Surgeons to Stop and Code Every 10 Minutes


There is a Medicare proposal to have surgeons use new billing codes to track their work in 10-minute increments during global surgical “packages”.  You can read more here but this would be the outcome:

In a survey of some 7000 surgeons conducted by 23 medical societies, 37% estimated that compliance would cost them between $25,000 and $100,000 in terms of modifying electronic health record (EHR) and billing systems, hiring scribes to document all 10-minute segments of work during a global period, seeing fewer patients, and other changes. Another 15% put the anticipated cost at over $100,000.

Isn’t it time we physicians work together to stop the madness?

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  10 comments for “Surgeons to Stop and Code Every 10 Minutes

  1. DrPhil
    September 22, 2016 at 9:26 am

    Wy not just have a GoPro on your head and then have someone bill everything….

  2. September 19, 2016 at 10:58 am

    It will not stop, because the voices of the surgical societies will be ignored – they will be mocked. In every great revolution, the Enlightened Wise must not only correct the masses, but punish them a little for their impertinence.

    Assuming that doctor-work is no different than Indonesian-factory-clothing-work, the animate thing in the assembly line – the “employee,” as it were – will try to do the least amount of work and collect the most amount of money. They must be watched!

    There is no magic mojo around sewing polyester ready-to-wear polo shirts. It is an orderly, efficient process that can be described in discrete stages. Those stages are executed properly, and each employee is paid a certain amount for their miserable little contribution to the finished product. There will be error – there will be waste. As long as it does not rise to the level of profitability, it is minimized but tolerated.

    Surgeons, on the other hand, are given free rein to do – whatever they want! – during a surgery. But surgery seems to be rather simple:

    Open the scalp.
    Open the skull.
    Take out the brain tumor.
    Close the skull.
    Close the scalp.

    Almost all of these steps are very perfunctory. Why should a neurosurgeon bill for opening and closing the scalp, for God’s sake? Or using a cerebellar retractor? Perhaps using Google Glasses, anyone can do this work – really, when it goes exactly right, it’s pretty simple.

    This is the near-psychotic delusion that brought Red China the Great Leap Forward, which killed perhaps sixty MILLION Chinese from bad ideas; or the Cultural Revolution, quite a bit fewer dead but still in the millions.

    How many psychiatrists does it take to change a light bulb? Only one, but the light bulb has to be willing to change. But if the light bulb should imagine it’s burning brightly in a room that is in fact pitch-black, there is no hope of change.

  3. drhockey
    September 19, 2016 at 9:10 am

    GXXX5 – P.S. These 10-minute interval insurance billings are even WORSE than I imagined they would be!

  4. drhockey
    September 19, 2016 at 9:09 am

    GXXX5 – finally did retire and am so happy, but feel the pain of my colleagues.

  5. drhockey
    September 19, 2016 at 9:08 am

    GXXX5 – Also, did want to deal with MACRA and whatever other bs thrown at us

  6. drhockey
    September 19, 2016 at 9:06 am

    GXXX5 – I hoped to retire before ICD-10 began

  7. drhockey
    September 19, 2016 at 9:05 am

    GXXX5 – I wanted to retire by the end of Sept. 2015, but could not get my act together in time

  8. drhockey
    September 19, 2016 at 9:04 am

    GXXX6 – This is not a joke. I read the linked article on Medscape.

  9. Thomas Guastavino
    September 19, 2016 at 6:41 am

    This is a joke, right? If not, what is the surgical societies position on this? When is enough going to be enough?

  10. September 19, 2016 at 6:20 am

    The other concern is it could cause for longer, more risky procedures if surgeons are encouraged to bill more ten minute codes

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