Solventum™ Coding and Reimbursement System Plus (CRS+)

Keeping up with the ever-changing rules and regulations of health care is difficult. Understanding and managing regulatory updates, classification guidelines, payment methodologies and the increasing volume of data in the EHR are formidable challenges.

In addition, computer-assisted coding (CAC), natural language processing (NLP), and the increased specificity required for ICD-10 have also become part of the coding landscape, adding to the complexity facing HIM professionals. These technologies have become key factors in the decision-making processes that can affect every level of a health care organization.

Decisions made to improve quality throughout the hospital are based largely on data supplied by the HIM department. New technology and changing regulations have not altered the fact that medical record coding provides the basic foundation of every organization’s data. Today most hospitals in the U.S. depend on the functionality and reliability of Solventum’s coding system to build that foundation.

The Coding and Reimbursement System Plus (CRS+) is a sophisticated yet easy-to-use suite of tools that supports coders with powerful coding logic, giving them the confidence of knowing their judgments are backed by Solventum experts and nosologists.

CRS+ is designed to provide appropriate support for novice to expert level coders. The system guides the coder through the coding process, covering the full range of situations from complex oncology treatments to repetitive or typical patient encounters. At any time, the coder can view the comprehensive selection of online references to clarify the situation and make appropriate decisions.

With CRS+, coders have a flexible tool that supports greater productivity— allowing direct coding for routine procedures, yet employing consistent rules and expert logic to help address unique or complex coding issues. For all of these reasons, Solventum uses this flagship coding and reimbursement solution as the coding engine for the Solventum™ 360 Encompass™ System.

Solventum CRS+ adds detailed reporting on your coded data via powerful, yet simple-to-use tools. With it, you can:

• Measure coding impact on case mix index
• Detect productivity issues by coder and case type
• Gauge ICD-10 impact on coders, allowing for training adjustments and workload realignment
• Report on and analyze the impact of new state payment methodologies (e.g., Solventum APR DRGs)
• Run ICD-10 analysis reports to see reimbursement impact

For over 30 years, Solventum has been a leader in coding and reimbursement for U.S. health care organizations, and has spent over a decade working with international clients to develop and implement ICD-10-based coding.

Let our expertise help you stay compliant and efficient. With Solventum CRS+, your coders can:

• Access an integrated ICD-10-CM and ICD-10-PCS code book from within the coding software
• Translate codes on claims
• Identify specificity gaps in the documentation that can impact ICD-10
• Perform improved ICD-10-PCS coding using a dynamic code builder (patent pending) that combines logic and table-based coding approaches
• Receive inpatient facility reimbursement values and automatically update Solventum CRS+ without manual data entry

• Solventum™ Codefinder™ Software—Helps you manage the complex rules and terminology found in mandated rules, principles and guidelines.
  
  
• Solventum™ DRGfinder™ Software—Provides accurate MS-DRG grouping capabilities for Medicare and other payers. DRGs are automatically computed to help improve coder productivity, and multiple DRGs can be calculated at the same time. Also indicates whether a code is an MCC or a CC.
  
  
• Solventum™ HCPCS/CPTfinder Software—Helps you determine the standard five-digit code for outpatient procedures and services.
  
  
• Solventum™ Advanced Analyzer Software—Helps coders pick up the specificity in clinical documentation and obtain the most precise and comprehensive set of codes; also provides suggestions for frequently missed codes that impact MS-DRG and Solventum APR DRG assignment, as well as severity of illness and risk of mortality, important quality metrics.
  
  
• Solventum™ Reimbursement Calculation Software—Calculates instantly the reimbursement based on formulas that use appropriate national and hospital-specific variables. It includes Medicare inpatient and outpatient formulas and accommodates various other pay.
  
  
• Solventum™ APCfinder™ Software (optional)—Calculates Ambulatory Payment Classifications (APCs) incorporating outpatient prospective payment system regulations for editing, grouping and reimbursement. It also includes estimated payment for APCs, fee schedules and beneficiary co-payments, and provides APC grouping and reimbursement capabilities for Medicare as well as OCE, NCCI and proprietary Solventum edits.
  
  
• Solventum™ 360 Encompass™ System (optional)—Is the only computer-assisted coding and clinical documentation improvement (CDI) solution fully integrated with the Solventum CRS+. It was developed to help coders realize the significant productivity gains from natural language processing (NLP) technology, without sacrificing the ability to understand the expert logic behind each computer-suggested code.

Solventum CRS+ can be interfaced and integrated with:

• Solventum™ Health Record Management (HRM) Software—Provides a comprehensive data abstracting and management tool for collecting and reporting on all inpatient coded, interfaced, abstracted, special study and reimbursement data.
  
  
• Solventum™ Ambulatory Revenue Management Software (ARMS)—Provides a central repository for and view into all three major data sources that impact outpatient revenue: HIM and chargemaster coded data, UB-04 codes, and remittance advice (RA) codes.
  
  
• Solventum™ Audit Expert System—Reviews 100 percent of inpatient records for compliance errors at the point of coding. Includes retrospective auditing for inpatient and outpatient.
  
  
• Solventum™ Clinical Abstracting Software – Care Planning Manager (CPM) Module—Integrates case management, social services, resource management and discharge planning in one comprehensive solution.
  
  
• HIS vendors and EHR systems available in the market today that have a software interface license agreement with Solventum.