Regarding “
RAC expansion questioned”:
The government does not recognize that there is an inherent under-documentation problem, which leads to under-coding and under-billing. Doctors are not trained to document accurately and completely in medical school. Their primary focus is patient care.
Additionally, the current ICD-9 process is outdated in relation to clinical advances. For example, doctors rightfully complain about documentation of treatment of systolic or diastolic heart failure, which relates to the left ventricle when they are treating both sides of the heart.
The Recovery Audit Contractor process spends very little time focusing on under-payments, and you have to wonder if they are really trying. Although they do have a top 10 list of areas where there is a propensity to under-code, they appear to have done little to find this under-coding.
Drew Swiss
Vice president, finance
Montefiore Medical Center
New York
Comment on today's news or other matters. Submit your comments to the Daily Dialogue at dailydose@modernhealthcare.com. Submissions must include name, title, affiliation, city and state. Modern Healthcare reserves the right to edit all submissions.
