Thursday, December 06, 2007
BLOGSCAN - Running Afoul of E&M Coding Rules
On the Covert Rationing Blog, DrRich continued his discussion of the irrationality of Medicare's E&M coding, that is, the bizarre and complex rules the US Medicare system uses to control its reimbursement for "evaluation and management services" that physicians provide patients. In turn, "evalation and management" means everything physicians do for patients: interviewing, examining, orderding tests for, diagnosing, counseling, prescribing treatments, etc for them. The regulations are so complex that it is virtually impossible to fulfill them. This, per DrRich, is a perfect example of a "regulatory speed trap." Again, while Medicare makes it so difficult, if not impossible, to bill correctly for office visits, it pays lavishly for procedures. Is it any wonder primary care is going out of business, and all physicians who mainly provide cognitive services (e.g., services as listed above, but not procedures or surgery) are seriously threatened?