Today's first important alert comes from Siouxsie, who was kind enough to forward the official list of ICD-9 changes for 2010.  Pediatric offices should read them carefully, as there are some doozies in there.  New codes for Colic, Irritability, Impulsiveness, and Nervousness -- sounds like me while coaching farm league.  There's a fascinating set of codes for "Activities" like the E005.3 (Activities involving trampoline) or E007.5 (Activities involving soccer).  My favorites might be the E018.3 or E019.1, look them up.

Note that there is a series of revised codes that affects pediatricians (V15.86 [Exposure to lead], V65.11 [Pre-natal consult], etc.) and these codes go into effect in fiscal year 2010, which is actually Oct 2009!

Next, I found this somewhat shocking piece about the relative scarcity of pediatricians.  Or, I should say, the lack of scarcity of pediatricians.  A study by Dr. Gary Freed, who already has the AAP (unofficial) endorsement with his immunization data, concludes that there are plenty of pediatricians in the market and we ought not be priming the pump of pediatric residency.   I'd love to know whether other primary care specialties have the same volume of part-time physicians (we see a quickly growing number of part-time peds in our practices).  One comment in the piece jumped out at me, however:

Medicaid covers the vast majority of poor children and its rates are established on a state-by-state basis, not by national policy decisions. Medicaid rates are lower than Medicare rates. Policy makers can't assume they've fixed the problem of reimbursement for primary care If they only focus on Medicare.

Guffaw. The implication of this comment is that only Medicaid pays less than Medicare.  What a joke - I just read yet another contract from UHC where the practice would receive a ~7.5% increase in their fees...and most of the codes were still below Medicare rates!