Medicare - False Diagnosis ??

[youbet]

The doctor put that diagnosis on the lab order to make sure that medicare covers your lab work

+1. See my post #14.

 

[Koolau]

Agree that if this is the case - her doctor should explain that to her as clearly as you did.

You may find that without the diagnosis some of your DW’s blood work or other tests are not covered by Medicare. Screening tests frequently aren’t. But paying for these things yourself is the right thing to do so report and show this doc you want things done the right way.

Sadly, physicians coding what in reality are “check-ups” (not covered) get flexible to save patients money with Medicare.

Yeah, I think this is it. Not fraud, just technical terminology. Mine is coded as level 2 IIRC. DW is worse but not official "end-stage renal failure" yet. DW's kidney doc is not too worried as here GFRs are fairly stable and he says she's likely to die from something else before dialysis BUT the diagnosis is still a form of kidney failure. Hope this helps (and hope it's correct.)

 

[Time2]

99.99999999% of the doctors don't cheat with false diagnosis. It is often our own over reaction.

On the other hand, I think there is a lot more of what Judge Wapner called "puffery".
Such as, when my son was in a hit and run, he was on his skateboard and a bicycle ran him down and knocked him unconscious for a short time. The bicyclist was no where to be found. A good Samaritan saw him and got an ambulance which took him to the emergency room. I was looking over the coding and looking up coding, and saw the coding for stitches up to 1-1/2' long laceration was one code and over 1-1/2" was a different code, obviously longer lacerations pay more. I measured the scar in his scalp and it was 1" long, but billed as over 1-1/2". Just a little puffery, and I'll bet it is common.

 

[RetMD21]

Since she is a retired nurse I'm sure she knows her glomerular filtration rate (GFR), and probably trends them in order to accurately assess her ongoing kidney function. We all have chronic kidney failure as we age. Most of us just don't live long enough to die from it. I think it's more of a terminology issue then clinical issue.

GFR naturally declines as we age, and since they are clinically categorized by lab results, it could be that she has just naturally moved into another stage. As per the National Kidney Foundation, stage 2 is actually very good.

GFR

My guess is that this is just a normal documentation of the aging process, with nothing negative intended at all. But I guess it depends on her most recent GFR.

Nice link.I wonder if the Electronic medical record automatically adds the diagnosis. Sort of a pain the the neck for the doctor since it is a common issue, probably doesn't need action. and leads to the patient leaving and filing a report with Medicare. The previous doc who avoided the issue was better off

 

[tpner1]

The doctor put that diagnosis on the lab order to make sure that medicare covers your lab work

+1

 

[ktdtx]

Sorry, off topic but what is "DW"

<<<My DW is 70 years old>>>

 

[omni550]

DW = Dear Wife

Similarly, DH= Dear Husband, DD = Dear Daughter, etc. etc.

 

[ktdtx]

Thanks...knew it was something like that.

 

[isisdave]

I would tell him, "If it's no big deal, take it off." There is a risk she might need care, and an unfamiliar doctor (or even one in your same town) would see that and take off down the wrong diagnostic path.

 

[FLD3C]

I am very glad I retired as an MD 10years ago.