New Coding dilemma
There continues to be ongoing talk and increasing resistance to a proposed transition from our current coding scheme called the ICD-9 to a new proposed system called ICD-10.
The transition is scheduled to be implemented by 2009. If this happens, it would involve increasing the number of codes we currently use from 24,000 to about 207,000.
This increase would cause a significant additional burden to physicians and their offices. It would also allow insurance companies to find new ways to impede their payment of claims. It would allow these companies to require different codes for the same overall condition and thereby placing increasing burdens on our offices.
An example is a patient with a simple sprained ankle. Currently there is a simple code that covers this injury. With the new system, it would have the options of specifying right vs. left, and the degree of swelling and pain. One insurance company may require all of these things to be listed whereas others may not. If you do not fill out everything they want, they will deny or withhold payment.
Physicians should not have to provide this specific of information to the insurance company. It does not affect the overall degree of the office visit. It just allows the insurances more ways to deny payments.
This is a very simple example and you can just imagine when it comes to complex problems difficult this problem could become.
We do not need to allow the medical coding to follow the same path as our tax codes have followed.
When are politicians going to learn??
The transition is scheduled to be implemented by 2009. If this happens, it would involve increasing the number of codes we currently use from 24,000 to about 207,000.
This increase would cause a significant additional burden to physicians and their offices. It would also allow insurance companies to find new ways to impede their payment of claims. It would allow these companies to require different codes for the same overall condition and thereby placing increasing burdens on our offices.
An example is a patient with a simple sprained ankle. Currently there is a simple code that covers this injury. With the new system, it would have the options of specifying right vs. left, and the degree of swelling and pain. One insurance company may require all of these things to be listed whereas others may not. If you do not fill out everything they want, they will deny or withhold payment.
Physicians should not have to provide this specific of information to the insurance company. It does not affect the overall degree of the office visit. It just allows the insurances more ways to deny payments.
This is a very simple example and you can just imagine when it comes to complex problems difficult this problem could become.
We do not need to allow the medical coding to follow the same path as our tax codes have followed.
When are politicians going to learn??
posted by Anonymous at 6:20 AM
3 Comments:
Hey, we finally agree on something! Question is - at this point, what do we do to stop it? It is like a runaway train and the bigger problem is that the average person has no idea what a quagmire that coding has become. Not only are there diagnosis codes, but also procedure codes and you're definitely right - I believe as well that insurance companies use these as a way to keep from making payments.
I would like to know what -if any- ideas that people have on revamping this system we currently use. It is time-consuming, ineffective and I for one would like to see it go by the wayside.
I request you read the 12th comment on the topic of "Worthless Meetings". Unfortunately I was not able to read your daily blog until this evening and would like your response to my comment on this topic. I hope others will see this commentary as well because it is important and might expose to the public a much needed message.
anonymous,
The comments you made were exactly on target. They may certainly feel intimidated, but that is no excuse for shirking their responsibility.
In addition, the Commissioners should be accountable as well for who they appoint to these positions.
Qualifications, experience, and knowledge should be requirements for appointing Board Members to a multi-million dollar organization.
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