Swine Flu Coding and Other Interesting News

Buried, which seems to be my status since August.  Some interesting items:

  •  An official study indicating that the use of an EHR can improve primary care and supports the Medical Home model.  This is something our clients have known for 25 years.
  •  Again, the MGMA tells us that “Medical practice revenues fall.”  At first, I was ready to write a long diatribe about how the MGMA is getting wrong, but I see that pediatricians had by far the biggest increase in revenue after costs from 2007 -> 2008 (9%!).  This is much more in line with the data we see at PCC.  Whew.
  • Oxford has sent out the scary “you can’t be a boutique practice and contract with us” message.  It’s too bad that my conversations with “boutique” (such a bad word) practices involving Oxford always concludes with, “…and we can finally stop dealing with Oxford and United!” [The Verden Group alerted me to this one.]

Finally, here’s the big one today.  What is the purpose of the new Swine Flu admin code?  It makes no sense to me.  Pediatricians are finally getting their heads around admin codes vs. product codes and the AMA races in to create a new product-specific admin code?

It used to be important to distinguish how the vaccine was given – oral/intranasal vs. injection.  Now, all that is tossed out just for this one strain of the flu.  What’s going to happen when some avian strain hits?  Or Swine Flu II?  Keep adding new admin codes?

I am upset about this because we have two new sets of codes, admin and product, to record the swine flu, doubling the number of codes that will be rejected by the payers when the time comes.  Note that I said, “will.”  But we gain nothing, as far as I can tell, in terms of data tracking…I can’t tell how the immunization is given (fat luck comparing efficacies).  I don’t know if counseling was given or if the recipient us under 9yo.

Someone smarter than I am, and that’s most of you, tell me what I’m missing.

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