Blog — Notes of a Plastic Surgeon

Welcome to my blog. I am a plastic surgeon in Seattle and have been in private practice since 1991. I've seen more than a few interesting faces and cases through my years spent in the exam room, the operating room and the emergency room. And I have an opinion on just about everything relating to plastic surgery (and a lot of unrelated stuff). If you like my blog, let me know. Thanks for reading! Lisa

ICD-10. It’s heeeeeeeere.

Don't worry Barbie. There's an IDC-10 for that squirrel encounter!

Don’t worry Barbie. There’s an IDC-10 for that squirrel encounter!

Today, October 1, 2015, is the day that doctors have to switch from ICD-9 to ICD-10 diagnosis codes.  Up until today, we doctors had to rely on a mere 18,000 ICD-9 codes to describe patient diagnoses.  Doctors rely on these mandatory codes for reimbursement from insurance companies.  Years ago, when I was doing a lot of insurance work, I had many of these codes memorized.  A couple of examples of ICD-9 codes I used a lot were 611.1 for overly large breasts, 173.30 for skin cancer and 873.50 for a gnarly dog bite to the face.

The new federally mandated version, ICD-10 expands the number of codes to around  from 18.000 to 140,000 codes.  That’s a lot of codes!

Here are a few examples I might possibly need to use for cases I see in the emergency room when I am on call:  Walked into a lamppost, initial encounter W22.02XA.  And if that patient walks into the lamppost again, ICD-10 has it covered:  “Walked into a lamppost, subsequent encounter, W22.02XD.  And for that occasional patient who suffers a burn while waterskiing: V91.07XA.  I occasionally treat animal bites and in the bird department I am covered.  There are 72 codes which cover ducks, macaws, parrots, geese, turkeys and chickens.  And if the chicken bite occurs in a chicken coop, there is an add on code for that!   And if it’s a squirrel bite, of course there is a code.  But what is it something other than a bite?  There’s a code for “other encounter with a squirrel.”  Doesn’t that just make your imagination run wild???

And sometimes, I’ll see a patient late at night in the ER who along with their chicken bite and/or lamp post  injury presents with a bizarre personal appearance (R46.1) and/or a very low level of personal hygiene (R46.0). I hope they don’t take it personally because in the middle of the night, both those codes just may apply to me!

I have to keep reminding myself that the feds who mandate this stuff are from the government and they are here to help.   Sometimes I just have to scratch my head.   I wonder if there is a code for that??????

Disclosure:  I borrowed heavily form an article in the Wall Street Journal written by Anna Wilde Mathews for this topic.

Thanks for reading!  Dr. Lisa Lynn Sowder


Category: Financial Issues, Government and Politics, This Makes Me Cranky. | Tags:

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