Want ICD codes? Have someone other than the doctor look them up

LETTER — Posted Aug. 28, 2006

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Regarding "Physicians push to delay move to new ICD code set" (Article, July 10): Your article on the controversy over when to adopt the new codes raises the question, "Why are we using physicians, who are very expensively educated to do diagnosis and therapy, to code?"

The administrative types are always after us to be more efficient, yet they lumber us with this time-consuming chore. As far as I am concerned, we are just translating our accurate verbal diagnoses to another language made up of numbers. It might as well be to ancient Sanskrit for all it means to me.

For instance, to give a patient a lab slip, one must first leave the patient to root out one's expensive-to-buy code book (verbal diagnosis/numerical diagnosis dictionary) while hoping that some number that more or less matches the verbal diagnosis can be found on the first try.

The computer is no more efficient. It needs to be gone to and changed from its usual work to the expensive-to-buy code program.

For example, yesterday I needed "ankle pain." Ankle wasn't listed under "pain" in my book so I had to choose between "leg" and "foot." Any clerk could have chosen just as accurately. This took five minutes away from patient care. This happens many times per day. These five-minute blocks of time add up.

The oft heard administrator argument that the doctor should do the code because that is making a diagnosis is a fallacy. What the doctors are really doing is wasting their time to translate the verbal language into a numerical language we do not need for our work.

If the administrative people need our diagnoses translated into a numerical language (or ancient Sanskrit) for the sake of their computers, then they should be doing it with labor that is cheaper than ours.

Do what you need to do with the coding system. Please leave my time for my patients, not your computers.

Ann Ewalt Hamilton, MD, Riverside, Calif.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2006/08/28/edlt0828.htm.

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