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Procedure vs Condition

Please raise your hand if you believe we will be able to move from billing at the CPT code level to billing at the ICD-9 level. While I personally believe that both systems impose an artifical taxonomy upon provider and patient, we ought to be able to bill for treating the condition.

My plumber doesn't bill me for each turn of the pipe wrench. He bills by the hour. I reckon I'd rather have an hourly rate from my doc, rather than an indecipherable EOB from an insurance company.

My building contractor bills me by the job. He gives me an estimate +/- a small percentage. I can accept that. He knows what materials, time and labor are going into the job. Doesn't my doc?

Maybe we, in the provider world, balk at ICD-9 billing because we really don't know how a given patient will respond to a given treatment. That's OK. Just tell me, the patient, what the risk of failure is. I'll decide to whether or not to risk my dollars on your proposed cure.

ICD-9 billing would require the collection of real outcome results. We have the ability to do this. Perhaps, we lack the will.

There are a few specialty groups who bill at the ICD-9 level, but they are rare exceptions.

What would it take to get a critical mass of providers to bill at the ICD-9 level?

I'd appreciate any feedback.

Respectfully,

Ben

Posted by: benjamin.atkinson@...   Posted on: 08/06/07 You are currently: a Guest | Members login | Terms of Use

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