Feet First

“It is much more important to know what sort of a patient has a disease than what sort of a disease a patient has.” - Sir William Osler

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    Monday, October 07, 2002
    The Coders

    My medical group is quite large and is spread amongst several offices, including an administrative office over on Wilshire Boulevard which handles lots of the tedious billing and paperwork generated by my efforts, among others. My office is on Olympic - it's the original office dating back to the first years of the group before we started expanding. On one side of the hall is a series of four suites where the doctors work and patient care is handled; the other side is administrative and hasn't been really used for a coherent purpose since the original administration moved to a different building near Cedars. As a result there has been a positive circus of people moving in and out of that space. If memory serves, we have played host at various times to Member Services (handling phone calls from patients trying to register with the group or who were having various problems), then Central Scheduling (an abortive experiment designed to make things easier for the front desk/receptionist area), who were then evicted and the space given to the coders.

    The Coders. Sounds like a WWII back-room operation, doesn't it? Unfortunately it's not nearly that exciting. The coders have been rotated to Olympic in batches from the Wilshire office. Their job is to translate the doctors' information on the fee tickets into codes which will be accepted by the insurance plans for reimbursement. The full name of the coding system is the ICD-9 coding system, or International Classification of Diseases, 9th revision. It's universally accepted by insurance plans, disability payors, insurance companies, etc. etc. ICD-9 merits its own post, which will be coming soon, I assure you. But for the moment, let us stick with the coders.

    Why are they being rotated here from their Wilshire homeland? Nobody seems to know. Why not just move one batch of people in here and leave them, so that they could get used to the place? Again, no answer. Our current batch of coders is a grim, monastic bunch. They don't seem to want to talk to anyone here, unlike their immediate predecessors, who were quite friendly and cheerful and seemed to like being at Olympic. They were always up for a chat if I wandered through en route to the Olympic manager's office. This group doesn't want us tromping through and disturbing them - they want us to go further up the hall and double back so we won't distract them from their exacting (HA!) work. As you can imagine, I have made it my business to wander through at every opportunity after hearing that.

    This afternoon, having a chat with the office manager, I nodded toward the coders' domain and asked, "Who are those guys?"

    She shrugged. "I dunno."

    I then told her about an article I'd read in the New Yorker about a year ago, about somebody who'd wandered into a dot-com company and stuck around for two weeks, showing up every day and hanging out in a cubicle, just to see if he could get away with it. He did; no one questioned his presence.

    "For all we know, that could be happening here," I pointed out. She cracked up.

    Our coders continue to sit across the hall, dug in like ticks. I hope we get a more cheerful group soon. We could use some party animals around here.



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