Funny Incidents by Pat Conrad MD


You had better believe, we in medicine know funny. Health care hilarity runs the gamut from the more deliberately biting parodies of the lauded Placebo Journal to the propeller-beanie wearing, oblivious numbskullery of the AAFP. Wrier, subtler humor can be enjoyed in Medical Economics magazine. In their regular feature “Coding Insights”, a reader posed a question regarding “incident-to billing”:

Question: If a nurse practitioner or physician assistant gathers the history and other information and the physician then examines the patient and establishes assessment and plan, does this qualify for incident-to billing even if a new problem comes up?”
Answer: In the situation that you described, incident-to guidelines wound not necessarily apply, depending on which part(s) of the history the nurse practitioner (NP) or physician assistant (PA) documents.”
Not having any idea what “incident-to billing” is, I read the rest of the page, and apparently this all has to do with how to get paid if one has NP’s or PA’s working for them. It is clear as an un-prepped bowel, relies on “guidelines” which is legal nicety for “you can still be found guilty” and scarier still, I started to understand it.
Is this not hilarious? If anyone still doesn’t get why Doug keeps pushing Direct Primary Care, then you probably won’t get that in the alternative, the joke’s on you.

Douglas Farrago MD

Douglas Farrago MD is a full-time practicing family doc in Forest, Va. He started Forest Direct Primary Care where he takes no insurance and bills patients a monthly fee. He is board certified in the specialty of Family Practice. He is the inventor of a product called the Knee Saver which is currently in the Baseball Hall of Fame. The Knee Saver and its knock-offs are worn by many major league baseball catchers. He is also the inventor of the CryoHelmet used by athletes for head injuries as well as migraine sufferers. Dr. Farrago is the author of four books, two of which are the top two most popular DPC books. From 2001 – 2011, Dr. Farrago was the editor and creator of the Placebo Journal which ran for 10 full years. Described as the Mad Magazine for doctors, he and the Placebo Journal were featured in the Washington Post, US News and World Report, the AP, and the NY Times. Dr. Farrago is also the editor of the blog Authentic Medicine which was born out of concern about where the direction of healthcare is heading and the belief that the wrong people are in charge. This blog has been going daily for more than 15 years Article about Dr. Farrago in Doximity Email Dr. Farrago – [email protected] 

  2 comments for “Funny Incidents by Pat Conrad MD

  1. Perry
    September 5, 2015 at 12:39 pm

    As an aside, I believe the person pictured in this article may suffer from R46.1, the ICD-10 code for Bizarre Personal Appearance.
    I would like to know if this code is reimbursable.

  2. Steve O'
    September 5, 2015 at 9:49 am

    Insight is a cruel mistress. It is immensely gratifying to be a fool, so long as one does not realize it. The Naked Emperor of legend was serene and regal until he realized that his Crown Jewels were on display.

    It is entertaining to read the work of those bereft of humility and insight, such as our friend the Coding Expert. Bureaucrats emit rules as freely and plentifully as the startled squid emits ink. It is strenuous enough answering sensible questions that people actually ask – providing senseless answers to questions nobody asked is truly the job for great minds.

    I suspect in Coding Insights, either a) the author was making up the questions, b) the asker was spoofing the answerer, or c) someone was attempting to code charts while huffing glue.

    Huffing glue while coding is not permitted by OSHA, disfavored by JCAHO, and may cause the coder to be distracted by a small herd of six-foot capybaras racing about the office squealing – which is either a detestable hallucination, or someone’s left the Republican Presidential Debates on the telly. Either of these possibilities is codeable under ICD-10, in fact.

    So glad you asked.

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