As if things weren’t complicated enough for healthcare in this country, they’re about to get worse. And if small medical practices aren’t properly prepared, the changes could increase wait times around the country.
So if things seem a bit tense in your doctor’s office soon, this new behind-the-scenes red tape is likely to blame.
Oct. 1st is the day when the nation’s physicians and hospitals must start using a massive new coding system to describe your visit on insurance claims so they get paid.
Today, U.S. health providers use a system of roughly 14,000 codes to designate a diagnosis, for reimbursement purposes and in medical databases. To get more precise, the updated system has about 68,000 codes, essentially an expanded dictionary to capture more of the details from a patient’s chart.
How precise? Get nipped feeding a bird, and the codes can distinguish if it was a goose or a parrot. Have a bike accident with one of those horse-drawn tourist carriages? Yep, there’s a code for that, too.
“ICD-10 has the potential to create many improvements in our public health system,” Andy Slavitt, acting administrator of the federal program Centers for Medicare and Medicaid Services (CMS), told health providers in a recent conference call.
But with the deadline approaching fast, he urged providers to make sure their offices are ready, and that they take advantage of Medicare-offered testing that lets whoever handles their billing file practice claims.
Why change things at all? Some say that with medical care gone digital, more precise diagnosis codes could allow researchers, even doctors themselves, to get a closer look at trends in one office or the entire country, Wergin said. A search of an office’s data could show how, say, all pregnant women with a urinary tract infection in the third trimester fared.
CMS can’t estimate how many health providers are ready for the switch but officials think most large practices and hospitals are, so the agency is intensifying its focus on smaller doctors’ offices, said Dr. Mandy Cohen, CMS’ chief of staff.
Private insurers told Congress months ago that they, too, are focusing on small providers.
Responding to concerns from doctors, CMS has promised some flexibility in the first year of assessing claims, if the coding is close.
“There will be bumps and challenges,” CMS’ Slavitt said, as he appointed an ombudsman to be the contact for health providers who experience them.
The Associated Press contributed to this article
Pat R says
“Red tape” was responsible for my losing a Nurse Practitioner who had just begun her practice. She was really good and took time to find out what was going on in my life that might lead to cause of issue…not just treating symptoms. Requirements for Medicare filing were so stringent (she had five Medicare patients), that her office help was spending more time on that than patient records, appointments, etc. She could not afford an insurance specialist in a newly established practice. So she stopped taking Medicare patients.
As of Oct 1, it seems doctors will be spending more time to meet insurance/Medicare standards (so someone across the country can see stats) than to meet patients’ needs.
As someone else said yesterday, when did we vote for representatives to tell us how we should/can live, what things we can buy, what we should eat or not eat/drink, whether we could get medical procedure or not, and restrict every aspect of lives with regulations? WE DIDN’T!
Don P.Simons says
Let’s all pray that we get rid of all the Democrat/Liberal/Socialists and get conservatives down there! The narcissistic rogue dictator has been a dangerous, treasonous, Soros-puppet all along and both need a stretch in Leavenworth Federal Prison. I exercise the First Amendment frequently and unless we get some wiser heads in the legislature – you can kiss that goodbye very soon! Where’s Mischele? That person with him has long hair hiding her face…looks suspicious to many! They have no doubt assumed the same relationship as Slick and his moll!