I suppose I am unique or maybe it is because I am a pediatrician. But, my patient comes in with a CC and history. I do a physical exam and arrive at a diagnosis. I then code that with an ICD-10 code. It may be just an ICD-10 code for an ear infection or it may be for that and chronic cough as well. Either way, whatever illness they have at that visit, I put down for codes.
I apply a CPT code which is justified by the diagnoses and documentation. I don't tend to worry about other diagnoses in the problem list which may affect the current illness like asthma or mitochondrial disease. I supposes I could, but it just doesn't seem relevant. They have chronic cough and otitis media, and I do not deem it to be asthma or asthma related. This may be a bad example since asthma is so inter-related to cough. The other earlier posts, notwithstanding, I am ignorant as to what putting in asthma will do for me down the road.
I like ICD-10 much better, and I do not seem to be overly concerned with reimbursement. I find most insurance companies (especially when dealing with a small practice like mine) are more interested in the bell-shaped curve of CPT codes than the ICD-10 codes.
Of course, I don't worry about HIPAA or drug diversion either. I don't mean I don't try to follow them, I just don't lose sleep over hard drive encryption or whether or not I have a drug contract on every patient on Vicodin.
One thing which has not been brought up is that if I sign off on a nurse practitioner, the ICD-10 and CPT codes are not recorded in the billing section like mine is.
