Anyone who has known me for any significant amount of time knows that when the calendar moves to October, it officially becomes “Spencer Time”. Not only does tonight mark the beginning of hockey season (beware of flying pucks!), but (much like the 19th Century Russian existentialist literature that I so enjoy) the sky turns grey, the cold air in my lungs awakens me from my overheated summer doldrums and the leaves around me begin to get the dry, multicolored, crackling smell of cyclical death. I wouldn’t trade being alive in the season of Autumn for anything in the world.

Yet the leaves are not alone in this season of change. All indicators point to strange times ahead in the medical reimbursement field. I thought I’d take a quick moment to point out some important bits of news to keep in mind as we move from Summer to Spencer Time.

ICD-9 Coding Updates - The 2010 ICD-9 codes are effective for all services dated today and forward. The majority of the changes in this year’s edition of the quickly-expiring ICD-9  (ICD-10 begins four years from today) are in the External Causes section. This is an outgrowth of the unfortunate reality of the increase in injuries to our soldiers serving in Iraq and Afghanistan. For commonly used codes, the diagnosis of gouty arthropathy (274.0) has been expanded to a 5th digit to indicate whether the condition is acute or chronic. There are a number of additions for venous emboli (453.50 thru 453.89), with language that for the first time identify the specific location of the embolism. There has also been a revision in the language of code 584.5 thur 584.9 from “acute renal failure” to ”acute kidney failure”.

Swine Flu Vaccine - With the sudden appearance of the H1N1 flu virus, it has become necessary for procedural coding to keep up with the treatment of this illness. For Medicare, code G9141 is to be used for the administration of the H1N1 vaccine and G9142 is used for the vaccine itself. For all other payers, the G codes will not be accepted, so instead use 90471 for the administration and 90663 for the vaccine.

The Red Flags Rules – The thrice-delayed FTC rules for establishing red flags for identity theft will begin to be enforced on November 1, 2009. If you have not done so already, be certain you have internal processes in place for a smooth transition to these rules. To review, every patient that presents for treatment should have hardcopy versions of a state issued ID and any insurance card. It is strongly recommended that any patient presenting for other than emergency treatment without these materials be deferred from care until such time as they can be legitimately acquired.

In related news, it is already shaping up to be an interesting month related to the many variations of the health care legislation furiously paddling their way through the paved swamp that is Washington, D.C. I advise the reader to rely heavily on trusted information sources and do their very best to cut through the layers of dogma and invective to find the truth about the future of health care in the United States.

For now, I have cold air that must be inhaled, leaves to crunch underfoot and dozens of hockey fights to which I must bear witness. All hail Spencer Time!

8:51 am, October 1st, 2009 |