In fact, make it at least TEN TIMES more complicated.
Take for instance, our current coding scheme for classifying diseases called ICD-9 codes. (ICD-9 stands for the ninth revision of the "International Statistical Classification of Diseases and Related Health Problems"). These codes are required on every insurance claim to justify a payout on behalf of the patient. If a procedure code does not match the appropriate disease code on an insurance claim.... BOOOIIINNNNGGGG, the insurance claim is denied, and Medicare and the insurers save money.
These codes are a picture of clarity. I mean, let's hear it for 427.0! Oh, baby, I can get my head around that code, can't you?
What, you don't know what that means?
Why, "SUPRAVENTRICULAR TACHYCARDIA!" I mean, I knew that, why didn't YOU? Sheesh! Any REAL doctor knows THAT code. After all, it makes so much sense, right? And 427.1? Why heck, any well-respected doctor should immediately be able to intuit that the code is used to denote VENTRICULAR TACHYCARDIA! What, you're lost? How can that be? I mean, it's so CLEAR!
And on and on it goes, some 17,000 codes for 17,000 kinds of ailments.
But for bureaucrats, 17,000 codes are not enough. They want MORE! Many, many more. And so, ladies and gentlemen, they have announce the introduction of...
... drum roll, please ...
Yep! Welcome to the world of the soon-to-be-enacted NEW AND IMPROVED 10th revision of the ICD codes with a staggering 155,000 codes to be implemented on 1 October, 2011!
Imagine, 290 codes just for diabetes! Yeeeee haaaaa! Diabetes with foot ulcers on the right foot gets one code, diabetes with foot ulcers on the left foot gets another code, diabetes with foot ulcers on both feet, but not involving the shins gets another code... I mean, a new code for every nuance of disease! You get the drift! Isn't this SPECIAL? Just think of the COST SAVINGS those clever bureaucrats have found!
Someone actually looked at the cost to implement this "cost-saving" coding scheme for doctors, and here's what they found:
The total estimated cost for a 10-physician practice to move to ICD-10 would be more than $285,000. These expenses include:Heck, I'm on board, aren't you? Especially since most stand-alone physician practices can't even afford yesterday's electronic medical record that will be obsolete before it's installed. Look, for instance, at this comparison of a family practice doctor's current 2-page "superbill" that will expand to a 9-page "superbill" using the newly proposed coding scheme.
- Training expenditures are estimated to total $4,745
- New claim form (superbill) software $9,990
- Business process analysis $12,000
- Practice management and billing system software upgrades $15,000
- Increases in claim inquiries and reduction in cash flow of $65,000
- Increased documentation costs $178,500
For a small, three-physician practice, the total cost to implement ICD-10 is estimated to be $83,290, for a large, 100-physician practice the estimated costs to implement ICD-10 is more than $2.7 million.
But lets not fool ourselves. This is exactly what the government wants: more complexity and bureaucracy in the name of lower "costs." One only needs to see how the government calculated their "cost" savings for justifying the massive increase in complexity to the coding scheme:
Benefit Assumption 1: Based on the data provided in a recent AHIP report the percentage of pended claims was assumed to be 14% of total claims.Yep, there you have it. CMS has justified the most massive expansion of electronic coding so "providers" and massive health systems can get their money without having to pick up the phone.
Benefit Assumption 2: Pended claims will be reduced by 0.28% (minimum) to 0.7% (maximum). Using the research and interviews, it was assumed that the pended claim percentage, currently 14% (Benefit Assumption 1), would be reduced through standardization.
Benefit Assumption 3: Reduced manual intervention will reduce the costs for providers by $3.20 per call and for plans by $1.60 per call. Manual intervention is required to resolve pended claims and both Healthcare providers and Health Plans incur these operational costs.
But just in case doctors aren't too keen about the complexity and expense of electronic medical records for their office due to the carefully-planned obsolescence of new systems, doctors are also being forced to e-prescribe next year in order to gain 2% more of their Medicare payment they were due.
My friends, soon we will see that the Beast has won. Independent stand-alone physician practices will soon be a thing of the past, brought to their knees by overbearing electronic billing and prescribing regulatory requirements. In their place will be physician-employees of major health care systems that are capable of purchasing computers, personnel and electronic reimbursement software upgrades annually, while they are subject to data-mining algorithms to assure "efficiencies" and "effectiveness" and "quality," all in the name of cost-savings.
Too bad its the patients who will ultimately have to bear the costs for this.