Medical coding is in its advanced phase with frequent introduction of the latest versions of classification systems such as ICD-10 and ICD-11. To reduce coding errors, most practices are outsourcing medical billing. According to the market report from Report Buyer, the global medical coding market size is expected to reach USD 25.4 billion by 2025, registering a 10.0% CAGR during the forecast period 2018 – 2025.
Certain factors that are expected to drive this market growth during the forecast period 2018-2025 include:
- Rising need for a universal language to reduce frauds and misinterpretations associated with insurance claims
- Escalating demand for coding services
- Constantly rising number of coders as a result of career opportunities in this field
- Constant revisions in classification systems and its global acceptance
Rising demand for world-class healthcare services in developing regions is also expected to boost adoption of medical coding procedures. The number of professional coders is also expected to rise significantly during the forecast period, increasing the number of medical coding companies providing platforms for these professionals.
Owing to high demand for specialist coders and the presence of a favorable healthcare system, North America is expected to dominate the market throughout the forecast period. The increasing number of trained coders and provider companies is anticipated to fuel market growth in the Asia Pacific region.
The market is highly fragmented with the presence of many local providers offering a wide array of services. Some of the major companies are Oracle Corporation; STARTEK Health, Aviacode, Inc.; Verisk Analytics; Maxim Health Information Services; Parexel International Corporation; Medical Record Associates LLC; and Precyse Solutions, LLC.
Latest Medical Billing and Coding Trends
As medical billing and coding trends are ever-changing, it is critical for billing specialists as well as medical billing outsourcing companies to stay up to date with the current trends. Some of the trends in 2018 include:
- EHR alignment – When it comes to technological advancement, electronic health record (EHR) implementation and management has seen a revolution. As there are reports that EHR shortcuts are resulting in coding errors and physicians using EHR for patient documentation is affecting doctor-patient relationship, EHR integrated medical coding services provided by experienced companies are ideal to reduce coding complexity and help healthcare entities to process their claims faster.
- Computer-assisted coding – Computer assisted coding system (CAC) refers to a software that analyzes healthcare documents and produces appropriate medical codes for specific phrases and terms within the document. The built-in system recognizes pertinent ICD-10-PCS codes, ICD-10-CM diagnoses, and CPT processes. According to the report from Markets and Markets, the global computer-assisted coding market that is valued at USD 2.76 Billion in 2017, is expected to register a CAGR of 11.5% to reach USD 4.75 Billion by 2022. The major end users of computer-assisted coding are hospitals, physicians’ practices, clinical laboratories, academic medical centers, and other healthcare institutions. Key factors that are driving this market growth include the growing need within the global healthcare system to curtail increasing healthcare costs, improve coding accuracy, and streamline the revenue process.
Though there is a concern whether the CAC and EHR can replace human medical coders, and there were reports that highlighted that CAC has shown signs of lower accuracy when it is not manned by a certified coder. Though the software may be useful, it is not capable of making standalone decisions or following detailed instructions.
- Blockchain – Blockchain technology is also being increasingly adopted in the healthcare industry. It has already been introduced in clinical trials and is favored by many in the medical sector. Experts are already predicting blockchain’s potential in EHRs. According to a Forbes article MedRec, one prototype using blockchain aims at improving electronic medical records by allowing patient records to be accessed securely by any provider who needs it without wasting time and money and avoiding duplication in procedures. MedRec’s goal is to give patients and their providers one-stop access to their entire medical history across all providers they have ever seen. Blockchain data storage will be mainly considered for its improved privacy, enhanced security and efficiency of data exchange. Experts are also acknowledging blockchain’s ability to transform RCM and claims processing for the better.