Will We Need Billing Codes Once We Have Nice Structured EHR Clinical Data?

Posted on July 27, 2015 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I had a really fascinating discussion recently with @AlexHBurgess where we discussed the role of billing codes in an EHR today and also the future of billing codes as EHR notes get much better and more granular. This is particularly interesting to me as I’m at the HealthPort HIM Summit the next couple days.

Here’s the question that started the conversation:

This was @AlexHBurgess’s response:

And then I replied:

The last question is something worth chewing on. I’ll have to ask it of a few HIM managers the next couple days. I think the simple answer is that we’ll still likely need billing codes. I don’t think that our payers are forward thinking enough or at least progressive enough to try and push forward a non-billing code reimbursement system. It’s pretty interesting to think about though.

The second reason I don’t think it’s likely to happen is that the data in the EHR will likely not be good enough. Although, if the data in the EHR (and not just the billing codes that were selected) were how you got paid, then you’d see a dramatic improvement in the quality of the EHR data. So, maybe it’s not a bad idea after all. I’m pretty sure my medical billing friends would scoff at this idea as they think about the number of times they’ve had to have doctors correct something in the paper chart to make sure the billing was ok.

Long story short, I think that you could theoretically get rid of medical billing codes and just use EHR data for reimbursement. However, in practice I don’t really see this ever becoming a reality. At least not in the short to medium term.