Gyroscopic Investing

Meaning, Yet Another Gigantic Waste of Time newly imposed on an already overburdened medical system.  Warning to anyone considering becoming a patient anytime soon: be prepared for office staff & physicians who are sufficiently overwhelmed by the new system that they have even less time to spend treating your problem than they did before.  I'll also bet the number of mistakes are bumping up.

I'm fortunately less affected because the my specialty is far enough under the radar that the codes didn't really change much.  Higher profile specialists & generalists are really in for it though.  Here's a sampling of just how ludicrously specific the whole thing is:

Y92253 - getting hurt at the opera [as opposed to an art gallery, which is a different code]

W2022XD - walking into a lamppost, subsequent visit [as opposed to walking into, say, a fire hydrant]

V97.07XD -  getting sucked into a jet engine

V91.07XD - being burned due to water skis catching on fire [really, I didn't know they could do that!]

W55.29XA - other contact with cow [apart from being bitten or kicked which have their own codes.  What other contact is this, pray tell?]

And keep in mind, if you pick the wrong code you might well find yourself accused of "Medicare fraud."

Any other physicians on the forum willing to contribute their favorite examples, or experiences with ICD-10?

I would be surprised if there were many claims on V97.07XD. 

My wife (an RN) suggested this one:

"They need a code for suicide while awaiting medical care delayed by the health care system trying to figure out what code to use on you. "

Of course, that may already be in there...

Libertarian666 wrote: My wife (an RN) suggested this one:

"They need a code for suicide while awaiting medical care delayed by the health care system trying to figure out what code to use on you. "

Of course, that may already be in there...

That would be a big one with soldiers experiencing PTSD. 

And alternative medicine is STILL excluded.

Idiots.

This is what happens when you elect lawyers to run government.

WiseOne wrote: Any other physicians on the forum willing to contribute their favorite examples, or experiences with ICD-10?

It's just more time charting and more chances for my chart to get down coded. 

I think good record keeping is an important part of practicing good medicine, but when it's done just for the sake of billing or medico legal protection I think it makes the quality of what gets documented worse sometimes. 

Physician notes are no longer human readable.  They're designed for administrators, lawyers, and billers.  We communicate via email & signouts now.

Are you so sure that "more time charting" only means more sloppy documentation?  I would only hope to be that lucky.

I suppose there is a code for one of my favorite lines from the Police Squad/Naked Gun Series - "Getting caught in the teeth of a combine..."

Of course there is!

W23.0.XXS - Sequela of being caught, crushed, jammed, or pinched between moving objects.

Note that if the objects are stationary, that's a different code.  Also different codes if the objects are specifically used for cutting.

My biggest fear is that the hospital will shut down access to Google search.  It's not like THEY are providing any searchable databases for these codes.  I guess they kinda expect physicians to take the next few months off work to memorize all 140,000 codes.

WiseOne wrote: My biggest fear is that the hospital will shut down access to Google search.  It's not like THEY are providing any searchable databases for these codes.  I guess they kinda expect physicians to take the next few months off work to memorize all 140,000 codes.

Whaaat, I thought you guys were all married to a laptop on a cute rolling cart for EMR now and just type in a search query and all 140,000 codes are searched to come up with the helpful box fill predict!  Idiot-proof, that.

Damn neolibs!

[quote=WiseOne]Of course there is!

W23.0.XXS - Sequela of being caught, crushed, jammed, or pinched between moving objects.[/quote]

I must say I am disappointed that combines do not get equipment-specific codes, but water skis apparently do. 

TennPaGa wrote:

WiseOne wrote: Physician notes are no longer human readable.  They're designed for administrators, lawyers, and billers.  We communicate via email & signouts now.

Who is driving this?  Is it an Obamacare mandate?  Or just an administrative "efficiency" thing?

Less seriously...

Perhaps all these codes will help you all will reach the state of nirvana exemplified in this parable.

Sort of.  The idea is to make it easier to mine medical data and also to monitor physicians for "quality control".

I've also wondered if it's to make it easier to design expert systems that can take over medical decision-making from physicians.    I expect there are lots of people thinking about this seriously right now, for the same reasons that self-driving cars are desirable.  Personally, I'll be more than happy to hang it up in favor of a robot and focus on research.