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Thread: What is 1/8" deep, 1/8" wide, 1/2" long and red?

  1. #31
    Join Date
    Apr 2009
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    Lasalle,Ontario
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    Wow I just found out you could quote a poster without his/her name!
    I've never figured out how to get the poster's name in

  2. #32
    Join Date
    Sep 2007
    Location
    Atlanta, GA
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    Quote Originally Posted by Phillip Gregory View Post
    Not quite

    How about open wound of finger (ICD9 883.0) and accidents caused by woodworking and forming machines (E919.4)? In reality, it would be coded as finger injury not otherwise specified (ICD9 959.5) and injury by other/unspecified cutting or piercing instruments or objects (E920.8/E920.9) as it takes too much time to look up the most specific codes and insurance doesn't really care as long as the diagnosis and E-codes justify the charges.

    Fortunately the first diagnosis wasn't traumatic amputation of other finger(s) without mention of complication (E886.0). Be careful!
    Having spent much time and my limited grey matter on the above, I feel compelled to say the above is ICD-9, which is still current (for the time being).

    What Phillip is not telling you is that an 883.0 is a bare-bones label. Only 4 digits, and anything ending in a '0' or '9' is relatively non-specific.

    The best codes are the longer, more specific ones-means more likely to actually get paid for what we do.

    E codes are nifty, but commercial insurers, my wife tells me, ignore them in determining appropriateness of services.

    ICD-10 is coming, our Dx codes will to from 14K to 68K different ones, you can certainly code for which finger on which hand, etc etc etc.

    The ICD-10 code starts with an S or a T. Sounds more like an avulsion than a laceration, right?

    The IMO (Intelligent Medical Object is what it stands for---please, don't ask) terminology axis code for finger tip tissue avulsion is 1044125.

    Anyone not in medicine reading this-forgive me.

    As always, just my opinion, not that of my employer.
    David
    Confidence: That feeling you get before fully understanding a situation (Anonymous)

  3. #33
    Quote Originally Posted by David Ragan View Post
    Having spent much time and my limited grey matter on the above, I feel compelled to say the above is ICD-9, which is still current (for the time being).

    What Phillip is not telling you is that an 883.0 is a bare-bones label. Only 4 digits, and anything ending in a '0' or '9' is relatively non-specific.

    The best codes are the longer, more specific ones-means more likely to actually get paid for what we do.

    E codes are nifty, but commercial insurers, my wife tells me, ignore them in determining appropriateness of services.

    ICD-10 is coming, our Dx codes will to from 14K to 68K different ones, you can certainly code for which finger on which hand, etc etc etc.

    The ICD-10 code starts with an S or a T. Sounds more like an avulsion than a laceration, right?

    The IMO (Intelligent Medical Object is what it stands for---please, don't ask) terminology axis code for finger tip tissue avulsion is 1044125.

    Anyone not in medicine reading this-forgive me.

    As always, just my opinion, not that of my employer.
    Yup, it's ICD-9. Can't use ICD-10 at all until October 1st at 0000, upon which everybody has to switch to ONLY using it. We are told to ignore it even exists until 10/01/2015 at 0000. Medicare, Medicaid, Tricare, and some commercial insurers are loving this as they get to deny payment for services rendered due to any hiccups in the switchover where the "wrong" code set was used- either ICD-10 too early or ICD-9 too late. Cerner Corporation, Epic Systems Corporation, McKesson, GE Healthcare, etc. are also loving this as they got to hit the hospitals and offices up for another big bunch of money to add/turn on the ICD-10 diagnosis code dictionary in their products.

    The ICD-10 code for a finger laceration starts with S61 and has a .2xx or .3xx suffix that varies depending on which finger, if there was or was not a foreign body, and if there was or was not damage to the nail. The "cause" codes are also much more specific as well. The OP's would be W31.2XXA most likely, contact with powered (as opposed to unpowered) woodworking equipment, first occurrence. If it happened before, W31.2XXD for recurrent episode.

    Actually being paid for services rendered is a black art. Putting an E-code (mechanism code) is absolutely required for Medicare, Medicaid, and Tricare patients, and variably required for commercial insurers to reimburse anything for a code that could be suspected to be caused by an injury. There are literally millions of lines of billing rules that one must follow to try to be paid in medicine, and if ANY of them are missed, the hospital or doc paid for that service to be rendered (the hourly/salaried staff, facilities, and supplies aren't free even if they can write off their labor.) Mind you the doctor put a nice long description of what happened in their note, but the insurers don't look at them unless there is at least one appeal by the doc/hospital. Initial denials are usually performed automatically based on a "CPT code(s) claimed do(does) not match allowable diagnosis code(s)" computerized sort algorithm. Do too many of these and you get audited...and that's REALLY fun. And time consuming. And very, very expensive.

    Yup, I have also devoted way too much of my life and gray matter to this topic as well.

  4. #34
    Quote Originally Posted by mike mcilroy View Post
    I've never figured out how to get the poster's name in
    If you click on the "reply with a quote" button it should include the name of the poster .

  5. #35
    Join Date
    Sep 2007
    Location
    Atlanta, GA
    Posts
    1,356
    Quote Originally Posted by Phillip Gregory View Post
    Yup, it's ICD-9. Can't use ICD-10 at all until October 1st at 0000, upon which everybody has to switch to ONLY using it. We are told to ignore it even exists until 10/01/2015 at 0000. Medicare, Medicaid, Tricare, and some commercial insurers are loving this as they get to deny payment for services rendered due to any hiccups in the switchover where the "wrong" code set was used- either ICD-10 too early or ICD-9 too late. Cerner Corporation, Epic Systems Corporation, McKesson, GE Healthcare, etc. are also loving this as they got to hit the hospitals and offices up for another big bunch of money to add/turn on the ICD-10 diagnosis code dictionary in their products.

    The ICD-10 code for a finger laceration starts with S61 and has a .2xx or .3xx suffix that varies depending on which finger, if there was or was not a foreign body, and if there was or was not damage to the nail. The "cause" codes are also much more specific as well. The OP's would be W31.2XXA most likely, contact with powered (as opposed to unpowered) woodworking equipment, first occurrence. If it happened before, W31.2XXD for recurrent episode.

    Actually being paid for services rendered is a black art. Putting an E-code (mechanism code) is absolutely required for Medicare, Medicaid, and Tricare patients, and variably required for commercial insurers to reimburse anything for a code that could be suspected to be caused by an injury. There are literally millions of lines of billing rules that one must follow to try to be paid in medicine, and if ANY of them are missed, the hospital or doc paid for that service to be rendered (the hourly/salaried staff, facilities, and supplies aren't free even if they can write off their labor.) Mind you the doctor put a nice long description of what happened in their note, but the insurers don't look at them unless there is at least one appeal by the doc/hospital. Initial denials are usually performed automatically based on a "CPT code(s) claimed do(does) not match allowable diagnosis code(s)" computerized sort algorithm. Do too many of these and you get audited...and that's REALLY fun. And time consuming. And very, very expensive.

    Yup, I have also devoted way too much of my life and gray matter to this topic as well.
    Let me tell you, I dont get a genuine smile as often as I would like, but the above really gives me one

    Phillip-you must be a professional coder?

    When iwas in practice out in Okla back in the 80s, the insurance co that ran the State Medicaid program.....the folks who keypunched/processed the individual claims, decided whether to pay them or not, got 25 cents for each one, whether the claim was paid or not. One of the locals told us that lots of claims were rejected by the processor/keypunch person just to get the $. We know this to be true, cause we would turn around and re-submit w/o any changes, and it would be paid.

    Phillip and I could go on and on. but, we won't cause it is not helpful, and I am wanting to ramp up to broad Societal Issues (quasi-political) and that ain't why we're here.

    Moderators-thanks for letting us post this.

    Standard disclaimer--my personal view, not that of my employer

    PS- a very smart British engineer and I were talking a couple of days ago....he told me....'you know, the US is the best place to live'

    Have a pleasant, safe 4th.
    David
    Confidence: That feeling you get before fully understanding a situation (Anonymous)

  6. #36
    Join Date
    Jan 2011
    Location
    Northern UT
    Posts
    762
    Quote Originally Posted by Brian Kent View Post
    I am just trying to decide the best treatment plan - cauterize with a soldering iron or just take the edges down with a belt sander.
    I suggest neither one. Use a route to smooth off those edges. Gives a better result and takes less time. A good trim router would be just the thing, and you get better control with one hand.

    I can relate. I slid the tip of my pinkie into a dado stack about a year ago. Painful, good lesson learned, and it healed up nicely. Mine was about 3/32 deep and 5/16 wide. I am more cautious now than I have ever been.

  7. #37
    We see a handful of people come in with woodworking injuries every year. Oddly enough very few are tablesaw injuries as most of the woodworking done in the area is rough construction or done at a couple of factories in town (yeah, I know, there actually is some manufacturing in the U.S. today!) Tablesaws aren't widely used; the furniture factories use jump saws and gang rip saws (very safe) and the construction guys use circular saws and SCMSes. The majority are nail gun injuries at a construction site. Lazy workers will modify their framing nail guns to disable the shoe safety and allow the gun to fire in full-automatic mode, so they can quickly slide the gun roughly along where a stud is to quickly nail exterior wall sheathing or flooring OSB/plywood. They'll slip and the gun will keep firing, so they'll fire one into their hand, arm, or legs before they let off the trigger. Next up is circular saw injuries, folks who shorten fingers with SCMSes, and then ones who face plane their right pinky finger on the jointer at the furniture factory. If you don't use push blocks with your jointer, don't leave your pinky trailing off the end of the board, because the jointer will happily joint it too.

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