ICD: Episode 10: Attack of the Codes

From Jane Zhang at the Wall Street Journal:

[M]any doctors in private practice are expected to have to scramble to adapt to the new system’s greater complexity — especially because regulators are aiming for the new system to be fully in place within three years. Many doctors and insurers are lobbying to extend that deadline to about five years or more, and some say the new codes are unnecessary.

“They are not simple changes. All of that is going to cost money” to buy and install new software and train physicians, coders and nurses, says Tom Felger, a family physician in South Bend, Ind. He worries that in the short run, the five doctors in his practice will end up spending more time on paperwork and less time with patients.

CMS estimates additional costs to the medical industry of adopting the new coding system of $1.64 billion over 15 years.

Some medical-industry officials also are concerned that consumers could see, at least initially, an increase in billing errors. That can lead, for example, to overcharging of patients, or an insurer denying payment for a claim because it was submitted with an incorrect code. Some officials also expect an increase in billing fraud and more delays in payments to doctors and consumers.

One partial solution would be to eliminate ridiculous codes from the set:

I can be quite direct with my coding for any hapless soul who gets run over by a spaceship: “accident involving spacecraft injuring other person” (E845.9). Of equally dubious value is code E996, “injury due to war operations by nuclear weapons.”


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