ICD codes

[Guest guest]

Greetings.

This may not work for everyone, but some may find it useful.

In about 1986 I copied four pages out of an ICD manuel relating to pain.

Head pain, knee pain, neck pain, etc. While practicing in

California until 1990, I had a fairly good insurance practice only billing

for something to do with pain.

Around 1990, insurance companies became more tight with their payments to

the extent that even some M.D.'s had trouble collecting.

The rationale is that when someone goes to an acupuncturist and the

insurance company sees a pain code, they are likely to agree that this type

of treatment is appropriate.

Of course, you could say something like abdominal pain due to liver

attacking spleen and write in the abdominal pain code.

For someone who wants to be completely honest, they would probably be better

to stay a strictly cash practice (if you can). It seems to me, that

insurance always involves some compromise. But so does life; so, this is

the insurance game.

For what it is worth, since leaving California in '95, I have had a cash

practice. But, when I give someone a super bill for them to collect from

their insurance company, I still always use a pain code from those same

sheets I copied years ago. And it still seems to work.

I learned this stategy from someone I was apprenticing with at the time and

pass it on for anyone who can use it.

At this end, Patrick - with no spell checker

[Guest guest]

Hello, Patrick,

 

Thank you for your advise.

 

The problem is that here in Illinois, ICD-9 codes must be provided by

physicians licensed to practise medicine; this does not include

acupuncturists.

 

I have been a part of a multi-faceted practise that included MD's,

DO's, DC's, OMD's, nutritionists, psychologists, massage therapists,

etc. The bottom line was that a tiered system evolved:

 

1. MD's and DO's

2. DC's, not licensed to prescribe pharmaceuticals or to offer IV

therapies,...

3. Other practitioners, like ourselves...

4. Nurses

5. Other staff.

 

Until we OMD's believe and insist that we are indeed " doctor's " , we

will be relegated to the ranks of PT's and other therapies, not

licensed to practise medicine.

 

luke

 

P.S.: This tiered treatment had nothing to do with what was proven

to be efficacious. It had to do with what procedures and codes that

insurance companies tended to pay for. Once again, the 'bottom

line'...

 

The AMA is about preserving the AMA. The 'bottom line' is really

that! Until we can raise a lot of money and play the political game

with success, we will face a role of practitioners subjected to AMA

domination. Such is the real world....

 

Until we can independently diagnose, within the terms insurance

companies dictate, namely ICD-9 codes, we will be merely technicians

and not physicians. This has nothing to do with proof!

 

 

 

 

, Patrick Holiman

<pholiman@e...> wrote:

> Greetings.

> This may not work for everyone, but some may find it useful.

> In about 1986 I copied four pages out of an ICD manuel relating to

pain.

> Head pain, knee pain, neck pain, etc. While

practicing in

> California until 1990, I had a fairly good insurance practice only

billing

> for something to do with pain.

> Around 1990, insurance companies became more tight with their

payments to

> the extent that even some M.D.'s had trouble collecting.

> The rationale is that when someone goes to an acupuncturist and the

> insurance company sees a pain code, they are likely to agree that

this type

> of treatment is appropriate.

> Of course, you could say something like abdominal pain due to liver

> attacking spleen and write in the abdominal pain code.

> For someone who wants to be completely honest, they would probably

be better

> to stay a strictly cash practice (if you can). It seems to me, that

> insurance always involves some compromise. But so does life; so,

this is

> the insurance game.

> For what it is worth, since leaving California in '95, I have had

a cash

> practice. But, when I give someone a super bill for them to

collect from

> their insurance company, I still always use a pain code from those

same

> sheets I copied years ago. And it still seems to work.

> I learned this stategy from someone I was apprenticing with at the

time and

> pass it on for anyone who can use it.

> At this end, Patrick - with no spell checker