Rise in Coding Levels Due to EHR's Ability to Capture Details, Hospitals, Vendors Say

Hospital and vendor associations attributed the rise in coding levels being billed for some Medicare services to the fact that electronic health records allow physicians to capture more detailed information than before, and to the increase in emergency department use, during a May 3 "listening session," held by CMS and the Office of the National Coordinator of Health Information Technology.

CMS and the ONC held the "listening session" to discuss the increase in coding levels billed for some Medicare services via EHRs. Leaders from hospital and vendor associations, who attended the session, addressed the concern that the rise in coding levels is fraudulent.  

According to Benjamin Chu, chairman of the American Hospital Association, there is data to prove that the severity of illness being treated in emergency departments is real, and that the higher levels of codes being billed is justified. However, national guidelines need to be developed to standardize coding practices, as "the variability is too great," he said.

Bruce Siegel, president and CEO of the National Association of Public Hospitals and Health Systems, defended the use of EHRs and said that the rise in coding levels is an expected result of the fact that EHRs allow physicians to capture data that could not be captured before.

To ensure that coding via EHRs remains ethical, it is essential to develop industry-wide guidelines for coding, said Sue Bowman, senior director, coding policy and compliance at American Health Information Management Association. Also EHR vendors and healthcare providers should share accountability for ensuring compliant documentation and coding practices, she said.

More Articles on Coding Issues:

7 Steps to Ease the Transition to ICD-10 for Physicians, Specialists and Groups
10 Most Common Medicare Risk Adjustment Coding Errors
3 Steps Hospitals Must Take With Their Coding Compliance Policies

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