David Williams on the travesty of code blending:
Anthem seems to be acting shortsighted. Assuming that Anthem and other payers gain from EHR adoption, they should allow physicians to generate higher revenues through improved documentation. That will encourage adoption. Indeed, studies of the benefits of EHR adoption typically include “increased reimbursement from more accurate evaluation and management coding” among the benefits to physicians.Once EHR adoption has increased to say 75 percent, it may be in Anthem’s interest to blend codes or reduce reimbursement for a given code. But with EHR adoption stuck at around 15-20 percent (at least in smaller practices) that point is nowhere near being reached. Anthem may cost itself more in the long run by taking away an economic incentive for EHR adoption.
Related posts:
- Looking outside of health care
- Odd codes
- Code blue
- New E&M codes
- Get ready for the ICD-10 codes
- "I’m a struggling doctor today"
- Do electronic medical records really reduce malpractice risk?
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This further illustrates how absurd the current system for E&M reimbursement really is. Doctors are smart. When reimbursement rates are flat and overhead expenses are constantly rising, one of the survival tactics is upcoding and finding a way to increase the documentation needed to justify higher codes. A rheumatologist I know has an EMR that spits out 10 pages of documentation for every follow-up visit. I’m sure she bills 99214 or 99215 for routine 15 minute visits. I’m surprised it took this long for some of the payors to get wise to this. Meanwhile the majority of us honest docs continue to sink deeper into the hole year after year.
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