ICD stands for International Statistical Classification of Diseases and Related Health Problems. ICD should not be confused with CPT® which stands for Current Procedural Terminology. I have previously explained the difference between ICD and CPT® codes for all who care to understand the alphabet soup of your health care. When you see your doctor, you are no longer a person with a beating heart and breathing lungs. You are a combination of letters and numbers that must be entered into your physicians EHR database in order for them to get paid. These ICD codes are used by hospitals to maximize their DRG collection by documenting complicating and major complicating conditions. They are used by your hospitalist to define why they are billing the Medicare National Bank $200 for their medically necessary 99223 visit. And they are used by physician offices every where to keep an accurate history and physical on file for any future preoperative evaluations.
However, sometimes hospitalists are asked to see the patient preoperatively for a history and physical. I often have to remind the preoperative nurse calling with the consult that hospitalist to see for history and physical is not a billable diagnosis. I've looked. Trust me. I've scoured the internet to try and find the ICD code for history and physical. It just isn't there. And I know the surgeon would never give a verbal order for hospitalist to see for history and physical any more than would a hospitalist admitting a patient with bilateral cellulitis would ask an ophthalmologist to follow in a patient with a history of cataract surgery 8 years ago. I think the Medicare Fraud detection team would frown upon hospitalists billing their daily 99232 or 99233 for doing absolutely nothing in hospitalist to follow consults on disabled 35 year old fibromyalgeurs with a chief complaint of not being happy. In fact, if nothing was an ICD code, I think nothing would rapidly become the most common ICD code used in many hospitalist consults.
But we don't have nothing. We have something. Something great. Something magnificent. Something extraordinary. Thanks to a reader, I have discovered the greatest ICD code that ever was. How can a hospitalist see a patient with no acute medical problems but continue to bill medically necessary services day in and day out simply because another doctor asked us hospitalists to follow? Want to collect your $50 daily offering from the Medicare National Bank, but don't want to be accused of fraud? I present to you ICD code V58.69
As a hospitalist, if you're having a problem deciding how you can continue to follow a patient and you don't want to be accused of fraud for not having an ICD code to link to your CPT code, always consider V58.69: Taking Medication For A Long Time. This, I believe, is the secret to economic success for hospitalists. If I could see every patient in the hospital and bill a 3 minute level one 99231 handwave from the doorway using just the V58.69 code for all of them, I could be done rounding by noon and have more than enough time to come up with thousands more someecards filled with crude medical humor. Or hang out in the doctors lounge and eat all the free food.
Sorry to cut this short. I've gotta run. My next 428.21 just showed up by ambulance after collapsing at Long Johns. I think I'll try adding on V58.69 to justify a critical care code.