Q&A: Hard versus soft coding

Q. What are the distinctions between hard and soft coding?

A. Coding occurs in two ways: hard coding and soft coding. Hard coding is when codes are assigned by the CDM without human intervention, whereas soft coding is when codes are manually assigned by a coding specialist.

The following two examples illustrated the difference between hard coding and soft.

Example One: First, let’s look at a complete blood count (CBC). A CBC is always the same. While the results of the test may differ from one patient to another, the test itself always looks at the same things from a blood sample. Because a CBC will always be reported with the same code, it is usually hard coded in the CDM.

Example Two: Now let’s look at a fracture as a second example. A fracture would be soft coded because each fracture is different. The fracture could be of any bone, in a different place on each bone, different parts of the bone, could be open or closed, etc. There are different codes for different types of fractures, so this would be soft coded.

For more information, see The Revenue Integrity Manager's Guidebook.

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