necessity tool can help organizations:
- Flag services that may be deemed medically unnecessary according to the patient's health plan guidelines
- Limit financial risk exposure for denied claims
- Improve referrer, staff and patient satisfaction by verifying medical necessity prior to performing clinical tests
- Identify tests that may need a prior authorization
- Determine whether or not an advanced beneficiary notice needs to be issued
Additional API tools are currently under development and expected to be released near the end of spring 2015.