The government is creating the environment for coding errors by promoting extreme complexity. Look at the proliferation of codes in ICD-10; this will do nothing to improve health care, but it will obviously create the opportunity for the government to threaten providers and take money back. Now, if you work in the compliance industry or in government, that’s a good thing for you personally in the short run, but this parasitic activity will eventually kill the host, aka, healthcare providers.
The answer is not better compliance teams for providers. Providers really need to critically look at either they should accept Federal health programs in the first place. And if they do accept Medicare et al, providers should take a critical approach that only accepts patients with very low coding risk and acceptable profit margins (which could mean very few or no Medicare patients).
The trend toward complexity in medical coding is all too real. The response that you suggest has been adopted by some providers but, by definition, cannot be embraced by more than a few or the health care system starts to implode. So far, the trend under Obamacare is of rising doctor compensation, probably because doctors are grabbing as much gold while they still can.
In California they made big changes to the billing codes about 7-10 years ago. It was impossible to tell what the correct codes should be in some instances. Billing agents had to call the state to find out the right codes. And when they called the state, the state was vague and nonresponsive.
It’s all a big game out there. The government doesn’t like spending money on health care, and when it has a lock on it, the stuff is really going to hit the fan.