This has actually come up for us in a big way recently - we're a small practice and the largest Medicare Advantage player in our area (Humana) just terminated our contract with them with no notice and no explanation to our patients, all of whom are elderly and many of whom have been with us for years. They left our commercial Humana contract intact, cancelled only the Medicare HMO one. We were pretty stunned. They sent our patients letters saying we were no longer in network and even sent them new Humana cards with the name of a new doctor on them... down at the local Jencare clinic.
We called, rather irate. Turns out the reason we were termed is that based on our coding (we had never used more than 4 codes before, either) our patients were "not as complex as they should be" and Medicare is apparently reimbursing Medicare HMO's at least partially based on the number of and complexity of the codes submitted. They didn't want us to undercode because it was costing them money. We could have waved goodbye to Humana but didn't for 2 reasons: 1. we like these 300 or so old folks and it's not their fault and 2. Medicare is going to start paying everyone this way before too long and we may as well get with the program.
So, we are not in the process of finding a new claims solution that allows us to submit 8 codes.
So, in short, being able to submit 8 Dx codes is not a big issue - yet - unless you see a lot of Medicare patients. But I anticipate commercial payors to follow suit before too long.
