Many are still struggling. We’ve had the ICD 9, with 16,000 codes, for about forty years.

The International Codes of Diseases were developed to provide doctors, hospitals, insurance companies the ability to speak the same language on the diagnosis and procedures we use. This was a civil thing until the 1980s when Medicare made it a criminal offense to use the wrong code. A physician from Sacramento spent 22 months in jail for using the wrong code and an ophthalmologist in Southern California spend 65 months in prison for using the wrong code. It has been determined that 59% of physicians disagree with the Centers for Medicare and Medicaid Services (CMS) as to the most appropriate ICD 9 codes to use. So CMS could prosecute up to 59% of us. 

The ICD 10 has 68,000 codes. Heart disease which had a 18 codes for the different types of heart disease according to Next Gen Informatics , now has dozens for each type and then up to a dozen for each subtype.

Emphysema, COPD, and asthma were simple to code. Now COPD has 25 approximate synonyms each with numerous categories which are further divided into subcategories.

I decided when the ICD 10s went into effect, I would close my office. So I eliminated the prospect of spending part of my remaining 20 years in Prison because of Medicare’s hostility and cruelty to our profession if they ever laid eyes on any one of us. The ICD 10s went into effect in October and I closed my office in adequate time so that I would never have to use them or be prosecuted for using them incorrectly.

Our profession needs to get out of government medicine or we will no longer be a profession. Medicare frequently pays less than a physician’s overhead, the cost of doing business in the practice of medicine. Medicaid is the step-child of Medicare pays less than half of what Medicare pays. Obamacare has increased the ranks of Medicaid to nearly one third of the population in some states, under the illusion that those without insurance now have health insurance and presumable access to medical coverage. We announced in January 2015 that we would be closing of our office on June 30. Patients begged us to see them after July 1, 2015, because they could not find a physician that would accept their coverage. We stated that we had to close our books by Oct 1, 2015, and so could not bill their insurance after June 30 and we would require $120 cash payments. We never saw so many $100 bills in our lift time. MediCal patients, who never paid me a cent, came in with their $100 bills. Some didn’t have any small bills and so we had to make change for two $100 C-notes. Many asked us to see them after December 31, 2015. We knew there weren’t enough of them to pay for my liability insurance for another year. And since I celebrated my 45 years in practice with the hospital giving me a 45 year plaque, we retired. We haven’t looked back since we still get all the Medicare and Medicaid notices of new restrictions in our mail.

See the ode below in Section 8

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Government is not the solution to our problems, government is the problem.

– Ronald Reagan