19 March 2008

Why do people go to the ER?

Skimming the billing reports -- usually I just look at the financial metrics, payor analysis, etc. -- the important stuff. For some reason I was caught by the list of most common diagnosis codes used in our ER, in order:

  • 786.50 UNSPEC CHEST PAIN
  • 789.09 ABDOMINAL PAIN OTHER SITE
  • 465.9 ACUTE UPPER RESP INFECTIONS UNS
  • 847.2 SPRAIN/STRAIN LUMBAR REGION
  • 558.9 OTH NONINFECTIOUS GASTROENTERITIS
  • 486 PNEUMONIA ORGANISM UNS
  • 466.0 ACUTE BRONCHITIS
  • 780.99 OTHER GENERAL SYMPTOMS
  • 784.0 HEADACHE
  • 346.90 UNS MIGRAINE NOT INTRACT
  • 847.0 SPRAIN/STRAIN OF NECK
  • 079.99 UNSPECIFIED VIRAL INFECTION
  • 599.0 URINARY TRACT INFECTION UNSPEC
  • 724.2 LUMBAGO
  • 338.19 OTHER ACUTE PAIN
  • 780.2 SYNCOPE/COLLAPSE
  • 780.97 ALTERED MENTAL STATUS
  • 786.09 RESPIRATORY ABNORMALITY OT
  • 428.0 CONGESTIVE HEART FAILURE UNSPEC
  • 787.03 VOMITING ALONE
  • 381.00 UNS ACUTE NONSUPPUR OTITIS MEDIA
  • 491.21 OBSTRUCT CHRON BRONCHITIS W EXAC
  • 493.92 ASTHMA UNSPEC W ACUTE EXACER
  • 625.9 UNS SYMPTOM FEMALE GENITAL ORGANS
  • 780.4 DIZZINESS/GIDDINESS
So there you have it. There's a lot of duplication, though. There are no fewer than ten different "Chest pain" codes. Gotta love coder-speak: "Other General Symptoms." What the heck does *that* mean? (Other than the coder couldn't figure out what the heck the doctor meant).

7 comments:

  1. I like "vomiting alone." It makes it sound as though they decided they wanted to vomit with other people, so they came to the ER.

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  2. I am 100% with Lorelei. Also, I am interested that there are symptoms of the female genital organs, but not of the male. And I'm pretty hesitant to imagine just what sort of symptoms these female genital organs are having. Ewwww.

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  3. I always thought that dizziness and giddiness was a bit unusual.

    Who comes to their doc complaining of giddiness?

    usually when I see a dizzy patient it's because they are vomiting uncontrollably with vertigo or they can't stand up. Never has it been because they are giddy.

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  4. 780.99
    I rarely use that code. Medicare doesn't like it and we must please Medicare.

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  5. Happy --

    I think the dizziness/giddiness is for the many geriatric patients who complain of being "weak and dizzy all over," for whom we cannot find anything at all wrong with them.

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  6. Ahhh...memories working with the ER staff. :)

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