June 20, 2016

Men Not Proactive in Matters of Personal Health

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June 19 was Father’s Day, and the conclusion of Men’s Health Week, which was celebrated June 13 through June 19. It appears that men are not proactive in taking care of their health, as evidenced by the Agency for Healthcare Research and Quality (AHRQ) data. The following statistics have been published on the AHRQ website: Men are 24 percent less likely to visit a doctor within the past year; 22 percent more likely to neglect cholesterol tests; 28 percent more likely to be hospitalized for congestive heart failure (CHF); 32 percent more likely to be hospitalized for long-term complications of diabetes or have a leg or foot amputated due to diabetes; and 24 percent more likely to be hospitalized for pneumonia instead of getting immunized for the disease.

In thinking about men’s health and ICD-10, I reviewed the areas that men should be monitoring and associated ICD-10-CM codes with these conditions:

Smoking: From an ICD-10-CM perspective, the code set can capture the type of tobacco that is being used in the F17 category if the patient is a current user. Former smokers are identified with Z87.891. AHRQ recommends that men are tobacco-free.

Drinking: The code set captures drinking usage in the F10 category. This category identifies alcohol use, abuse, and dependence. An important addition in ICD-10-CM is the term “alcohol use.” Physicians must be educated regarding the terms and the impact on the codes. AHRQ recommends that if you drink and you are 65 or younger, that you should drink no more than two drinks per day. If you are older than 65, then your alcohol consumption should be limited to one drink per day.

Weight: Two codes are needed to describe a patient’s weight. One code will identify the patient’s weight diagnosis (malnutrition, underweight, overweight, obese, and morbid obesity) and the second code identifies the patient’s body mass index (BMI). The BMI cannot be coded without a weight diagnosis according to the guidelines. The BMI can affect the reimbursement for inpatients as a BMI of 40 or greater is a CC. AHRQ recommends that men should maintain a healthy weight, make healthy food choices, and be physically active.

Checkups: Men should have regular checkups that address cancer. The sites that are typically screened are colon (for those over 50), prostate, skin, and lung. The ICD-10-CM category for screening is Z12. Blood pressure numbers are important during a checkup and the category of high blood pressure screening is Z13.6. Cholesterol screening falls under the ICD-10-CM code of Z13.220 and diabetes screening is Z13.1.

As we age, osteoporosis is another focus of screening, and this is indicated by code Z13.820. For men who are sexually active, routine screening is another health concern, identified as Z11.3. Our senses change with aging as well, so hearing and vision screen should be completed (Z13.5).

Another virus that all patients are at risk for is hepatitis C, which is captured with Z11.59. If you are male, a smoker or former smoker, and age 65–75, you are at risk for abdominal aortic aneurysm. This screening is captured with Z13.6.

In this age of spiraling healthcare costs and bringing healthcare closer to the patients, it is important to take charge of our health. While these topics are the focus for Men’s Health Week, they can be applied to all patients (with the exception of screening for prostate cancer). The cost of healthcare is reduced when we are all proactive in our health.

Resources: http://www.ahrq.gov/sites/default/files/publications/files/men-over-50.pdf
Laurie Johnson, MS, RHIA, CPC-H, FAHIMA, AHIMA-Approved ICD-10-CM/PCS Trainer

Laurie M. Johnson, MS, RHIA, FAHIMA is currently a senior healthcare consultant for Revenue Cycle Solutions based in Pittsburgh, Pa. Laurie is an AHIMA approved ICD-10-CM/PCS Trainer. She has more than 35 years of experience in health information management and specializes in coding and related functions. She has been a featured speaker in over 40 conferences and will be speaking at 2017 AHIMA Coding Community Meeting in Los Angeles, Ca. Laurie has been a frequent guest on Talk Ten Tuesdays.

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