First order of business: ICD-9 changes for 2008 go into effect on 10/1 and there’s a doozy in there.  Here’s a copy of a message we’ve sent to PCC clients and I’ve left some of the PCC links in there, because anyone can use them and it’s easy to cut and paste!

New Diagnosis Codes - Effective 10/1 New Diagnosis Codes On October 1st, the CDC’s 2009 diagnosis code (ICD-9) changes become effective. Your office should learn about the changes to diagnoses you frequently use and update your Partner Diagnoses table in the Table Editor (ted). Major Change of Note to Pediatricians: Fever New fever diagnosis codes are particularly important to pediatric offices. All fever diagnoses now require a 5th digit. Here is a summary of the new fever diagnoses: 780.60 Fever, unspecified 780.61 Fever presenting with conditions classified elsewhere 780.62 Postprocedural fever 780.63 Postvaccination fever 780.64 Chills (without fever) 780.65 Hypothermia not associated with low environmental temperature Get the Complete List and More Information You can download the lists of new diagnosis codes, revised diagnosis code titles, and invalid diagnosis codes from the Client Lobby on PCC’s Web site. The complete list of ICD-9 changes, with notes and further information, is available on the CDC’s Web site. The Checkout and ECS Programs Help Prevent Claims With Expired Codes Partner’s Checkout and Preptags programs will warn the user and hold claims that contain expired diagnosis codes. How to Update Your Diagnoses Table..[etc.]

Item #2: a few weeks ago, I spoke about the ICD-10 changes and the Pediatric Coding Pink sheet gave me a call (Hi, Alison!). There’s more to the piece, including from me, but here’s an excerpt:

“Unlike the procedurally driven specialties, pediatrics is very dependent on cognitive work,” says Hart, whose clients include 800-plus pediatricians at 200 locations in more than 40 states. “There are a lot of gray areas where it’s not easy to code something with the existing codes. But with more distinct diagnoses, it will
actually be easier and more obvious for physicians to pick the right code. This will make their lives easier.” It’s also essential to the child’s medical record to have an accurate diagnosis code, says Hart. Sometimes, physicians don’t understand why they can’t just circle the most general, all-inclusive ICD-9 code they find on their superbill. “But they may not be the doctor who’s going to see this kid next,” says Hart. Having the medical record clearly denote the condition as specifically and accurately as possible will make it easier for provid ers to coordinate care.

Finally, I had an interesting time in my son’s 3rd grade class today.  I was there to read to them, which I appreciate getting a chance to do (today’s choice: The Mad Scientist’s Club, one of the great books for kids, especially for boys…I love that book).  At the end, the teacher asked me to spend a minute talking about my work.

I have a hard time describing what I do to adults, so I tried to put it in the perspective of what happens in a pediatric office and how we help with that.  For some reason, the conversation turned to immunizations and the kids suddenly got really interested and asked ALL KINDS of questions.  “Can you get chicken pops in your mouth?  Does an iron lung hurt?  How many people died in the influenza pandemic? How many shots can you get at once?”  It was quite surprising - the kids were fascinated by the entire history of infectious diseases, how immunizations work, etc.  I was waiting for SOMEONE to drop a bomb - this is Vermont, afterall - but it never came.  I’m going to make a call or two to some local friends and suggest they offer to come into the school!