Government Gobbledygook.

I stopped using the expression "It's not rocket science" a couple of years ago after a Mars probe failed because engineers forgot to convert from English units to metric, costing us untold millions of dollars. Officials at the Health Care Financing Administration made an even bigger snafu when they issued their byzantine Medicare evaluation and management guidelines.

After sincerely trying several times to memorize all the nuances of the guidelines' classifications of office visits and the components of each (and even trying to design an appropriate form), I felt like a failure. I concluded that when in doubt I would undercode and be safe. I would do anything to avoid federal charges of Medicare fraud and abuse, resulting in an involuntary locum tenens at the Club Fed.

But now I find that undercoding is illegal. "We want to see 'rightcoding,'" said Gail Wilensky, chair of the Medicare Payment Advisory Commission. "It is not appropriate to have people underbill for the services that they are providing, and it's not fair." Not fair to whom?

We are presented with a mandatory system to document and evaluate our services that is so complex that it has undergone several revisions since its inception and is still difficult to use. We are told that if our charges are too low or too high we can become targets for the Office of the Inspector General. Not surprisingly, HCFA reports that since the inception of the E&M guidelines, physicians' Medicare claims have been significantly lower.

On the same general theme, a new 800-pound gorilla ...