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How Medical Coding Can Ruin Your Life

 
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This is a stretch between these two diagnoses, but I think you understand my point.

Cancer policies are common now. Years ago there were no such policies. These can be financially life-saving if an individual has the unfortunate experience of being diagnosed with cancer after having purchased one of these policies.

However some patients with carcinoma in situ which is the same as a Stage 0 cancer are being denied their benefits under these cancer policies. This comes from a confusion between the diagnosis of "IN3" intraepithelial neoplasia Grade 3 and carcinoma in situ or CIS.

Intraepithelial neoplasia can be used when relating to the cervix (CIN), vagina (VaIN), vulva (VIN) or anus (AIN). There is no difference between a diagnosis of, for example, a CIN3 and a carcinoma in situ. As I mentioned above regarding coding, individuals who are being denied their benefits under these policies need to get with their physicians and get this corrected.

Your physician needs to correct and send follow-up to your insurance company (health insurance) and cancer insurance company and utilize the correct code, which in the case of the cervix, is 233.1.

There is no reason why coding errors should be the cause of individuals being denied benefits they so deserve, especially, in my opinion, when dealing with cancer.

Sources:

Adams, Diane L., et al. "Addressing medical coding and billing part II: a strategy for achieving compliance. A risk management approach for reducing coding and billing errors." Every Patient's Advocate Web September 15, 2011 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2594405/

Tarrey,Trisha.”How a Wrong Diagnosis Code Effect a Patient.” Every Patient’s Advocate August 2009. Web September 15, 2011
http://trishatorrey.com/guest-postings/how-a-wrong-diagnostic-code-may-affect-a-patient/

Reviewed September 15, 2011
by Michele Blacksberg RN
Edited by Jody Smith

Add a Comment2 Comments

EmpowHER Guest
Anonymous

Medical coding is the process of transforming descriptions of medical diagnoses and procedures into universal medical code numbers..The diagnoses and procedures are usually taken from a variety of sources within the health care record..Surgical Billing

March 30, 2012 - 4:57am
EmpowHER Guest
Anonymous

This is a great article about how consumers should review their medical bills. Correct billing is incredibly complicated. Overall though it should be rare for an outpatient bill to contain more than three procedures and three diagnoses. If you see more than that, contact your doctor and then your insurer. You can also look up codes in tools like SpeedECoder, http://www.speedecoder.com.

September 16, 2011 - 8:18am
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