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Posts Tagged ‘healthcare costs’

ICD-10 and why healthcare is expensive

Posted in Health care, NP practice, Uncategorized, tagged , , , , , , , , , , on February 11, 2012| 3 Comments »


I was in the bathroom at work yesterday, and this poster is hanging on the door.

Really???? What are these idiot politicians thinking of when they dream up this stuff?
And they constantly cut the pay to the providers and then expect them to try to keep up with all of these ridiculous new regulations and rules.

Do they actually believe that all of this stuff is going to improve healthcare, decrease fraud and decrease the cost of healthcare?  Evidently they do:

Check this link: ICD-10 benefits for healthcare providers

Note that the guy writing it, if you even get half of what he is saying, is an IT guy, NOT a healthcare professional. The talk is about “data-driven” patient care. Huh? My patient care is driven by the patient’s needs, not some IT guy’s addiction to data in his little cyber-world. I don’t think that a coding set is going to alter the fact that a laceration that is bleeding all over the place needs to be sutured. Who gives a crap if the cut is caused by a paring knife versus a steak knife. Time is wasted in asking the difference and looking up the code in a set of 140,000 codes.

“The increased auto adjudication of claims due to increased granularity of ICD-10 code will help in reduced number of claims being investigated or rejected due to insufficient information. ” Right. The fact the patient is cut and bleeding is not enough information to pay for a suture job?

The codes are bordering on the ridiculous. I heard stuff I couldn’t believe. Yet, when looking them up, it turns out to be true. Example: Here in Florida, there is the occasional person who gets injured at the beach. Here are the codes for one type of incident:

2012 ICD-10-CM Diagnosis Codes > External causes of morbidity V00-Y99 > Exposure to animate mechanical forces W50-W64>

Contact with nonvenomous marine animal W56- >

Type 1 Excludes

  • contact with venomous marine animal (T63.-)
W56Contact with nonvenomous marine animal
W56.0Contact with dolphin
W56.01Bitten by dolphin
<span class="identifier">W56.01XA</span> is a billable ICD-10-CM diagnosis codeW56.01XA…… initial encounter
<span class="identifier">W56.01XD</span> is a billable ICD-10-CM diagnosis codeW56.01XD…… subsequent encounter
<span class="identifier">W56.01XS</span> is a billable ICD-10-CM diagnosis codeW56.01XS…… sequela
W56.02Struck by dolphin
<span class="identifier">W56.02XA</span> is a billable ICD-10-CM diagnosis codeW56.02XA…… initial encounter
<span class="identifier">W56.02XD</span> is a billable ICD-10-CM diagnosis codeW56.02XD…… subsequent encounter
<span class="identifier">W56.02XS</span> is a billable ICD-10-CM diagnosis codeW56.02XS…… sequela
W56.09Other contact with dolphin
<span class="identifier">W56.09XA</span> is a billable ICD-10-CM diagnosis codeW56.09XA…… initial encounter
<span class="identifier">W56.09XD</span> is a billable ICD-10-CM diagnosis codeW56.09XD…… subsequent encounter
<span class="identifier">W56.09XS</span> is a billable ICD-10-CM diagnosis codeW56.09XS…… sequela
W56.1Contact with sea lion
W56.11Bitten by sea lion
<span class="identifier">W56.11XA</span> is a billable ICD-10-CM diagnosis codeW56.11XA…… initial encounter
<span class="identifier">W56.11XD</span> is a billable ICD-10-CM diagnosis codeW56.11XD…… subsequent encounter
<span class="identifier">W56.11XS</span> is a billable ICD-10-CM diagnosis codeW56.11XS…… sequela
W56.12Struck by sea lion
<span class="identifier">W56.12XA</span> is a billable ICD-10-CM diagnosis codeW56.12XA…… initial encounter
<span class="identifier">W56.12XD</span> is a billable ICD-10-CM diagnosis codeW56.12XD…… subsequent encounter
<span class="identifier">W56.12XS</span> is a billable ICD-10-CM diagnosis codeW56.12XS…… sequela
W56.19Other contact with sea lion
<span class="identifier">W56.19XA</span> is a billable ICD-10-CM diagnosis codeW56.19XA…… initial encounter
<span class="identifier">W56.19XD</span> is a billable ICD-10-CM diagnosis codeW56.19XD…… subsequent encounter
<span class="identifier">W56.19XS</span> is a billable ICD-10-CM diagnosis codeW56.19XS…… sequela
W56.2Contact with orca
W56.21Bitten by orca
<span class="identifier">W56.21XA</span> is a billable ICD-10-CM diagnosis codeW56.21XA…… initial encounter
<span class="identifier">W56.21XD</span> is a billable ICD-10-CM diagnosis codeW56.21XD…… subsequent encounter
<span class="identifier">W56.21XS</span> is a billable ICD-10-CM diagnosis codeW56.21XS…… sequela
W56.22Struck by orca
<span class="identifier">W56.22XA</span> is a billable ICD-10-CM diagnosis codeW56.22XA…… initial encounter
<span class="identifier">W56.22XD</span> is a billable ICD-10-CM diagnosis codeW56.22XD…… subsequent encounter
<span class="identifier">W56.22XS</span> is a billable ICD-10-CM diagnosis codeW56.22XS…… sequela
W56.29Other contact with orca
<span class="identifier">W56.29XA</span> is a billable ICD-10-CM diagnosis codeW56.29XA…… initial encounter
<span class="identifier">W56.29XD</span> is a billable ICD-10-CM diagnosis codeW56.29XD…… subsequent encounter
<span class="identifier">W56.29XS</span> is a billable ICD-10-CM diagnosis codeW56.29XS…… sequela
W56.3Contact with other marine mammals
W56.31Bitten by other marine mammals
<span class="identifier">W56.31XA</span> is a billable ICD-10-CM diagnosis codeW56.31XA…… initial encounter
<span class="identifier">W56.31XD</span> is a billable ICD-10-CM diagnosis codeW56.31XD…… subsequent encounter
<span class="identifier">W56.31XS</span> is a billable ICD-10-CM diagnosis codeW56.31XS…… sequela
W56.32Struck by other marine mammals
<span class="identifier">W56.32XA</span> is a billable ICD-10-CM diagnosis codeW56.32XA…… initial encounter
<span class="identifier">W56.32XD</span> is a billable ICD-10-CM diagnosis codeW56.32XD…… subsequent encounter
<span class="identifier">W56.32XS</span> is a billable ICD-10-CM diagnosis codeW56.32XS…… sequela
W56.39Other contact with other marine mammals
<span class="identifier">W56.39XA</span> is a billable ICD-10-CM diagnosis codeW56.39XA…… initial encounter
<span class="identifier">W56.39XD</span> is a billable ICD-10-CM diagnosis codeW56.39XD…… subsequent encounter
<span class="identifier">W56.39XS</span> is a billable ICD-10-CM diagnosis codeW56.39XS…… sequela
W56.4Contact with shark
W56.41Bitten by shark
<span class="identifier">W56.41XA</span> is a billable ICD-10-CM diagnosis codeW56.41XA…… initial encounter
<span class="identifier">W56.41XD</span> is a billable ICD-10-CM diagnosis codeW56.41XD…… subsequent encounter
<span class="identifier">W56.41XS</span> is a billable ICD-10-CM diagnosis codeW56.41XS…… sequela
W56.42Struck by shark
<span class="identifier">W56.42XA</span> is a billable ICD-10-CM diagnosis codeW56.42XA…… initial encounter
<span class="identifier">W56.42XD</span> is a billable ICD-10-CM diagnosis codeW56.42XD…… subsequent encounter
<span class="identifier">W56.42XS</span> is a billable ICD-10-CM diagnosis codeW56.42XS…… sequela
W56.49Other contact with shark
<span class="identifier">W56.49XA</span> is a billable ICD-10-CM diagnosis codeW56.49XA…… initial encounter
<span class="identifier">W56.49XD</span> is a billable ICD-10-CM diagnosis codeW56.49XD…… subsequent encounter
<span class="identifier">W56.49XS</span> is a billable ICD-10-CM diagnosis codeW56.49XS…… sequela
W56.5Contact with other fish
W56.51Bitten by other fish
<span class="identifier">W56.51XA</span> is a billable ICD-10-CM diagnosis codeW56.51XA…… initial encounter
<span class="identifier">W56.51XD</span> is a billable ICD-10-CM diagnosis codeW56.51XD…… subsequent encounter
<span class="identifier">W56.51XS</span> is a billable ICD-10-CM diagnosis codeW56.51XS…… sequela
W56.52Struck by other fish
<span class="identifier">W56.52XA</span> is a billable ICD-10-CM diagnosis codeW56.52XA…… initial encounter
<span class="identifier">W56.52XD</span> is a billable ICD-10-CM diagnosis codeW56.52XD…… subsequent encounter
<span class="identifier">W56.52XS</span> is a billable ICD-10-CM diagnosis codeW56.52XS…… sequela
W56.59Other contact with other fish
<span class="identifier">W56.59XA</span> is a billable ICD-10-CM diagnosis codeW56.59XA…… initial encounter
<span class="identifier">W56.59XD</span> is a billable ICD-10-CM diagnosis codeW56.59XD…… subsequent encounter
<span class="identifier">W56.59XS</span> is a billable ICD-10-CM diagnosis codeW56.59XS…… sequela
W56.8Contact with other nonvenomous marine animals
W56.81Bitten by other nonvenomous marine animals
<span class="identifier">W56.81XA</span> is a billable ICD-10-CM diagnosis codeW56.81XA…… initial encounter
<span class="identifier">W56.81XD</span> is a billable ICD-10-CM diagnosis codeW56.81XD…… subsequent encounter
<span class="identifier">W56.81XS</span> is a billable ICD-10-CM diagnosis codeW56.81XS…… sequela
W56.82Struck by other nonvenomous marine animals
<span class="identifier">W56.82XA</span> is a billable ICD-10-CM diagnosis codeW56.82XA…… initial encounter
<span class="identifier">W56.82XD</span> is a billable ICD-10-CM diagnosis codeW56.82XD…… subsequent encounter
<span class="identifier">W56.82XS</span> is a billable ICD-10-CM diagnosis codeW56.82XS…… sequela
W56.89Other contact with other nonvenomous marine animals
<span class="identifier">W56.89XA</span> is a billable ICD-10-CM diagnosis codeW56.89XA…… initial encounter
<span class="identifier">W56.89XD</span> is a billable ICD-10-CM diagnosis codeW56.89XD…… subsequent encounter
<span class="identifier">W56.89XS</span> is a billable ICD-10-CM diagnosis codeW56.89XS…… sequela
Do you get paid more to stitch up an killer whale (orca) bite than a sea lion bite? How does this information improve patient care in the future as stated by the panting IT guy? Will there be required signage on a beach that says “Caution: orcas are 19.75% more likely to bite you than dolphins. Stay clear of orcas.”?
ICD-9 codes numbering at 17000 was bad enough, but 144000 is clearly over-the-top.
This one is also so very necessary here in Florida:  2012 ICD-10-CM Diagnosis Code V91.07XA: Burn due to water-skis on fire, initial encounter.

According to the poster, every form, every procedure, every contract has to be changed to conform to the new rules. Everyone has to be retrained. I love the part where the coding clerks are required to have “a more detailed knowledge of anatomy and medical terminology”. And the nurses have to “revise or recreate every order”. Sure, they have time for that.

Here is a good one, in light of the fact that the government can’t get its shit together with current new guidelines and hasn’t paid our little clinic yet this year for any Medicare or Medicaid bills we turned in,(also note ICD-10 has been delayed due to its cumbersomeness, but when the government says GO! there can be no delay on your part!). The poster states “changes to software, training, new contracts and paperwork have to be paid for.” By whom? The individual provider, of course.  A report by a Nachimson Advisors Study shows that on average, the costs of transitioning to ICD-10 were as follows: Small practice (3-9 physicians) = $83,000, Medium practice (10-99 physicians) = $285,000, Large practice (100+ physicians) = $2.7 million.

There comes a time in each person’s mind when they are just overwhelmed and stop giving a crap.

This will do it.

And all I want to do is take care of patients. I wish the politicians and IT guys would walk a mile in our shoes.

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