In all fairness, a lot of billing errors stem from, I believe, an institutional lack of awareness and a lack of clarity on the part of those that actually bill.
Sure, there are the ICD-9 codes. For example, systolic hypertension, primary hypertension, and essential hypertension are all different diagnostic codes, but can be used fairly interchangably( esp primary and essential).
then there's the CPT codes, which are billing and procedure codes.
Then there are the HCPCS codes.
So, really, in addition to all the medical stuff, you expect doctors to be financial whizzes too? Have you actually tried to sit down and bill a regular office visit? There's all sorts of criteria, some vague, on how to bill even that. Do you add a -25 modifier? No? Was this simple, complex? Both? How much time was spent "counseling" versus "treating?" What counts as either, when so much of therapy is education?
You think it's tough to pay, try billing it. I seriously doubt many folks out there are trying to scam money, ESPECIALLY since so many folks can't pay for it anyway!