The ICD-10 Travesty
Right now the AAFP and the AMA are fighting with the government to delay the ICD-10 introduction. You can see that here and here. The reasons are obvious and are listed in both articles. This next mandate is just a statistical nightmare whose use is so that others may play with the medical data even more (and make money off us). Oh, and so insurance companies can find ways to NOT pay us. Like all the other crap I spout on about in this website, there is no evidence that it helps patient care. Isn’t that what healthcare should be about? So why does the idiots at the AAFP and AMA wait until now to complain? I have been talking about this for years! This link even shows that the AMA adopted a resolution in 2011. So what happened? Wait a minute, doesn’t the AMA make money off the ICD somehow? Or maybe it is just about putting on a show for them. They can say they complained but, alas, the government didn’t listen. Now pay your dues because they do so much for us.
I thought the increases in specificity of diabetes and CHF diagnosis were a pain. I had a few different cheat sheets for those. Now what. Keep the book with me. Sorry the EMR does not help with this – we still have to take time to find the diagnosis.
You “forgot” to mention the addition of a few more codes to the ICD list. The present number is 17,000 and the new list adds “a few” so the new total is 155,000 (not a misprint or typo — One Hundred Fifty Five Thousand codes. YIPES !!!
Here is the article spelling it out —
Code Chaos
Another nightmare for doctors, courtesy of the federal government
Mar 10, 2014, Vol. 19, No. 25 • By STEPHEN F. HAYES
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Ever considered suicide by jellyfish? Have you ended up in the hospital after being injured during the forced landing of your spacecraft? Or been hurt when you were sucked into the engine of an airplane or when your horse-drawn carriage collided with a trolley?
Dave Malan
Chances are slim.
But should any of these unfortunate injuries befall you after October 1, 2014, your doctor, courtesy of the federal government, will have a code to record it. On that date, the United States is scheduled to implement a new system for recording injuries, medical diagnoses, and inpatient procedures called ICD-10—the 10th version of the International Classification of Diseases propagated by the World Health Organization in Geneva, Switzerland. So these exotic injuries, codeless for so many years, will henceforth be known, respectively, as T63622A (Toxic effect of contact with other jellyfish, intentional self-harm, initial encounter), V9542XA (Forced landing of spacecraft injuring occupant, initial encounter), V9733XA (Sucked into jet engine, initial encounter), and V80731A (Occupant of animal-drawn vehicle injured in collision with streetcar, initial encounter).
The coming changes are vast. The number of codes will explode—from 17,000 under the current system to 155,000 under the new one, according to the Centers for Medicare and Medicaid Services (CMS).
The transition to ICD-10 was planned long before Congress passed the Affordable Care Act in 2010. But Obama administration officials say it is a critical part of the coming reforms. “ICD-10 is the foundation for health care reform,” said Jeff Hinson, a CMS regional administrator, in a conference call about ICD-10 for providers in Colorado.
Sorry, the complete article is here —
http://www.weeklystandard.com/articles/code-chaos_783576.html
Have a great month reading and memorizing all the new codes.
Don’t blame the WHO for this mess.
Each country designs its own version of ICD-10. Most countries now using it have about 15-20K codes, close to what we have currently.
This Rosemary’s baby is entirely the product of CMS and HHS, under both Democratic and Republican administrations.
Then “W.H.O.” Forced “U.S.” To have an ICD-10 at all?
Yes, it is a bi-partisan abuse of power, which is hardly a defense.
From MedPageToday.com, author Dr. David Pittman:
W30.3XXA: Contact with grain storage elevator, initial encounter (In fact, there is a whole section of ICD-10 dealing with contacts with farm equipment including hay derricks and combine harvesters.)
W21.04: Struck by golf ball (Think “Caddyshack,” in memoriam Harold Ramis. There are separate codes for being hit by a football, soccer ball, baseball, basketball, volleyball, and softball.)
W56.21xD: Bitten by orca, subsequent encounter
Z62.891: Sibling rivalry
V97.33XD: Sucked into jet engine, subsequent encounter
W61.92: Struck by other birds (There are also separate billing codes for being struck by parrots, macaws, psittacines, chickens, geese, and ducks. W61.92 is for all other types of birds.)
Z63.1: Problems in relationship with in-laws
W45.8XXA: Other foreign body or object entering through skin, initial encounter
V52.2XXA: Person on outside of pick-up truck or van injured in collision with two- or three-wheeled motor vehicle in nontraffic accident, initial encounter
V00.32: Snow-ski accident
X92.0: Assault by drowning and submersion while in bathtub
W00.1: Fall from stairs and steps due to ice and snow
To suggest a code for this list, email [email protected].
Really it raises two topics. The first is ICD-10, which will raise costs and the hassle factor for all of us while providing nothing in the way of improving care. I can see some of the ICD-9 codes are overly broad and antiquated. but it seems like some minor tweaks would have been all it needed. I don’t see any utility to specifying something like a phalangeal fracture down to L vs R, which finger, proximal, medial or distal, routine vs delayed healing, non-union or malunion, and initial vs follow-up visit. Heck half the time they come in a month after the injury and I don’t even do anything for it except tell them it’ll hurt for a while.
The other issue is the lack of effectiveness from the AAFP and AMA, who seem to have lost touch with many practicing physicians. As far as I can tell their policy is “we must do what the government wants so we can keep our seat at the table”. Who knows what they are doing at the table, possibly they are underneath it, or maybe they are at the “kiddie table” like when you had Thanksgiving without enough seats to go around and the kids had to sit at the Fisher-Price picnic table.
How very gracious of AMA prez Hoven to speak out against ICD-10 after the fix is in. Has she ever spoken against the large-scale government provision of health care? Fellow readers might find my take a bit tendentious – okay, maybe a lot – but this is only the latest, direct result in government involvement in health care. Why should any of us give a damn what the W.H.O. wants for data collection? Because the U.S. bureaucrats who write much of our paychecks and practically all of our rules say so.
If there were ever any use whatsoever to the AMA or AAFP, this abusive, pointless horseshit would have been stopped long ago. Instead, these Vichy organizations continue to take Uncle Sam’s table scraps and goodwill promises, while rear-ending their shrinking memberships.
Note to would-be med students: if you’re the sort who reads this story and wants nothing to do with 21’st century health care, then Bravo!, you are one of the smart ones; if you’re the sort who thinks it’s no big deal, and that being ordered about is a noble privilege, then you’re not the sort I would want (but will get stuck with) for my doctor.