The Medicare Payment Advisory Commission officially asked HHS to create a national guideline for coding all emergency department visits by 2022.
Currently hospitals make their own guidelines that can be based on resources from the American Hospital Association or American College of Emergency Physicians, but commission members were worried about a lack of consistency.
"The potential benefits of national guidelines include that payments could accurately reflect hospital resources used to provide ED care, hospitals would have a clear set of rules for coding ED visits and CMS would have a firm foundation for assessing and auditing hospital coding practices," commission staff member Dan Zabinski said during the meeting Thursday in Washington, D.C.
The commission, which approved the recommendation unanimously, cited rampant problems with coding in the Outpatient Prospective Payment System as the reason for the recommendation.
Scrutiny of ED visits and spending has increased as the healthcare industry shifts towards more value-based care. A report released in February from Premier found that about 30% of ED visits in 2017 for patients that suffer chronic conditions were possibly preventable or could be treated in another setting.
