300 Automatic E&M Coders in EMRs

Automated coding has been a popular topic ever since I first started blogging about EMR software 7.5 years ago. In fact, back then the discussion was usually around how great automated E&M coding was going to be for a doctor. Everything from increased coding levels to firing your billing person were talked about. However, I think the reality is that we’ve seen something much different happen.

Many people hate the automatic E&M coding in EMR because it is wrong so often. If they can’t trust it to do the right coding, then what savings are they really getting from the automation? To put it in the words above, they still need their billing person. Plus, the idea of coding higher is great because it can mean more revenue. However, it also can be seen as upcoding and give you plenty of grief as well. “My EMR told me to do it” isn’t a great defense for over coding a visit.

As I think about these automatic E&M coding engines, it makes me wonder why we don’t have someone who’s created a really great coding engine like we have with drug databases. Since there isn’t that means that every one of the 300+ EMR vendors has their own coding engine. That means we have 300 different E&M coding engines all with different ways to approach coding.

I imagine many would argue the reason the E&M coding engine needs to be part of the EMR is because it needs deep integration with the EMR data. This is true, but the same is going to be true as we enter the world of smart EMR software with deep CDS applications. EMRs aren’t going to build all of these pieces. They’re going to have to enable entrepreneurs to build some really cool stuff on top of their EMR. Why not do the same with E&M coding?

Although, it’s also worth consider, is medical billing one area where human touch is better than automated coding?