The Pathologists Report
I blogged about an uninsured client I have here on December 7, and cross posted at SignalHealth. It was picked up by the Kevin MD web log where a pride of irate MDs, set upon me, daring me to stand up to their criticism, mostly cherry picking my rhetoric and complaining that, HOW DARE I QUESTION THE DOCTOR"S CHARGES!! THE DOCTOR MUST BE PAID!!!
No one mentioned the anesthesiologist that wasn't there but charged as though he were, the clearly up-coded ED Doc, the unbillable supplies, the inflated room costs.
No, what sparked their ire mostly was that I was not sure I would recommend paying the Pathologist what he was said he should be paid, according to his coding.
The specimen is a miscarriage; the billing was coded as high as a pathologist could: gross and microscopic examination - as high as for a full mastectomy with nodes, for instance, or a colon resection, or an extensive soft tissue dissection. They shrieked that I didn't have all the records yet, so I shouldn't have written about it at all.
Well, now I have the records. The narrative is only of the gross examination. A total of five slides were made of both specimens (two of the fetus and three of the placenta), noted only as "representative specimens." There is no microscopic narrative. So I can't even tell that the pathologist looked at the slides - only that he took them. Actually, I can't even tell that without obtaining another record.
So tell me, Doctors, how would you code this? You think this is a level VI? The charge difference between a simple gross examination is about $400. The correct designation lies somewhere in between, and probably closer to a Level III. If you don't want to call this fraudulent (a word that really got their dander up), what is it?
Cross posted at http://www.signalhealth.com/node/550
No one mentioned the anesthesiologist that wasn't there but charged as though he were, the clearly up-coded ED Doc, the unbillable supplies, the inflated room costs.
No, what sparked their ire mostly was that I was not sure I would recommend paying the Pathologist what he was said he should be paid, according to his coding.
The specimen is a miscarriage; the billing was coded as high as a pathologist could: gross and microscopic examination - as high as for a full mastectomy with nodes, for instance, or a colon resection, or an extensive soft tissue dissection. They shrieked that I didn't have all the records yet, so I shouldn't have written about it at all.
Well, now I have the records. The narrative is only of the gross examination. A total of five slides were made of both specimens (two of the fetus and three of the placenta), noted only as "representative specimens." There is no microscopic narrative. So I can't even tell that the pathologist looked at the slides - only that he took them. Actually, I can't even tell that without obtaining another record.
So tell me, Doctors, how would you code this? You think this is a level VI? The charge difference between a simple gross examination is about $400. The correct designation lies somewhere in between, and probably closer to a Level III. If you don't want to call this fraudulent (a word that really got their dander up), what is it?
Cross posted at http://www.signalhealth.com/node/550
posted by
at 12:17 PM
2 Comments:
I support you, Lin--those doctors have no idea what it's like to be an uninsured person in America. (I don't either, but I see them and try to care for them at our free clinics.)
Interresting thoughts
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