I work everyday with numbers, being a Finance Officer for a hospital. Most of the time, the numbers I work with are intended to add, subtract, multiply or divide to come to an answer. Not today.

Good evening, all – I hope your day went well.

In a previous blog, I explained that I had suffered a back injury some thirty years ago http://musingsofjustjon.wordpress.com/2008/03/20/back-to-the-future-and-a-carnival-ad-to-boot-%e2%80%93/ – I spent much of today arranging the care I am to get for the back problem, and never have I run into so many numbers that don’t add up.

First of all, I have a bleeding problem that makes anesthesiologists hesitant to stick a needle into my spinal column – I wonder why. Could it be the risk of bleeding into the spinal canal, leading to the potential of paralysis? Ya think?

So, my first task was to arrange an infusion (CPT code 90765) of a drug (DDAVP, HCPCS code J2597) for my qualitative platelet defect (ICD-9 code 287.1). Has anyone noticed that we have already used three different classification systems here already?

Anyway, the manager of my doctor’s office was having difficulty getting this infusion preauthorized – her problem was that she was trying to preauthorize the infusion using my low back pain ICD-9 code (724.2), which really should be coded as an HNP, lumbar (722.10), but am I to argue? Once I got that corrected, we were in dutch – at least I think we are.

Tomorrow, I will have an epidural injection (CPT code 64479) under flouroscopic guidance (CPT code 77003), perhaps even bilaterally since I am having both left and right leg symptoms. The good news is that the same anesthesiologist who performed these epidurals back in 1999 has agreed to do them again – I really trust him, which is a bonus, and he is a neighbor of my orthopedist, which means a cul de sac consult will probably be charged (he says sarcastically).

With all these numbers floating around, is it any wonder that our health care system has higher administrative costs than any other country in the world? Can’t we simplify things? I mean, I work in a hospital – can you imagine if this situation presented itself to a farmer who had no knowledge of these various coding systems (and I am not expert on coding, mind you).

BTW – if you know someone who wants a good job in healthcare, tell them to become a certified coder. They are in great demand and pay is good.

Anyway, I will keep you all updated.

JustJon