Re:Thoughts on Insurance
by dragonwriter on Thursday June 29, 2017 @04:20PM
(#14666559)
> ICD codes are what's used for public health statistics, whereas CPT codes are used for billing.
Very roughly (it's more complex, but not worth more detail here) ICD-10-CM diagnosis codes are used for billing, and ICD-10-PCS procedure codes are used for institutional billing, as well. HCPCS (which include CPT) procedure codes are used for professional services billing.
Re:Thoughts on Insurance
by chimeracoder on Thursday June 29, 2017 @04:33PM
(#14666641)
> Very roughly (it's more complex, but not worth more detail here) ICD-10-CM diagnosis codes are used for billing, and ICD-10-PCS procedure codes are used for institutional billing, as well. HCPCS (which include CPT) procedure codes are used for professional services billing.
Yeah, this is the rabbit hole I was hoping not to have to go down. :)
All I wanted to illustrate was that the desire for public health statistics could be satisfied without requiring a move to the flaws of the current billing model - they're different systems.
(And historically, the move to the current billing model came about primarily for reasons other than a desire for public health statistics).
We actually don't really get those out of the medical billing situation either. ICD codes are what's used for public health statistics, whereas CPT codes are used for billing. I mean, we could use that data for public health statistics, but we don't really. And we could still have gotten it without the rest of the sacrifices that have come along with the code-based payment systems that have turned practices into offices for billing, with a marginal medical practice on the side.
Unfortunately, as you said, because Medicare is 40% of the payer market, once they switched to this model, it created the vicious cycle we're now in.