ICD 10: anticipated an unanticipated consequences of government mandate
Craig M. Wax DO
October 1, 2015 ICD 10 was mandated by the US federal government department of health and human services (HHS). Their stated goal was to improve data collection and research but the consequences, both anticipated and unanticipated, are becoming clear.
Even before day one of implementation, it has been costly in time, money, and work that needed to be redone. Laboratories and other testing facilities call constantly for new codes in ICD 10 before they will do testing on patients, even though the codes are for billing, insurance, and government bureaucracy purposes only. Patients are being turned away from labs and radiology facilities.
Patient history and examination time is now squandered due to electronic health records EHR and chasing new ICD 10 codes. Insurance companies have required “referrals” since about 2000. Originally, referrals meant when a doctor recommends another doctor or facility and gave them an RX script to use that service. Initially, referrals become a paperwork game where a form was filled out for insurance to recognize the service. The insurance companies even said that the referral wasn’t even a guarantee of payment, so what was it for? Since, it has become an electronic online process with an Internet company owned by insurance companies called Navinet. Now, our staffs have to enter all the referring information and diagnosis codes in order for the insurance process to even begin or the patient be scheduled for the test at all. Now with ICD 10, the systems are not recognizing the codes and not allowing these insurance mandated processes that waste our time to even carry to completion so a patient can get the study they need.
Due to all these exogenous process mandates, patient care suffers. Less patient physician contact time is possible in the exam rooms. Physicians, and their staff, are designated data gatherers for insurance and government whims. Time and money are wasted by all parties that are gathering the mandated data. The data will be aggregated by government and pirated, patients extorted, and data lost, with no party responsible except for the physicians who entered it. Patients get frustrated because care is denied due to insurance not reimbursing for procedures due to flawed, complicated processes mandated by the insurance industry. All individual patients’ and physicians’ privacy, security, and care is lost.
This is yet another government, and their industrial cronies, scheme to command the data and make money for themselves, while patients go without care and physicians suffer the unanticipated consequences. The medical community and its physicians must stop abiding by all the nonsense and get back to patient care with direct primary care; putting the patient first and responsible for their care.
Best wishes for good health,
Craig M. Wax, DO
Host of Your Health Matters
Rowan Radio 89.7 WGLS FM