- - Wednesday, September 30, 2015

ANALYSIS/OPINION:

“Gray’s Anatomy” illustrated the entire human body with 1,247 engravings when it was published in 1918, but starting today doctors must employ nearly 70,000 codes to document their efforts to heal it. The bureaucrats who crowd the corridors of power like plaque in a clogged artery have dreamed up new hoops for medical professionals to jump through. It’s about keeping up with the complexification of health care.

Americans weary of big government may view health care’s Y2K day with legitimate dread. Warns one medical provider: “Don’t go to the doctor on Oct. 1. It will be a nightmare.” Though the current Classification of Diseases regimen, in place since 1975 with its 14,000 codes has been complicated enough, the 10th iteration, called ICD-10, contains about 68,000 codes. The number of clinical procedure codes jumps from 4,000 to 87,000. The revamped system, mandated by the Centers for Medicare and Medicaid Services, will take doctors and hospital clerks some getting used to, likely resulting in slower billing and payments. Training and equipping staff for the challenge has cost smaller practices thousands of dollars and regional medical centers millions.

Data-driven medicine preceded the advent of Obamacare, but neither the president’s re-engineering of the nation’s health care system nor the move toward the digitizing of patient records has managed to slow the cost of the premiums Americans pay for their health care. The Office of Personnel Management announced Tuesday that health care benefits for federal employees will jump an average of 6.4 percent in 2016, the largest increase since 2011. Requested increases in Obamacare-compliant private insurance plans vary from 0.5 percent in New York City to a stunning 43 percent in South Dakota.

Medicine by the numbers encourages the intrusive gaze of the federal Leviathan. Privacy is out and specificity is in: If a patient has been bitten by a killer whale, there’s a code for that: W56.21. If he is merely struck by one, that’s a different code: W56.22. Such detailed coding arguably does not run afoul of the Hippocratic Oath, which says, “First, do no harm,” except perhaps to frazzled insurance specialists who must comb through reams of codes to locate the correct one. But whether he was bruised or bitten by a descendant of Moby Dick should be of little importance to anyone but the patient and his doctor. A button-pusher in Washington who feels a need to know has a lot of time on his hands.

Some medical researchers do, in fact, argue that increasingly detailed medical data-mining can help them identify previously unknown side effects resulting from combinations of medications. In 2012, the Stanford University School of Medicine developed a computer algorithm that detected in patient records an adverse reaction between a type of antidepressant and a common blood pressure medication that could lead to a fatal heart condition.

The complexity of the new codes might make Americans healthier or it might merely afflict them with unnecessary headaches. Yea or nay, the next medical coding upgrade, ICD-11, is scheduled to launch in 2017. With the human body consisting of 100 trillion cells, the bureaucrats no doubt dream of writing a code for every one of them. By then, mercifully, a lot of us will be enjoying the ultimate privacy of the coffin.


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