What exactly is a diagnosis code? Duh........

[Amyloo]

Ok I know that sounds really stupid.  If a doctor puts a diagnosis code on something, does that mean that is what he is saying you have?  Thanks, Amy

[mikemolly]

I found a link to the diagnostic codes:

http://www.icd9data.com/2007/Volume1/

I miss everyone too! A few weeks ago, my right hand was injured (3 avulsions) on a hay rake so typing has hurt- my fingers were not bending. Also, I've had migraines and eye pain the last month. They are gone now.  :)

Now that I can type again, I'll be back on "night shift" here, lol. When my doctor decides to tell me the results, I'll post 'em.

Take care,
Bethany

[Heather3418]

I wonder where we can get a copy of what these codes are?  I see them on my sign out sheet at my primary care doctor's, all the time.  She always communicates with me, what she is diagnosing so I dont' have any trouble there, but would like to have a list for those doc's that don't talk much at all.  If you know what I mean?

Haven't seen you post in a while Bethany.  I hope we "see" more of you.  And don't you hate it when they now say demyelinating diesase of unknown cause?  I was lucky with my first MRI, the report said demyelinating disease, quite possibly due to MS.  Now the others?  Duh!  No way...

Hope you are well, we have missed you.  Please keep us posted if you hear from your doctor.

Heather

[mikemolly]

I was wondering about diagnostic codes.  Thanks!

A month ago, I went for a spine MRI- the code was 341.9 (Demyelinating disease of central nervous system, unspecified) Eeekkk!!  The doctor has not called with the results yet- I plan on calling AGAIN in the morning.

Take care & God Bless,

Bethany

[Amyloo]

You are very sweet; thanks for the encouragement!  I do find my strength in God, I walk tightly with Him.  I know you do too, from other posts by you.  I think he's thinking MS as well, although he did say my lesions were not typical of it. I am 44 by the way; have been having problems for a couple of years now and was diagnosed with fibromyalgia in July of 05.  Thank you for your interest; I will pray for you.  Amy

[Momzilla]

You have a fantastic, attitude, Amy.  I looked on your profile to get your age, and I saw that you love the Lord, too.  Now I can understand where you find that strength, or at least I think I know.

If you're asking me what I think from what I know about billing, what your doctor is saying by using the diagnosis code for MS, without using "r/o" in front of it, then I would stick my neck out and say he believes you have MS.  I hate to say that, because I am not a doctor.  Perhaps Quix will come on tonight and tell you the complete opposite.  

By doing more labs on you, he is trying to rule out any mimics, still, it sounds like.  Blood work will not confirm MS.  The other tests will.  Some of the blood tests may tell him things like if there may be a viral cause or link of MS, if that's what you have.  Mostly, though, as you probably know, there are no blood tests that confirm MS.

I believe your walking will get better, too.  Mine did.  But I am undiagnosed.  I have no lesions that anyone has seen on an MRI, so no Dx, yet.  Hopefully you'll be able to get treatment soon, like IV steroids and your legs will get stronger.  This exacerbation will pass.  I really think this doctor is on top of things, Amy.  Don't worry.  Hang tough for a bit longer.  You'll have some answers and get some treatment.

I hope I haven't steered you wrong!  I'm only an unemployed biller!  Let us know how things are going and feel better!

Zilla*

[Amyloo]

Thank you Zilla, you are very sweet.  Not walking does stink, but I think it will get better. As far as the "sensory disturbance skin", he did do a test where he touched something to the top of each foot and said "is it hot or cold?"  so maybe it is related to that.  

Tell me what you think as far as him using the diagnostic code for "ms".  It doesn't say "r/o ms", which has been written on my MRI request forms.  And it's ok, no matter what.  I think thats what it is, and seeing all the strength you all have, I know I can do it too.  God bless, Amy

[Momzilla]

Oh my gosh, Amy!  I had no idea you were going through all this.  You may have posted this, and I hope you did and got some support from people on the forum.  I did not see it, I'm sorry.  The not walking gig has got to be the worst.  HATE it!  It makes you feel so helpless.  Again, I'm sorry.

Well, it sounds like the last neuro was an idiot, and the new one is a gem!  Good for you!

The diagnosis codes CAN be symptoms the patient has reported, but they would be more subjective, like headache, or pain.  I think if the doctor is going to state something such as "muscle weakness, abnormal involuntary movements and sensory disturbance, skin," he has observed SOMETHING in you.  Of course, he can't have observed the sensory symptom of your skin sensation.  That is patient reported, of course, and he is allowed to use that as a code.  

It sounds like he is being very thorough, which is great!  Don't be scared by the codes he is using; this is really just the part of his business that gets the bills paid.  It truly is.  I doubt he feels you have meningitis, but if you have had it, it can help him get a certain test covered without being fraudulent.  He's doing his job.  And it sounds like he's doing a good one, and will take excellent care of you.

Again, I am so sorry you are going through all this, Amy.  Try to hang in there, and lean on your wonderful family and all of uswhen you need to.

Feel well, and take care of yourself!

Zilla*

[Amyloo]

Ok, here's what happened:  went to 3rd neuro on Fri.  FABulous man.  (I have had an increase in number and size of lesions on my brain in the last 10 months; last neuro said it was either from fibro or just "magic.")  He ran the gammet of tests.  By the way I have been in a wheelchair for ten days now; walking consists of five to six steps and then legs go tight and shaky and won't work.) Bummer, but my family is great.

So he wants the following:  new brain mri even though I had one in Sept.  Full spinal mri.  Spinal tap, asap.  Evoked potentials.  Labs, labs, labs.  On the lab request he has eight different diagnosis codes, and yes I looked them all up.  They are all for things I have already been diagnosed with; ie fibromyalgia, meningitis, (when I was 2) etc.  Except for three and one is MS.  Also, a diagnosis code of "muscle weakness" , "abnormal involuntary movements" and sensory disterbance skin".

Would these be written as "diagnosis codes" if they were just things I told him, or are they written as "diagnosis codes" only if the doctor actually witnesses these things happening?  Thanks gals; Amy

[Momzilla]

Hi, Amy~

I took a medical billing course and am trying my darndest to start up a business of my own so I can have my boss kiss my  you-know-what!  Tee hee!

Anyway, Heather is right.  A diagnosis code is just a numbered code the insurance industry uses that is universal in the medical community so they can decide whether they will or won't pay for a particular procedure.  If the diagnosis code wrrants having a particular procedure done, then the insurance company will pay for it.

For example, if a patient has knee pain, and the doc wants an X-Ray, the doc will use the Code for "knee pain," and the procedure code for "X-Ray."  That is really simplifying it.  The doctor may ALSO state r/o MS  and order an MRI of the brain, which means "rule out Multiple Sclerosis," something like that.  That would certainly warrant an MRI, so the insurance company would pay for it.  However, if the doctor was ever auditied, and the patient didn't have any symptoms dictated in the chart to back up ruling out MS, that's fraudulent.  So, the doc knows she/he has to be able to back up these tests, as they are expensive, and can't do them for no reason. Know what I mean?

That's probably more than you wanted to know.  But I paid for the class, and I thought I'd pass the info along!  Why do you ask?  What diagnosis did the doc stamp on you?

Billa Zilla*

[Momzilla]

Heather--I hope you feel better!  Take it easy!

Zilla*

[Heather3418]

And yes Amy, if 197.2 really did mean that you had Type 2 Diabetes, yes he would be saying that is what you have.  I didnt' even answer your originial question.  I just now realized I did that.  Amy honey, I am sorry.  I am really having a rough day with sorting things out in my brain.  If you could see me typing and having to use the delete key, you would understand how I am really struggling just to get my fingers to type what my brain is TRYING to convey.  This is MS though and this is one of the parts that can be so frustrating.  I am thankful for the "delete and start over stupid" key.

[Heather3418]

See this is what happens when someone is deep into an MS flair...not trying to say this as a joke, but showing you as an honest example of what happens or what can happen and what IS happening to me..

I MEANT  "industry"  I hate when I get like this...this is the hard part of having this stupid, idiotic, crappy disease....sorry having a flair-up makes me cranky.  I DO apologize.

[Heather3418]

*insurance not inductry...sorry having alot of MS brain burps today...

[Heather3418]

The "insurance code," is used by his office and the insurance inductry to identify a diagnosis, let's say 197.2 means Type 2 Diabetes.  It's an insurance code and used by all doctor's, hosptials and insurance company's.