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I Have Alzheimer’s or Another Dementia
NY Times. I'm Still Alice & other comments.
Thanks for sharing, MiMi.
Peace and Hope,
Mimi, thanks for posting. It was an interesting article. Not sure how to take it though but interesting none the less.
God bless, Paul
FYI: The term 'cognitive dysfunction' has ICD-9 and ICD-10 codes, so it is being used and will continue to be used.
Let me try that without the apostrophes: cognitive dysfunction.
Hi Mimi: This will be a bit long and can be a bit confusing, but that being said; most patients do not know about the coding system and it is VERY important to patients and ultimately, coding is key to having a medical bill paid by the insurer. Here goes:
ICD = International Classification of Diseases. There are two versions currently in use, 9 and 10. These are alphanumeric lists of classification of diseases and each diagnosis is assigned a specific code number of its own. If you have multiple conditions, each will have its own Code assigned.
These alphanumeric assignments are given to every single diagnosis, to symptoms and also to cause of death.
The word International sometimes raises eyebrows; but the coding system was developed and is overseen by the WHO (World Health Organization). In the United States, the centers for Medicare and Medicaid oversee the ICD Codes in conjunction with the WHO. They do this through the US National Center for Health Statistics.
As said, for each and every diagnosis a person has a code number. Every medical provider, no matter where they are, will be able to understand the diagnosis the same way as designated by the code.
If one has a chronic condition such as diabetes, COPD, heart disease, etc.; the ID Code stays with you in your record and follows you throughout your lifetime.
There are different Codes for different purposes: Diagnoses; Tracking certain diseases such as TB; HIV; Influenza, etc.; for Cause of death which also is tracked.
These Codes are valid worldwide and there is a number added to the codes that indicates which country the Codes are coming from. This really helps to track infectious diseases.
These Codes are used by all providers, doctors, hospitals, and all other healthcare providers.
NOTE: When we notice the Code on our paperwork we get from our doctor's appointments, these are CPT Codes (Current Procedural Terminology). These are used to indicate what services were provided for billing purposes. There may be errors made and often these errors will be why the insurer is not paying one's claim.
You will see the ICD Code on your Medicare EOB (Explanation of Benefits) and you can Google and look it up to see what it indicates.
BEWARE OF CODING ERRORS AND IF YOU RECEIVE AN INSURANCE DENIAL; CONTACT THE BILLING DEPARTMENT AND ENSURE THE PROPER CODE WAS USED AND IF ANY ERRORS WERE MADE. IF SO, THE CODING CAN BE CORRECTED AND THE BILL RE-SUBMITTED.
On the billing, the HCPS Codes have two levels. One is the CPT code and another is the alphanumerical code . . . one identifies what supplies and services were provided when done so outside the physician office.
CAVEAT: Insurance companies and Medicare and Medicaid will NOT pay a claim if not submitted with Codes and they must be accurate.
Who does the Coding: One cannot just step in and willy-nilly try to apply Codes. It takes a highly skilled, highly trained person. There are multiple HUGE Code Books filled with Codes. One has Codes and sub-codes and shades of codes that go along with a person's diagnosis; especially during a hospital stay. Some providers try to do an up-tick in coding for increased reimbursement; but if caught, the claim is not paid, must be re-submitted accurately and there can be penalties to the provider.
So; if your claim is denied, but you feel it was valid and a covered benefit of your private insurance or Medicare or Medicaid, you will want to have the biller check the following and more:
- Did they bill the correct insurance? Sometimes our provider changes and the biller may not be up-to-date. Did they enter the correct policy number?
- Did they Code accurate patient information? Name spelled correctly, correct gender assigned, correct policy number, etc.
- Did the Coder use an accurate Code or make a typo or use an old, out-dated Code
- Did the Coder misrepresent the bill to try and maximize payment; they may have to audit the patient record to see.
I know some Coders and am just amazed at the complexity of it all and a good Coder is worth their weight in gold. Sometimes, we can take that literally.
So there we are; we become alphanumeric and we are tracked by multiple entities into perpetuity. Little did we know . . . .
Whoops! Looks like Marta and I were typing in at about the same time.
To be perfectly honest, I have not seen the movie, no will I. I did , however read the book , I wasn't impressed. I know its a work of of fiction. I don't think its actual reflection, of the real world.
How many of us here, are highly educated , and have a second home on the beach ?The book barely touches on the financial impact EOAD has on real people, living in the real world. I got a big kick out of the husband, that goes of to New York to persue his dream job. The adult children, then took over the day to day care. Right ...how many of us care givers can relate to that ? The employer that gently asks her, to perhaps give up teaching. Though, she can stay on in some less important function. How many of our LOs got that option?
So a bunch of producers, and actors, and writers , made a whole lot of money, portraying a subject that's very interesting to the aging boomers. I guess its the same thing that motivates people to stare at a car wreck on the side of the highway.
I deal with the ravages of EOAD, with all its heartbreak, 24/7. I don't feel a need to be entertained, or reminded by it. I'm glad that some folks here enjoyed it. God knows, we need something, anything, to make our life easier.
No....sorry "Still Alice" didn't do it for me.
Mike- I agree with you. Haven't seen it, don't want to.
I've read many, many books since Dan was dx'd and a few of them, while true stories, are just completely unrelateable to some of us.
Can't afford multiple homes, can't afford to move several times looking for the best place or climate, can't afford full time care. A great many of us struggle financially to stay home and care for our LO, with little to no outside help or family support.
does the move accurately portray the day-to-day incontinence, losing so many things, constant shadowing and/or questions, the anger or aggression, the difficulties we encounter trying to take our LO somewhere- you get my drift.
I suppose the movie was intended to portray the patient's anguish and struggles over the initial diagnosis and adjustment and for that I hear it is excellent and Julianne Moore obviously did an Oscar-worthy job.
Aside from that, it's not all that realistic to most of us.