I was on another list serve this am and someone asked how to code for immunizations. Having worked on doing this for the past 6 years, I was more than happy to help out. But, the larger issue here is why an obviously intelligent person cannot figure out how to get reimbursed for giving immunizations.
Medical coding is a game played between the doctor's office and the insurance company. The doctor's office wants to get paid for the service rendered and the insurance company wants to make sure the appropriate service was done. Initially, it kind of made sense to set things up this way. But now there are over 10,000 codes with millions of possible combinations, which has spawned multiple industries with coding classes and coding experts to "help doctors maximize their profits" and numerous software programs to "look for irregularities and deny claims." The codes also change every few years just to make it even more confusing. It is actually so complex and convoluted that most doctors do not understand how to do it even though it represents the way most of us get paid.
And yet, as we discuss how to save money in the medical system, this area remains the elephant in the room--an area of huge financial waste, an area of huge frustration for docs, and an area that does absolutely nothing to enhance the doctor-patient relationship. I know I long for the day I no longer have to help others figure out how to get paid for providing essential services.
John
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