Medical coding system with integrated codebook interface

• US 10,366,424 B2
• Filed: 06/04/2014
• Issued: 07/30/2019
• Est. Priority Date: 06/04/2014
• Status: Active Grant

• Current Assignee: Microsoft Technology Licensing LLC (Microsoft Corporation)
• Original Assignee: Nuance Communications, Inc. (Microsoft Corporation)
• Inventors: Spitznagel, Regina, Sarkar, Debjani
• Primary Examiner(s): Ruhl, Dennis W
• Assistant Examiner(s): Lultschik, William G
• Application Number:
  US14/296,214
• Publication Number:
  US 20150356646A1
• Time in Patent Office: 1,882 Days
• Field of Search: None
• CPC Class Codes: G06F 40/279 Recognition of textual entities
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/04 Billing or invoicing
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G06Q 50/22 Social work or social welfare, e.g. community support activities or counselling services
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms

Abstract

Techniques for use in medical coding include applying a natural language understanding engine to a free-form text documenting at least one clinical patient encounter to generate a set of one or more medical billing codes for the patient encounter. A user interface may be provided, configured to allow one or more human users to review and correct the generated set of medical billing codes. Within the user interface, in response to user selection of a first medical billing code of the generated set of medical billing codes, at least a portion of a government-authorized codebook for the first medical billing code may be displayed, and a position of the first medical billing code may be indicated in the displayed portion of the codebook.

Claims

1. A method comprising:

applying a natural language understanding engine to a free-form text documenting at least one clinical patient encounter to generate a set of one or more medical billing codes for the at least one clinical patient encounter;

in response to a user'"'"'s selection of a first medical billing code of the generated set of medical billing codes in a user interface configured to allow one or more human users to review and correct the generated set of medical billing codes, the user interface comprising a window having a first portion and a second portion, the first medical billing code being a member of a standardized code set and the generated set of medical billing codes being displayed within the first portion of the window in the user interface;

displaying within the second portion of the window in the user interface, and simultaneously with displaying the generated set of medical billing codes within the first portion of the window in the user interface, at least a contiguous portion of a codebook specifying an order and hierarchy of codes in the standardized code set, the at least a contiguous portion of the codebook including at least the first medical billing code and a second medical billing code, and

indicating a position of the first medical billing code within the order and hierarchy of codes in the standardized code set specified in the displayed at least a contiguous portion of the codebook,

wherein displaying the at least a contiguous portion of the codebook comprises maintaining the order and hierarchy of the codes in the at least a contiguous portion of the codebook as displayed in the second portion of the window in the user interface in response to the user'"'"'s selection of the first medical billing code in the first portion of the window in the user interface;

receiving a user'"'"'s selection of the second medical billing code within the second portion of the window in the user interface; and

in response to the user'"'"'s selection of the second medical billing code within the second portion of the window in the user interface, replacing the first medical billing code in the first portion of the window in the user interface with the second medical billing code selected in the second portion of the window in the user interface,

wherein the receiving and the replacing are performed while the first portion and the second portion are simultaneously displayed within the window.

2. The method of claim 1, wherein the codebook is an official ICD or HCPCS codebook.

3. The method of claim 1, wherein the codebook comprises a data structure representing a tree of medical billing codes, wherein the position of the first medical billing code selected by the user is a node in the tree.

4. The method of claim 3, wherein displaying the at least the contiguous portion of the codebook comprises displaying the node corresponding to the first medical billing code selected by the user in context of adjacent nodes in the tree.

5. The method of claim 1, further comprising displaying, within the user interface, one or more coding rules for the first medical billing code selected by the user.

6. The method of claim 1, further comprising allowing the user to navigate the at least a contiguous portion of the codebook to select the second medical billing code as a replacement for the first medical billing code.

7. The method of claim 6, further comprising re-training the natural language understanding engine based at least in part on the user'"'"'s selection of the second medical billing code as the replacement for the first medical billing code.

8. The method of claim 1, further comprising:

determining whether a combination of medical billing codes in the generated set of medical billing codes violates one or more coding rules associated with the first medical billing code; and

generating an alert in response to determining that the combination of medical billing codes violates the one or more coding rules associated with the first medical billing code.

9. The method of claim 8, wherein the one or more coding rules comprises a first rule that indicates that a particular medical billing code is not to be assigned in the same at least one clinical patient encounter as the first medical billing code or a second rule that indicates that an additional medical billing code is to be assigned in the same at least one clinical patient encounter as the first medical billing code.

10. The method of claim 1, further comprising:

displaying at least a first and a second user-selectable graphical user interface (GUI) element associated with the first medical billing code within the second portion of the window in the user interface;

in response to a selection of the first user-selectable GUI element, displaying information relating to guidance for the first medical billing code; and

in response to a selection of the second user-selectable GUI element, displaying information relating to tips for the first medical billing code.

11. The method of claim 1, further comprising:

scrolling to at least the contiguous portion of the codebook containing the first medical billing code, and

visually distinguishing the first medical billing code from other codes displayed in the at least the contiguous portion of the codebook.

12. At least one non-transitory computer-readable storage medium storing computer-executable instructions that, when executed, perform a method comprising:

applying a natural language understanding engine to a free-form text documenting at least one clinical patient encounter to generate a set of one or more medical billing codes for the at least one clinical patient encounter;

in response to a user'"'"'s selection of a first medical billing code of the generated set of medical billing codes in a user interface configured to allow one or more human users to review and correct the generated set of medical billing codes, the user interface comprising a window having a first portion and a second portion, the first medical billing code being a member of a standardized code set and the generated set of medical billing codes being displayed within the first portion of the window in the user interface;

displaying within the second portion of the window in the user interface, and simultaneously with displaying the generated set of medical billing codes within the first portion of the window in the user interface, at least a contiguous portion of a codebook specifying an order and hierarchy of codes in the standardized code set, the at least a contiguous portion of the codebook including at least the first medical billing code and a second medical billing code, and

indicating a position of the first medical billing code within the order and hierarchy of codes in the standardized code set specified in the displayed at least a contiguous portion of the codebook,

wherein displaying the at least a contiguous portion of the codebook comprises maintaining the order and hierarchy of the codes in the at least a contiguous portion of the codebook as displayed in the second portion of the window in the user interface in response to the user'"'"'s selection of the first medical billing code in the first portion of the window in the user interface;

receiving a user'"'"'s selection of the second medical billing code within the second portion of the window in the user interface; and

in response to the user'"'"'s selection of the second medical billing code within the second portion of the window in the user interface, replacing the first medical billing code in the first portion of the window in the user interface with the second medical billing code selected in the second portion of the window in the user interface,

wherein the receiving and the replacing are performed while the first portion and the second portion are simultaneously displayed within the window.

13. The at least one non-transitory computer-readable storage medium of claim 12, wherein the codebook comprises a data structure representing a tree of medical billing codes, and wherein the position of the first medical billing code selected by the user is a node in the tree.

14. The at least one non-transitory computer-readable storage medium of claim 13, wherein displaying the at least the contiguous portion of the codebook comprises displaying the node corresponding to the first medical billing code selected by the user in context of adjacent nodes in the tree.

15. The at least one non-transitory computer-readable storage medium of claim 12, wherein the method further comprises displaying, within the user interface, one or more coding rules for the first medical billing code selected by the user.

16. The at least one non-transitory computer-readable storage medium of claim 12, wherein the method further comprises allowing the user to navigate the at least a contiguous portion of the codebook to select the second medical billing code as a replacement for the first medical billing code.

17. The at least one non-transitory computer-readable storage medium of claim 16, wherein the method further comprises re-training the natural language understanding engine based at least in part on the user'"'"'s selection of the second medical billing code as the replacement for the first medical billing code.

18. Apparatus comprising:

at least one processor; and

at least one computer-readable storage medium storing processor-executable instructions that, when executed by the at least one processor, perform a method comprising;

applying a natural language understanding engine to a free-form text documenting at least one clinical patient encounter to generate a set of one or more medical billing codes for the at least one clinical patient encounter;

in response to a user'"'"'s selection of a first medical billing code of the generated set of medical billing codes in a user interface configured to allow one or more human users to review and correct the generated set of medical billing codes, the user interface comprising a window having a first portion and a second portion, the first medical billing code being a member of a standardized code set and the generated set of medical billing codes being displayed within the first portion of the window in the user interface;

displaying within the second portion of the window in the user interface, and simultaneously with displaying the generated set of medical billing codes within the first portion of the window in the user interface, at least a contiguous portion of a codebook specifying an order and hierarchy of codes in the standardized code set, the at least a contiguous portion of the codebook including at least the first medical billing code and a second medical billing code, and

indicating a position of the first medical billing code within the order and hierarchy of codes in the standardized code set specified in the displayed at least a contiguous portion of the codebook,

wherein displaying the at least a contiguous portion of the codebook comprises maintaining the order and hierarchy of the codes in the at least a contiguous portion of the codebook as displayed in the second portion of the window in the user interface in response to the user'"'"'s selection of the first medical billing code in the first portion of the window in the user interface;

receiving a user'"'"'s selection of the second medical billing code within the second portion of the window in the user interface; and

in response the user'"'"'s selection of the second medical billing code within the second portion of the window in the user interface, replacing the first medical billing code in the first portion of the window in the user interface with the second medical billing code selected in the second portion of the window in the user interface,

wherein the receiving and the replacing are performed while the first portion and the second portion are simultaneously displayed within the window.

19. The apparatus of claim 18, wherein the codebook comprises a data structure representing a tree of medical billing codes, wherein the position of the first medical billing code selected by the user is a node in the tree.

20. The apparatus of claim 19, wherein displaying the at least the contiguous portion of the codebook comprises displaying the node corresponding to the first medical billing code selected by the user in context of adjacent nodes in the tree.