As professional coders, we know it is hard to know everything about every type of coding, from inpatient to outpatient, from long-term care to post-acute care, and from CM to PCS to CPT. Single-path coding is a workflow model that may remove some of the roadblocks to coding productivity.
In single-path coding, one coder does it all. They code the encounter for the facility side, as well as for the professional side. When we think about how some of our workflows may be currently set up, these functions are usually performed by two different coders, with maybe several intermediary steps in between. In single-path coding, one coder codes the chart in its entirety.
While this idea is certainly not new, it is gaining in popularity. A 2022 article in the Journal of the American Health Information Management Association (AHIMA) titled “The Move to Single-Path Coding” details both some pros and cons of this process. It also documents their three pillars for success for single-path coding process transition. If you are thinking about implementing this process or want to know more, I encourage you to read it.
One major positive to the single-path coding process is that one coder performs both the facility and the pro-fee coding. This same coder will be reviewing and interpreting the information for both sets, not just eliminating the need for two coders, but eliminating one entire workflow. One coding session will apply the codes for both sides. This streamlining of duplicate processes eliminates areas of inefficiency, potentially increasing compliance and decreasing denials. Coding for the facility side is not totally different from the professional side – there are definite similarities. In this environment, where facilities are looking at ways to maximize productivity and decrease overhead, single-path coding may be a solution. Could having one coder reviewing documentation potentially help with documentation improvement by the providers, or at least facilitating communication? I think that would be a possibility.
As for a negative, as I noted earlier, it is hard to know everything about all types of coding. Here the coding professional would need to know about facility coding as well as all the ins and outs of coding on the professional side. While noting the definite similarities between facility-side and pro-fee coding, there are very distinct and very important differences the coder must be aware of. The use of modifiers is one such area and would require the coder to be diligent in their application. How code assignment drives reimbursement also differs between the two sides. Confusion or uncertainty by the coder in this area could prove to be very costly. The correct coder for the job could make or break the process. A coding professional who is well-versed in both facility-side and pro-fee coding would be crucial to single-path coding success.
There are other considerations when thinking about a transition to single-path coding. For example, what technology is being used, and is it the same for both sides? Are the education requirements and/or required credentials the same for both facility-side coders and pro-fee coders? How do the job descriptions differ?
What will need to be added or removed from the job as part of the single-path process?
And we can’t forget about artificial intelligence (AI) – will that change things, and if so, how?
With proper implementation, the single-path coding workflow may be the road to success. Having the right coding professional in the driver’s seat will get you to the finish line.
