I'm just wondering how can you cope with a doctor who's saying that the codes on the ICD 9 coding books are wrong? I always got annoyed when this doctor comes to me & tell me that I used the wrong code & when I showed him the book, he said that whoever created this coding books are a bunch of (excuse me) moron! Need advice please, anyone...thanks
You might mention that the code books are created by the CDC made up of physicians, they study statistics and data from all over the world and create codes to be used for this purpose.
Debra A. Mitchell, MSPH, CPC-H
The doctor is partly right. Many times in the physicians' world things are clinically the same, but there are different codes in ICD. ICD was creatd by the World Health Organization, the CM after ICD 9 and ICD 10 means Clinical Modiication and was adapted especially for the US. We are the only country that uses ICD for payment of claims, the rest of the world uses it for statistical data.
Now back to the perceived errors, according to my cardiologist, Shortness of breath and Dyspnea are the same thing clinically, but try looking them up in ICD. You get two different codes 786.05 and 786.09. Doctors are looking at these from a clinical point of view and as coders we are looking at the diagnosis literally, we look up exactly what the physician documented. The reason we are going to ICD 10 is for greater specificity, ICD 9 is limited and we use alot of Unspecified of NOS codes. ICD 10 will hopefully alleviate that.
Instead of getting annoyed with the doctor, try to talk with him about how he feels ICD is wrong, if there are particular dx codes that you and he are having trouble with, ask him to explain what it means clinically. You'll be amazed at what you can learn and how your coding will improve.
Last edited by dclark7; 10-25-2011 at 06:38 AM.
Our first response is generally to get annoyed and try to defend the books, cause those are our tools! Just like when a patient calls and tells us the insurance company said we "coded it wrong".
Instead, try to approach the issue by thinking of it as two different languages trying to describe the same incident. He is speaking "doctorese" and you are speaking "coderese". I try to empathize with the doctor, he doesn't understand the coding book and the language does not always make sense in "doctorese". They don't teach coding in medical school, and we don't go to medical school to become coders. This doesn't make the book "wrong", but it means we are looking at the information from two different perspectives.
Tell him you understand it is frustrating, but if you work together to get to the correct interpretation, then his work will be accurately reflected in the record, and to the payor for reimbursement. We coders should work as a team with the providers to our common goal.