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Showing posts from September, 2015

ICD-10-CM and the Panic that Numbers Ensue

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For those of you who do not know the meaning of ICD-10-CM , it is the International Classification of Diseases, a lengthy clinical catalog system conjured up by the World Health Organization  (WHO) to designate medical codes. Physicians and clinicians everywhere are bound by them, use theses codes for billing and diagnostic purposes. The ICD-10-CM replaces ICD-9 on October 1, 2015. To bill, we need to code, and start with  procedures . Your primary care doctor perfunctorily codes hundreds of procedures, ranging from removing a dot on your skin, to listening to lungs, heart beats, peeking down throats and wiggling toes. General check-ups might be called  wellness visits , now, because things just have to keep changing. Mental health professionals have only a few procedure codes, a handful, really. Is this an initial evaluation? Group or family therapy? A 15 , 30 , 45 , or maybe a 52 minute -hour? There are a few more. Then come the codes for diagnoses , naturally. Here's where menta

Snapshots: Mostly Jewish

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We're not likely to get that short (1)      Looking up   The other day we were standing in stocking feet and I asked FD, “Am I getting shorter?  And what happens when do you get shorter? Do you lose weight?” He faced me and said, with certainty, his head inches from mine, “Yes, you are getting shorter. We all get shorter.”  He didn’t respond to the weight question. And I noticed, as he said this, that he had lost some height, and that my chin didn’t point up as high as usual as we spoke, and our eyes weren’t level, but they were almost level. It was alarmingly intimate. (2)     Holidays and guilt   FD waking me up with the shofar It has happened many times. I’ll be listening to a patient who will suddenly look directly at me, across that perfectly calculated space between us, and declare: “It’s Catholic guilt. The problem is Catholic guilt.” There will be a pregnant pause, then a bold continuation: “You Jews have it too, I think. The guilt.”  And I confirm this. It is true, for ma