Dr. Westby G. Fisher is a cardiologist at NorthShore University HealthSystem who writes regularly at Dr. Wes.
More from Dr. Wes
Imagine if lawyers had to bill like doctors:
Beginning July 1, 2010, under the Legal Billing Obfuscation Act of 2009, lawyers will receive their payments for services rendered after approval by a central US government Payment Distribution Authority (USPDA).
Inside an Automated Healthcare Practice: Redesigning Care Around People, Not Paperwork
By reducing administrative burden and redesigning workflows around human needs, it creates space for what matters most: connection between clinicians and patients.
To receive payment from the Authority plaintiff and defendant complaints must be coded and filed electronically using the International Classification of Legal Complaints, 10th edition (ICLD-10), copyright © 2009, American Bar Association and Legal Proceeding Terminology (LPT) codes, copyright © 2009 American Bar Association.
The full publication of each of these codes will be available in print March 1st 2010 and in electronic form on DVD in July 2011.
To familiarize lawyers with the new coding scheme requested by the USPDA, a small sample for the complaint of “Spilling” is shown below:
- Spilling 200
- Spilling, Water – 210
- Spilling, Water, Hot – 211
- with blisters 211.1
- without blisters 211
- Spilling, Water, Warm – 212
- Spilling, Water, Cold – 213
- Spilling, Water, Hot – 211
.
.
. - Spilling, Water – 210
- Spilling, Coffee – 240.1
- Spilling, Coffee, Hot – 240.11
- with blisters – 240.121
- without blisters 240.122
- Spilling, Coffee, Hot, With Cream only – 240.12
- Spilling, Coffee, Hot, With Regular Milk only – 240.13
- Spilling, Coffee, Hot, With 2% milk only – 240.14
- Spilling, Coffee, Hot, With Skim Milk – 240.15
- Spilling, Coffee, Hot, With Soy milk only 240.16
- Spilling, Coffee, Hot, With Sugar only – 240.17
- Spilling, Coffee, Hot, With Artificial Sweetner (of any type, including, but not limited to Nutrasweet, Spenda, Sweet ‘n Low) – 240.18
- Spilling, Coffee, Hot, With Cream and Sugar 240.16
.
.
.
- Spilling, Coffee, Hot – 240.11
The Power Behind Enterprise EHR Software for Large Healthcare Systems
Enterprise EHR boosts scalability, interoperability, and governance for large healthcare systems.
Pairing of improper complaint codes with legal proceeding codes will result in non-payment. “Up-coding” of legal proceedings shall constitute grounds for prosecution with some additional fines imposed by the IRS, as determined by the Office of Health and Human Services. For instance, pairing a legal complaint of “Spilling, Coffee, Hot, with blisters” to and of those of Divorce, same gender, living apart, male (or female) (shown below) will result in non-payment.
- Divorce: 100-199
- Between husband and wife 100.1
- Between same gender couple, living together, male, 100.011
- Between same gender couple, living together, female, 100.012
- Between same gender couple, living apart, male, 100.021
- Between same gender couple, living apart, female, 100.022
.
.
.
Valid code pairings for spillage include Accident codes (0010-0059), Assault codes (4400-4499), or Battery codes (5500-5599) provided documentation supports the requests for payment.
-Wes
Westby G. Fisher, MD, FACC is a board certified internist, cardiologist, and cardiac electrophysiologist (doctor specializing in heart rhythm disorders) practicing at NorthShore University HealthSystem in Evanston, IL, USA and is a Clinical Associate Professor of Medicine at University of Chicago's Pritzker School of Medicine. He entered the blog-o-sphere in November, 2005. He writes regularly at Dr. Wes. DISCLAIMER: The opinions expressed in this blog are strictly the those of the author(s) and should not be construed as the opinion(s) or policy(ies) of NorthShore University HealthSystem, nor recommendations for your care or anyone else's. Please seek professional guidance instead.
This post appears through the MedCity Influencers program. Anyone can publish their perspective on business and innovation in healthcare on MedCity News through MedCity Influencers. Click here to find out how.