November 13, 2012

Proof Read

By

If you are one of the thousands of 17 people who bother to read my contribution each month, you know I’m opinionated, somewhat caustic, and borderline rude I can be somewhat acerbic in my presentation.  I have been advised by 42 air-headed pseudo-intellectuals one individual that I should take it down a few notches a more subtle, a more gentle approach. And so it shall be.

At the same time, I thought you might be bored with yet another ICD-10 article enjoy seeing the struggle this process entails, so I am retaining the “proofing edits” that crept into my original document, so you can see the “BS” behind experience the evolution of a genuine “Internet Editorial Masterpiece”.

ICD-10 is yet another chapter in government interference the logical culmination of our nation’s inexorable march from ICD-1. The journey has transpired over more than 100 years. Yet, even as we implement this gargantuan pork barrel of a data system great leap forward in health information management, ICD-11 is looming on the horizon.  Does anyone else think this scenario smacks of abject stupidity seems somewhat poorly conceived?

In any case, we must concede the inmates are running the asylum our elected representatives and the professional civil servants in the Administrative Branch are doing what they were told believe is best, and now we in the industry must make it happen. There is no sense in most of this in pretending we can ignore it and it simply will resolve itself. ICD-10 is the biggest load of natural fertilizer law of the land, and as citizens and professionals we’ve no choice but to comply.

A Few Random Considerations

There are up to seven characters in an ICD-10 code. Seven is a holy number for Judaism, Christianity and Islam. That HAS to mean something, right? I’m not suggesting there is any significance to this. I’m sure it’s simply one of those unfortunate coincidences in which some as yet unnamed fanatic someone will try to find significance.

Lesson 1: It is irrelevant.  Sometimes, coincidences are just coincidences (with apologies to S. Freud.)

ICD-10 codes – just like ICD-9 codes – contain letters and numbers, but no punctuation marks.  (If you think that little dot thing is a “decimal point”, think again that would be an erroneous understanding.) Why did the bureaucrats our public servants skip this golden opportunity to make an obscenely complex system even worse? Or, did they…?

Lesson 2: No matter how bad something is, someone in government can usually find a way to make it worse. That’s called “job security”. It’s also called “making life intolerable for the little guy.”

It’s been estimated by a highly reliable source my opinion that all the extra ICD-10 codes, combined with the ability of the 837i to handle 27 diagnosis codes and 27 procedure codes (on inpatients, only, of course) will add 1.2 pounds ounces to the weight of each medical encounter record. If everyone in the United States has two encounters per year, on average, and there are roughly 310 million people in the country, then we’re looking at ICD-10 eventually causing our landfills to increase by 23-1/4 million thousand tons per year that we would not have seen with ICD-9.  (Don’t bother confirming this…just take my word for it.)

Lesson 3: Matter (and energy) can neither be created nor destroyed. If you increase the number of codes six times over, the amount of trash will could increase proportionally...

The recent, modest, decrease in unemployment probably was the result of providers being compelled to hire people to deal with ICD-10! A successful ICD-10 implementation requires a boatload of time and money commitment from management, professional providers, and others, and the costs of that commitment will be through the freakin’ roof can be expected to be quite high. While ICD-10 is not the most expensive project the “Beltway” has foisted on the American people passed into law for our common good, it certainly is one of the more costly.

Lesson 4: No matter how good a shopper you are, you can’t always get a good deal.

And with that, my friends, we close.

‘til next time…

About the Author

Billy K. Richburg, M.S., FHFMA is HFMA-Certified in Accounting and Finance, Patient Accounting and Managed Care. Bill graduated from the U. of Alaska, Anchorage and earned his M.S. in Health Care Administration from Trinity University, San Antonio, TX. Over a career spanning more than 40 years, Bill has held positions including CEO, COO, CFO, and CIO in hospitals ranging from 75 beds to over 300 beds, and in home health agencies, DME stores, and a home infusion company. Bill is a Board Member of the Lone Star Chapter, HFMA, and is Director of Government Programs for the Revenue Cycle Technologies business segment of MedAssets, Inc. His office is in Plano, Texas.

Contact the Author

To comment on this article please go to

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.
Billy Richburg, M.S., FHFMA

Billy K. Richburg, MS, FHFMA is HFMA-Certified in Accounting and Finance, Patient Accounting and Managed Care. Bill graduated from the University of Alaska, Anchorage and earned his MS in Health Care Administration from Trinity University, San Antonio, Tex. Over a career spanning more than 40 years, Bill has held positions including CEO, COO, CFO, and CIO in hospitals ranging from 75 beds to over 300 beds, and in home health agencies, DME stores, and a home infusion company. Bill is a Board Member of the Lone Star Chapter, HFMA, and is Senior Director of Government Programs for the Revenue Cycle Technologies business segment of MedAssets, Inc. His office is in Plano, Texas.